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Suction Assisted Lipectomy (SAL)
by Dr. Lisa Santos
Post-Operative Questions?
The goal of aesthetic surgery is to help you look as good as possible. If you expect a miracle
transformation from surgery you will be disappointed. Plastic surgery is a combination of art and science. It is not an exact science. Some of the factors involved in producing the final results (such as the
healing process) are not entirely within the control of either the surgeon or the patient; therefore, it is impossible to guarantee or warranty the results. The surgical results from SAL are more
predictable in some patients than in others. This is determined by such factors as physical condition of the body, elasticity and condition of the skin, cellulite, underlying bone structure, heredity, hormonal
influences and other factors.
The surgery is intended to improve your body contour. Size and shape of your body are normally characteristics inherited from parents, and particularly true with respect to
body contour. No matter how we scramble the genes, those that control fat tissue deposits in certain areas show themselves with few modifications.
We are all born with a definite number of fat tissue cells.
Weight gain involves enlargement of these cells and weight loss means that the cells have shrunk in size. Anything that decreases the number of cells has a permanent effect. The suction procedure does exactly that.
SAL is for localized fat tissue deposits only. It is not for general obesity. A very important factor in determining the final result is the degree of normal skin tone. Younger skin has a great deal more elasticity
so, after removal of fat, the skin contracts or shrinks leaving a smooth surface. Older skin has lesser elasticity and it is possible that some wrinkling or irregularity will remain following even the best
technical procedures. These circumstances are much the same as when there is generalized weight loss by diet. Younger people can loose weight with good shrinkage of the skin surface; when older people lose weight the
skin has a tendency to hang in folds and/or have surface wrinkles.
Skin looseness or absence of the best elastic quality will limit the amount of shrinkage one can obtain. Under such circumstances a smaller
amount of fat can be removed, but some contour improvement can still be realized. If one is willing to accept a limited degree of surface irregularity, additional tissue can be removed. For many individuals, improvement
of he overall contour is the most important factor since small irregular areas can be covered with clothing. The fat cells are removed permanently and will not return with weight gain.
Your surgery will be done
entirely by me. I will be assisted by one of our operating room technicians, but I perform all surgery on my patients. Pre-operative medical photographs allow me to evaluate your problem areas in relationship to your
body. I study these pictures carefully before your surgery and they are mounted in the operating room for my reference, greatly aiding the performance of surgical variations as indicated for each
individual. These photos
are part of the confidential records of my patients and are not shown to others.
Someone else's result would not look the same on your body.Surgery under Chin and Neck
Following suction
Lipectomy under the chin and/or neck area, you will wear a head dressing that serves the same purpose as the girdle discussed above. The head and neck dressing
is removed in 24 to 72 hours, depending on any associated surgery. Wear the compression garment at night for the next two weeks, then you may discontinue the garment.
You will notice this area
continuing to reduce for a period of three months.
Normal Post-Operative Events
There will always be a small skin mark at the site where the skin incision is made. This varies in length from
one-eighth to one-half of an inch and can usually be located so that it falls into a normal skin fold where it is less obvious.
With movement of the instrument through the tissues there is anticipated disruption
of small blood vessels attached to the fat globules. Bleeding from these areas always takes place, but since most of it is from tiny vessels it is limited in degree. Bruising of the treated area must be expected.
It is variable in degree and sometimes quite extensive, but there is no way to avoid this. Depending upon the size and location of the area treated, bruising may last three or four weeks. Following the procedure a
dressing will limit blood accumulation/bruising, and a long or short girdle will be required.
Since many fat cells are removed and others disrupted, you can expect some drainage from the surgical site.
Depending upon the location and the amount of fat tissue removed surface contour depends upon collapse of the fat tissue layer after suction tunnels are made. When there is good skin tone and fat tissue removal can be
kept quite deep, the surface remains remarkably smooth.
Complications
Minor or significant contour variations can occur. Rarely, large blood collections play a role. There is a relatively narrow
margin between removal of sufficient tissue and overly enthusiastic efforts. Most surgeons are conservative in their judgment as to the degree of reduction to be undertaken. One can always remove a bit more as a
secondary touch up procedure, but "putting it back" is indeed difficult. A variety of other potential problems are also possible including adverse surface pigmentation and dimpling in places, but these
conditions will gradually improve over time.
One should anticipate a variable degree of numbness in the areas treated for some time after the procedure. Generally, normal feeling will return,
but it is possible that limited amount of permanent sensory loss will remain. During the healing process occasional discomfort and a localized burning sensation may be noted.
Anesthesia
General
anesthesia is used for fat suction operations. Drugs are given to you before going into the operating room to make you sleepy and calm. Additional medication is given in the operating room as indicated. This requires an
expert anesthesiologist who charges a separate fee for his services. Aesthetic fat suction surgery can be performed at the time of some other aesthetic surgical procedure.
Ambulatory Surgery
If I think it appropriate you may choose to have your surgery performed in the ambulatory surgery facility at the hospital. You will arrive the morning of surgery and remain two to five hours after surgery. You will
be-discharged the same day as surgery. This is entirely safe providing you follow instructions and use common sense. When extremely large amounts of fat are removed a one or two day hospital stay may
be recommended and you will be visited each day by me.
Pain
Most patients do not have pain following fat suction, but there is some discomfort as you would expect. Any pain or discomfort is easily taken
care of with analgesics. I will make sure that you are taken care of in this regard. Since incisions are very small and there are usually a few stitches, dissolvable sutures are used with no need for their removal.
Anticipated Results
Occasionally the immediate post-operative appearance does not look remarkably different than it did before the surgery. This is the result of swelling and may take several weeks
to change. When the fat tissue has been removed there will be a very definite change. Patience is required while the final results are awaited. Final contour shape, shrinkage and normal softness are probably not reached
for at least six to nine months depending on the area that is suctioned. |