Liposuction is a procedure that can help sculpt the body by removing unwanted fat from specific areas, including the abdomen, hips, buttocks, thighs, knees, upper arms, chin, cheeks and neck. During the past decade, liposuction, which is also known as “lipoplasty” or “suction lipectomy,” has benefited from several new refinements. Today, a number of new techniques, including ultrasound-assisted lipoplasty (UAL), the tumescent technique, and the super-wet technique, are helping many Dr. Nikolov to provide selected patients with more precise results and quicker recovery times. Although no type of liposuction is a substitute for dieting and exercise, liposuction can remove stubborn areas of fat that don’t respond to traditional weight-loss methods.
If you’re considering liposuction, this brochure will give you a basic understanding of the procedure — when it can help, how it is performed and how you might look and feel after surgery. It won’t answer all of your questions, since much depends on your individual circumstances. Please ask Dr. Nikolov if there is anything about the procedure you don’t understand.
To be a good candidate for liposuction, you must have realistic expectations about what the procedure can do for you. It’s important to understand that liposuction can enhance your appearance and self-confidence, but it won’t necessarily change your looks to match your ideal or cause other people to treat you differently. Before you decide to have surgery, think carefully about your expectations and discuss them with Dr. Nikolov.
The best candidates for liposuction are normal-weight people with firm, elastic skin who have pockets of excess fat in certain areas. You should be physically healthy, psychologically stable and realistic in your expectations. Your age is not a major consideration; however, older patients may have diminished skin elasticity and may not achieve the same results as a younger patient with tighter skin.
At The Nikolov Center for Plastic Surgery, your positive patient experience is our main priority. That is why we are excited to offer a new procedure that allows us to gently remove unwanted fat from thighs, hips, abdomens, chests, love handles, knees, backs, arms, chins and just about any other body part you can imagine. With VASER® Lipo, it is now easier than ever to reduce those stubborn spots that just will not respond to diet and exercise! VASER Lipo, also known as LipoSelection®, is an advanced body contouring procedure that uses gentle ultrasonic energy to selectively remove unwanted body fat. An alternative to the harsh techniques of traditional liposuction, VASER Lipo preserves important tissues like nerves, blood vessels and connective tissue to promote smooth results and fast recovery. We welcome the opportunity to help you determine if the VASER Lipo procedure is right for you.
As with any type of surgery, there are risks and complications associated with plastic surgery. The degree of risk will depend on a number of factors, including whether the surgery is to a small or large area of tissue, the surgeon’s level of experience and the overall health of the person having the procedure.
Some procedures carry specific risks, but general risks include infection, scarring and the failure of the repaired area of skin due to a restricted blood supply.
Dr. Nikolov takes great pride and care to ensure a beautiful outcome with each procedure to minimalize any risk.
Planning Your Surgery
In your initial consultation, Dr. Nikolov will evaluate your health, determine where your fat deposits lie and assess the condition of your skin. Dr. Nikolov will explain the body-contouring methods that may be most appropriate for you. For example, if you believe you want liposuction in the abdominal area, you may learn that an abdominoplasty or “tummy tuck” may more effectively meet your goals; or that a combination of traditional liposuction and UAL would be the best choice for you.
Be frank in discussing your expectations with Dr. Nikolov. He or she should be equally frank with you, describing the procedure in detail and explaining its risks and limitations.
Getting The Answers You Need
Individuals considering liposuction often feel a bit overwhelmed by the number of options and techniques being promoted today. However, Dr. Nikolov can help. In deciding which is the right treatment approach for you, your doctor will consider effectiveness, safety, cost and appropriateness for your needs. This is called surgical judgment, a skill that is developed through surgical training and experience. Your doctor also uses this judgment to prevent complications; to handle unexpected occurrences during liposuction surgery; and to treat complications when they occur.
Preparing For Your Surgery
Dr. Nikolov will give you specific instructions on how to prepare for surgery, including guidelines on eating and drinking, smoking, and taking or avoiding vitamins, iron tablets and certain medications. If you develop a cold or an infection of any kind, especially a skin infection, your surgery may have to be postponed.
