Liposuction
Am I a Good Candidate for Liposuction?
Good candidates for liposuction are typically individuals who are close to their ideal body weight but have specific areas of stubborn fat that are resistant to diet and exercise.
Liposuction is not a weight-loss procedure and is not a substitute for a healthy diet and exercise.
The ideal candidate for liposuction should also have good skin elasticity and be in good overall health. Liposuction can remove fat, but it cannot address loose or sagging skin. In this case, using laser liposuction can provide contraction for the skin with minimal laxity. However, if the skin in the treated area is too loose or sagging, additional procedures such as a tummy tuck or body lift may be necessary.
Liposuction is not recommended for individuals who are significantly overweight or have health conditions that could increase the risk of complications. A body mass index (BMI) of < 30 is suggested for a liposuction candidate.
It is important not to gain weight after liposuction as this will ruin the results you achieved. Dr. Demirkan suggests having liposuction in a phase of your life in which your body weight is stable.
It is important to discuss your medical history and any medications or supplements you are taking with Dr. Demirkan to determine if you are a good candidate for liposuction. Some chronic diseases and medications like blood thinners may be contraindications for this procedure. Being pregnant or in the breastfeeding period are also contraindications.
Additionally, it’s important to have realistic expectations about the results of liposuction. Liposuction can improve body contours and remove stubborn pockets of fat, but it cannot completely reshape your body or address cellulite.
Overall, good candidates for liposuction are individuals who are close to their ideal body weight, have good skin elasticity, and are in good overall health with realistic expectations about the procedure.
Types of Liposuction
Which one is the Best for me?
There are several types of liposuction, each with its own specific advantages and technology.
Liposuction Types:
It’s important to note that while these are the most common types of liposuction, there are other techniques and variations as well. The best type of liposuction for you will depend on your individual needs and preferences, as well as the expertise of your surgeon. Dr. Demirkan will help you to find the best technique suitable for your body type.
The most important variable in the success of liposuction is the expertise of the surgeon, not the type of liposuction device.
Which Parts of the Body is Suitable for Liposuction?
May be More than you Think!
Liposuction can be used to remove stubborn pockets of fat from many different parts of the body. Some of the most commonly treated areas include:
- Abdomen And Waist: Liposuction can be used to remove excess fat from the abdomen and waist area, including the love handles and muffin top.
- Thighs: Liposuction can be used to remove excess fat from the inner and outer thighs, which can help to create a more toned and balanced appearance.
- Hips And Buttocks: Liposuction can be used to remove excess fat from the hips and buttocks, which can help to improve the overall contour of the body.
- Arms: Liposuction can be used to remove excess fat from the upper arms, which can help to create a more toned and defined appearance.
- Back: Liposuction can be used to remove excess fat from the upper and lower back, including the bulging areas above and below the bra straps, which can help to improve the overall contour of the body.
- Chest: Liposuction can be used to remove excess fat from the chest area in men, which can help to create a more masculine chest contour and treat gynecomastia.
- Neck And Chin: Liposuction can be used to remove excess fat from the neck and chin area, which can help to create a more defined jawline and improve the overall contour of the face.
- Knees: Fat deposits just above and in the inner aspects of the knees can be removed by liposuction giving your legs a more youthful appearance.
- Ankles And Calves: Fat accumulation in these areas usually occurs in lipedema and can be effectively removed by special liposuction techniques.
- Breasts: In some forms of breast hypertrophy in young females, fat liposuction may reduce the breasts’ size without resorting to excision techniques.
How Much Fat can be Removed with Liposuction?
“Are you a Liposuction or Bariatric Surgery Patient?”
The amount of fat that can be safely removed with liposuction varies depending on a number of factors, including the patient’s overall health, the specific areas being treated, and the type of liposuction being performed.
In general, the American Society of Plastic Surgeons recommends removing a maximum of 5 liters of fat (or about 11 pounds) in a single liposuction procedure. This is usually adequate to accomplish the desired look in patients whose BMI is <25.
However, in larger patients, this amount may not be sufficient enough to make a remarkable difference. In a technique called “large-volume liposuction”, up to 15 liters of fat may be removed in selected patients who are young and in good health conditions. However, removing more than 5-7 liters of fat is usually associated with increased hospital stay and with blood transfusions in patients with low preoperative hemoglobin values.
The risk of other complications, including fluid imbalance and blood clots may also increase. If you have a BMI of 32 and above, Dr. Demirkan will suggest you consult with a bariatric surgeon.
It’s also important to note that removing fat is not the solution in a patient with too much unless there is a major change in lifestyle and diet. All of the removed fat may come back quickly, creating irregularities or asymmetries in the skin, or fat accumulation in previously slim areas. For this reason, it’s important to have realistic expectations about the results of liposuction and to discuss your goals and concerns with your surgeon.
Dr. Demirkan has a unique 360 approach for his liposuction patients for maintaining the liposuction results. This approach involves dietary coaching, psychological support, and lifestyle changes.
Ultimately, the amount of fat that can be safely removed will depend on a number of individual factors, and Dr. Demirkan will work with you to develop a personalized treatment plan that is tailored to your specific needs and goals.
Are Liposuction Results Permanent?
Nothing, in this life, is permanent ..
Liposuction can provide long-lasting results if you can keep your weight stable with a healthy diet and exercise plan. Therefore, it is important to adjust your lifestyle accordingly, otherwise, a vicious cycle may take you back to where you begin.
Gaining weight following liposuction is the single most important factor that will undermine the success of your operation.
