American Medical Association Family Medical Guide - American Medical Association [783]
Numbness and swelling will cause some loss of sensation in your breast skin and nipples. The numbness usually goes away in 6 weeks but may take a year or more to completely subside. Your scars will be lumpy and red for a few months and then will fade, but they will never disappear. Resume your activities gradually, according to your surgeon’s instructions. You can probably return to work a week or two after your surgery.
Complications are unusual after a breast lift but can include bleeding, infection, unevenly placed nipples or asymmetrical breasts, or loss of a portion or all of a nipple. You can minimize these complications by carefully following your doctor’s instructions after your surgery.
Body Contouring
Cosmetic surgeons can reshape your body to change its appearance. Body-contouring techniques accomplish this goal by removing unwanted fat from problem areas. The top two body-contouring procedures are liposuction and abdominoplasty. The two techniques can be combined in one surgical procedure to produce even more dramatic results.
Liposuction
Liposuction, also called lipoplasty or suction lipectomy, reshapes the body by vacuuming out excess fat deposits. It is the most frequently performed cosmetic surgery procedure in the United States. Liposuction is not a substitute for weight loss but is designed to remove deposits of fat that persist despite diet and exercise. Using liposuction, a surgeon can remove unwanted fat from many parts of the body, including the abdomen, hips, buttocks, thighs, knees, calves, upper arms, chin, cheeks, and neck. The procedure works best on healthy people of normal weight who have firm, elastic skin.
Before surgery, your surgeon will evaluate your health, examine the fat deposits to be removed, and check the elasticity of your skin. Age is no barrier to liposuction, but older people tend to have looser skin and may not achieve the same effects as younger people. If liposuction is not appropriate for you, your surgeon may recommend an alternative method. For example, if you seek liposuction to reduce fat deposits in your abdomen, an abdominoplasty (see next page) might be more effective.
Liposuction techniques are available that give surgeons more precise control and make recovery time faster. One such technique, called ultrasound-assisted lipoplasty, uses an instrument that produces ultrasonic (sound wave) energy. The sound waves explode the walls of fat cells and liquefy the fat so it can be removed more easily. This technique works best on the hips, abdomen, thighs, and neck.
In a procedure called fluid injection, the surgeon injects a solution containing medication and an anesthetic into the fat deposits to help ease their removal. Depending on the technique the surgeon uses, the amount of injected fluid may equal or be up to three times the amount of fat to be removed.
The Procedure
Liposuction is almost always performed as an outpatient procedure. Liposuction performed to remove small amounts of fat from only a few sites can be done using a local anesthetic, with or without light sedation. More extensive areas of the body are treated using regional anesthesia such as an epidural block (see page 532), the same type of anesthesia used for pain management during delivery of a baby. Removal of a large amount of fat requires general anesthesia and intravenous fluids and, in some cases, a blood transfusion.
During a liposuction procedure, the surgeon makes a small incision in the skin over the area to be treated and inserts a narrow tube called a cannula under the skin. He or she pushes and pulls the tube through the underlying layer of fat and suctions the fat away with a vacuum pump or syringe. When one site is finished, the surgeon moves to the next area until all the designated areas are treated. The small incisions are closed with stitches. During and after surgery, you will be given intravenous fluids to