Liposuction, lipo and plastic surgery in Tunisia




	Liposuction Liposuction is a surgical procedure for reducing body contours by removing fat cells. Although it was originally developed for the torso and thighs, liposuction is now done to most parts of the body. It has proved particularly helpful in contouring the area under the chin and can be used alongside face lifting. Two methods exist, the Ultrasonic Technique, which is still in an experimental stage, and the Tumescent Technique. In the Tumescent Technique, which causes the least post-operative bruising and pain, a 4mm - 6mm incision is made near the area from which the fat is to be removed. A specially designed tube called a surgical cannula, which is attached by flexible tubing to a vacuum pump, is placed through the incision into the fat. The cannula is manipulated under the skin, removing the fat by suction. Liposuction is not a substitute for a healthy diet nor is it useful for generalised weight reduction. Although this seems obvious, I mention it because patients may expect localised fat removal to result in a dramatic weight loss. This is not possible.
	Here are some questions frequently asked about liposuction.
	Why am I only fat in certain areas ? Fat distribution is determined by heredity and diet. Heredity dictates the location and number of individual fat cells and these are fixed and unchanging after puberty. Diet can increase or decrease the amount of fat in each cell but will not affect the total number of cells or their distribution. If you inherited large numbers of fat cells on your thighs and small numbers of fat cells on your chest, you will always have more fat on your thighs than on your chest. Strenuous attempts at weight loss can leave you with the common problem of a thin upper body and persistently bulky thighs. Will my appearance change very much after liposuction ? Your appearance after liposuction will be influenced by your general state of health, your age, weight, the overall condition of your skin, hormonal influences and other factors. Each patient is unique and during our consultation I will discuss in detail how these general factors apply to you in particular. Patients may experience contour irregularities in the treated areas after surgery but this is usually temporary. In the occasional patient it might be permanent. Symmetry is the goal but small side to side differences can occur. It is important to understand that no person is perfectly symmetrical from one side to another. Every attempt will be made to minimize your side to side dissimilarities, but such differences always persist to some degree, even after the most successful operation. Are the results permanent ? Since the actual fat cells are removed, the procedure is permanent and the body will always have less fat in the treated areas after liposuction. Should you gain weight following liposuction, you will tend to deposit the fat in areas other than those treated. Five per cent of patients receive secondary surgery or a touch-up after six months, usually for the removal of additional fat. This can be done under local anaesthetic if the area is not extensive and is something we would discuss in detail beforehand. Is it true that people with loose skin can't have liposuction? Some individuals have loose muscles and skin, with or without excess fat. These patients need additional procedures such as tummy tucks and thigh lifts. During your consultation I will evaluate your skin and muscle tone as well as the way in which the fat on your body is deposited. What about my cellulite? Will it also be treated ? The word cellulite has no precise medical meaning although most people use it to describe dimpling and irregularities on the surface of the skin. This dimpling effect is caused by protein degeneration in the skin and its supporting structures. Although liposuction will not cure cellulite it will remove fat and reduce contour. In mild cases, liposuction may lessen the intensity of cellulite. Severe cases, however, need an abdominoplasty (tummy tuck) or thigh lift for permanent improvement. How long does the operation last and when may I return to work ? The operation lasts for between one to four hours depending on how many areas are treated. You may return to work after a week, although some patients return earlier. You may not do vigorous sport or exercise for three weeks. What happens after surgery and how often will I be examined ? Bandages and dressings are not usually applied. Patients who have large amounts of fat removed may need a urinary catheter. If this is needed it will be placed during surgery and removed just before you are discharged from hospital. The placement and removal of the catheter is painless. You will wear a support garment immediately after surgery for four to six weeks. This may be removed to shower 24 hours after surgery. If your calves and/or ankles are treated, you will wear support hose for up to six weeks. You will experience pain and some mild discomfort. You will be given a prescription for light pain medication. All patients, except those having a very small volume of fat removed (neck only or knees only) take an iron supplement for one month after surgery. What will my body be like and feel like after liposuction ? You will have bruising and you can expect a certain amount of numbness or reduced sensation in the treated area. For the first week following liposuction the treated areas will be swollen and will not show any reduction in contour. In fact, you may appear larger than you did before surgery! Your clothes may fit more tightly and you may weigh more! By the end of the first week the swelling associated with surgery will begin to subside. By the second seek you will notice a diminution in contour and the treated areas will be smaller than they were before surgery. Your final improvement will only be apparent three months after surgery. Will I have scars? In the past, scars from body contouring were long and obvious. Nowadays liposuction scars are usually less than a centimetre long. They are placed in natural body creases where they are not conspicuous or where they can be easily hidden by clothing and bathing suits. Usually the scars will be red or pigmented for between three and six months but they will gradually fade until by 12 months after surgery they are barely noticeable. However, you should know that all scars are permanent and their length, width and final colour are not totally predictable. Are there any complications to liposuction ? Serious complications are uncommon with this kind of surgery. However, as with all surgery, bleeding, infection and other complications are possible. Although most patients have very satisfactory results, as with any operation certain problems can occur and it is important that you be aware of the risks involved. Permanent problems rarely occur. However potential complications with this procedure include thickened or unattractive scars at the site of the small incisions; irregularities of contour such as waviness or depressions; the possibility of skin loss which may result in permanent scarring or necessitate skin grafting; wrinkling or sagging of the skin; numbness or increased sensitivity in the area treated; injury to a motor nerve, which may be temporary or permanent; prolonged swelling of the area treated; accumulation of blood or serum under the skin which will need to be removed; asymmetry between the treated sides (they will not look alike); a change in skin colour or infections. Of course, it is not possible to advise you of every conceivable complication and other unexpected problem. It should be noted that the complications associated with this procedure are frequently related to the amount of fat which must be removed and the age of the patient. No surgery can be totally safe. However liposuction compares favourably with any cosmetic procedure. Summary Liposuction is a safe and relatively simple means of reducing contours in selected parts of the body. Coupled with a general improvement in eating habits and an exercise programme it can help you achieve a pleasing shape and body image.