Though it is rarely necessary, Dr. Nikolov may recommend that you have blood drawn ahead of time in case it is needed during surgery.
Also, while you are making preparations, be sure to arrange for someone to drive you home after the procedure and, if needed, to help you at home for a day or two.
Where Your Surgery Will Be Performed
Liposuction may be performed in a Dr. Nikolov’s office-based facility, in an outpatient surgery center, or in a hospital. Smaller-volume liposuction is usually done on an outpatient basis for reasons of cost and convenience. However, if a large volume of fat will be removed, or if the liposuction is being performed in conjunction with other procedures, a stay in a hospital or overnight nursing facility may be required.
Anesthesia For Liposuction
Various types of anesthesia can be used for liposuction surgery. Together, you and Dr. Nikolov will select the type of anesthesia that provides the most safe and effective level of comfort for your surgery.
If only a small amount of fat and a limited number of body sites are involved, liposuction can be performed under local anesthesia, which numbs only the affected areas. However, if you prefer, the local is usually used along with intravenous sedation to keep you more relaxed during the procedure. Regional anesthesia can be a good choice for more extensive procedures. One type of regional anesthesia is the epidural block, the same type of anesthesia commonly used in childbirth.
However, some patients prefer general anesthesia, particularly if a large volume of fat is being removed. If this is the case, a nurse anesthetist or anesthesiologist will be called in to make sure you are completely asleep during the procedure.
The Liposuction Surgery
The time required to perform liposuction may vary considerably, depending on the size of the area, the amount of fat being removed, the type of anesthesia and the technique used.
There are several liposuction techniques that can be used to improve the ease of the procedure and to enhance outcome.
Liposuction is a procedure in which localized deposits of fat are removed to recontour one or more areas of the body. Through a tiny incision, a narrow tube or cannula is inserted and used to vacuum the fat layer that lies deep beneath the skin. The cannula is pushed then pulled through the fat layer, breaking up the fat cells and suctioning them out. The suction action is provided by a vacuum pump or a large syringe, depending on Dr. Nikolov’s preference. If many sites are being treated, Dr. Nikolov will then move on to the next area, working to keep the incisions as inconspicuous as possible.
Fluid is lost along with the fat, and it’s crucial that this fluid be replaced during the procedure to prevent shock. For this reason, patients need to be carefully monitored and receive intravenous fluids during and immediately after surgery.
The basic technique of liposuction, as described above, is used in all patients undergoing this procedure. However, as the procedure has been developed and refined, several variations have been introduced.
Fluid Injection, a technique in which a medicated solution is injected into fatty areas before the fat is removed, is commonly used by plastic surgeons today. The fluid — a mixture of intravenous salt solution, lidocaine (a local anesthetic) and epinephrine (a drug that contracts blood vessels) — helps the fat be removed more easily, reduces blood loss and provides anesthesia during and after surgery. Fluid injection also helps to reduce the amount of bruising after surgery.
The amount of fluid that is injected varies depending on the preference of the Dr. Nikolov.
Large volumes of fluid — sometimes as much as three times the amount of fat to be removed — are injected in the tumescent technique. Tumescent liposuction, typically performed on patients who need only a local anesthetic, usually takes significantly longer than traditional liposuction (sometimes as long as 4 to 5 hours). However, because the injected fluid contains an adequate amount of anesthetic, additional anesthesia may not be necessary. The name of this technique refers to the swollen and firm or “tumesced” state of the fatty tissues when they are filled with solution.
The super-wet technique is similar to the tumescent technique, except that lesser amounts of fluid are used. Usually the amount of fluid injected is equal to the amount of fat to be removed. This technique often requires IV sedation or general anesthesia and typically takes one to two hours of surgery time.
Ultrasound-Assisted Lipoplasty (UAL). This technique requires the use of a special cannula that produces ultrasonic energy. As it passes through the areas of fat, the energy explodes the walls of the fat cells, liquefying the fat. The fat is then removed with the traditional liposuction technique.
UAL has been shown to improve the ease and effectiveness of liposuction in fibrous areas of the body, such as the upper back or the enlarged male breast. It is also commonly used in secondary procedures, when enhanced precision is needed. In general, UAL takes longer to perform than traditional liposuction.
After surgery, you will likely experience some fluid drainage from the incisions. Occasionally, a small drainage tube may be inserted beneath the skin for a couple of days to prevent fluid build-up. To control swelling and to help your skin better fit its new contours, you may be fitted with a snug elastic garment to wear over the treated area for a few weeks. Your doctor may also prescribe antibiotics to prevent infection.
Don’t expect to look or feel great right after surgery. Even though the newer techniques are believed to reduce some post-operative discomforts, you may still experience some pain, burning, swelling, bleeding and temporary numbness. Pain can be controlled with medications prescribed by Dr. Nikolov, though you may still feel stiff and sore for a few days.
It is normal to feel a bit anxious or depressed in the days or weeks following surgery. However, this feeling will subside as you begin to look and feel better.
Getting Back To Normal
Healing is a gradual process. Dr. Nikolov will probably tell you to start walking around as soon as possible to reduce swelling and to help prevent blood clots from forming in your legs. You will begin to feel better after about a week or two and you should be back at work within a few days following your surgery. The stitches are removed or dissolve on their own within the first week to 10 days.
Activity that is more strenuous should be avoided for about a month as your body continues to heal. Although most of the bruising and swelling usually disappears within three weeks, some swelling may remain for six months or more.
Dr. Nikolov will schedule follow-up visits to monitor your progress and to see if any additional procedures are needed.
If you have any unusual symptoms between visits — for example, heavy bleeding or a sudden increase in pain — or any questions about what you can and can’t do, call your doctor.
Your New Look
You will see a noticeable difference in the shape of your body quite soon after surgery. However, improvement will become even more apparent after about four to six weeks, when most of the swelling has subsided. After about three months, any persistent mild swelling usually disappears and the final contour will be visible.
If your expectations are realistic, you will probably be very pleased with the results of your surgery. You may find that you are more comfortable in a wide variety of clothes and more at ease with your body. And, by eating a healthy diet and getting regular exercise, you can help to maintain your new shape.
Smartlipo™ Laser Body Sculpting
Laser Assisted Liposuction Is The Latest Technology In Liposuction
Dr. Nikolov uses a small canula with a laser inside to remove unwanted fat from many areas of the body. With great skill and precision he can remove unwanted fat deposits from many areas of the body.
The most commonly treated area for Smartlipo is the abdomen. A bulging midsection can affect women and men, young and old alike. But what diet and exercise can’t change, Smartlipo can transform in just one treatment.
Smartlipo removes fat located just below the skin to reveal the muscles underneath. And the procedure’s tightening effect through coagulation makes the end result even better than with traditional liposuction.
- Removes fat from the upper and lower abdomen, waist, sides and back
- No general anesthetic needed
- Minimal scarring
- Minimal downtime
- Slims your waist
Smartlipo is perfectly suited to treat delicate skin on the neck. With Smartlipo, the fat cells are permanently removed so the results are long lasting. It tightens the skin and slims through coagulation.
This procedure is a minimally invasive alternative to a surgical neck lift. No general anesthetic required and minimal downtime.
The Smartlipo laser is used to apply laser energy underneath the skin where it’s proven most effective at tightening the tissues on your cheeks, jowls and neck. The treatment can be performed while you are awake with using very small incisions.
Laser facial sculpting with more permanency than many injectables with less invasiveness of a facelift. Less downtime. (2 days versus 5-7 days of recovery time)
Arms And Legs
Unfortunately, it’s only natural–fat accumulates in areas such as the hips, knees and under the arms, especially for women. These fat deposits, particularly around the arms, are resistant to diet and exercise.
Smartlipo trims triceps and downsizes “saddlebags” by removing excess fat permanently. No general anesthetic need, minimal scarring, short downtime and slims the area.