Liposuction removes the fat with its enclosing cells, and it cause a definite decrease in your body’s fat percentage. This is unlike many other heavily marketed and purported non-surgical fat reduction treatments. In none of these “alternative” treatments, there is a net fat removal from your body.
Cool sculpting, external laser applications, or other transdermal energy devices such as focused ultrasound or radio-frequency, can damage superficial the fat cells in the skin, however, the fat displaced from these cells will travel in the bloodstream and be captured by the nearby or distant adipose tissue, or worse in your liver. This is why you are asked to exercise right after these applications and change your diet during the course of these treatments.
However, it’s important to understand that fat cells which are removed during liposuction may grow back if your calorie intake is more than you can burn. In the areas where fat has been removed, there will be a reduction in the number of adipocytes (fat cells).
However, mesenchymal stem cells (MSCs) which are abundantly present in fat tissue, may migrate to the liposuction area, and differentiate into new adipocytes to store fat, potentially leading to a partial reversal of the liposuction results.
The extent to which this occurs is not well understood and may vary depending on a number of factors, including the patient’s overall health, the amount of fat removed during the liposuction procedure, and the specific technique used by the surgeon. Therefore, it’s important to maintain a healthy lifestyle, diet, and exercise regularly to maintain the results of liposuction.
In response to changes in the body’s energy balance, such as excess calorie intake or hormonal changes, mesenchymal stem cells can be triggered to move into liposuction areas and differentiate into fat cells, and store excess energy as fat.
Additionally, the body will continue to age naturally after the procedure, which can result in changes to the overall contour of the body over time. However, the removal of excess fat can still have a significant impact on the appearance of the body, and the results of liposuction can be very long-lasting if proper maintenance is taken.
Ultimately, the longevity of liposuction results will depend on the individual’s lifestyle habits and overall health, as well as the specific technique used during the procedure and the expertise of the surgeon.
High Definition Liposuction
“3D Liposuction”
High-definition liposuction, also known as HD Liposuction or 3D liposuction, is an advanced type of lipo sculpting procedure that can highlight certain muscle groups while removing excess fat deposits from the region.
The aim is to create a fit, youthful, and muscular appearance. This technique requires a thorough knowledge of artistic human anatomy used in sculpture to create light and shadows, the use of Vaser Liposuction and specific cannulas to curve around the muscle groups, and etching negative spaces.
The negative space concept in high definition liposuction refers to the idea that creating a well-defined appearance is not just about removing excess fat, but also about strategically leaving certain areas of fat to create contrast and definition. For example, in the upper abdominal area, the negative space concept might involve leaving a small amount of fat over the muscle packs, while removing fat almost totally from the inter-muscular troughs surrounding them to create contrast and definition.
Sometimes fat injection might be a great tool to increase contrast or muscle volume, in areas like the upper chest, deltoid region, and buttocks, in men.
It should be noted that the success of the high-definition technique depends on careful patient selection: the ideal patient is a fit man with a low BMI and who has or has had some natural muscular definition before the liposuction. This procedure should be perceived as one that augments the existing reality, not as fat sculpting from scratch.
Depending on the patient’s sex and body characteristics, the high-definition technique can be applied to different parts of the body in different combinations and strengths. The etching amount should be proportionate to the overall body fitness and muscle percentage.
Areas of muscle definition in men:
- Upper abdomen (4 or 6-packs)
- Lower abdomen (lateral rectus and adonis lines)
- Chest (negative spaces in lower quadrants and axilla, fat injection to upper quadrants)
- Upper arm (deltoid muscle and triceps)
- Buttocks (lateral negative spaces and fat injection medially)
- Thighs (rectus femoris borders)
In women, a muscular appearance is not usually preferred but carving a narrow waistline, creating a shadow under the rib cage in the upper abdomen and lateral borders of the rectus muscle may be an artistic appeal. The high-definition procedure has a specific preoperative marking ritual.
In the postoperative phase, special foams are applied under the corset to preserve the negative spaces created. The corset use is longer than usual (6 weeks). Pre and postoperative use of a muscle-building exercise plan or an electromagnetic muscle stimulation device will be helpful in achieving the desired result. A protein-oriented sports diet may be used if there are no contraindications.
Potential Health Benefits of Liposuction
“Excess Fat is a Source of Several Diseases”
Liposuction is primarily considered a cosmetic procedure, however, it may have potential health benefits in certain cases. Here are some of the potential health benefits of liposuction:
Reduced Risk of Metabolic Syndrome-Related Complications: Fat tissue is mainly a storage place for energy, however, it should not be regarded as a passive cellular depot. Fat tissue releases hormones that control metabolism and appetite, and that affect insulin sensitivity (i.e., tumor necrosis factor-alpha, interleukin-6). It is a tissue that plays a role in inflammation, immune function, and secretion of some steroid hormones.
Reduction in the amount of fat with liposuction is shown to affect metabolic processes in the body through the mechanisms mentioned above. Usually, there is a reduction in insulin resistance and inflammatory markers when the acute postoperative phase is over.
Improved Mobility: Carrying excess weight can put stress on the joints, making it more difficult to move around and participate in physical activities. Liposuction can reduce the amount of weight being carried, making it easier to move and potentially improving mobility.
Improved Self-Esteem and Mental Health: Excess weight can also take a toll on mental health, leading to feelings of low self-esteem and depression. Liposuction can help improve body confidence and self-esteem, which can have positive effects on mental health.
Improved Lipids profile: Liposuction has been shown to have a positive effect on lipid profile by reducing total cholesterol and LDL (bad) cholesterol levels and increasing HDL (good) cholesterol levels in some individuals.
Treatment of lipodystrophies: Lipodystrophies are medical conditions that affect the way the body stores fat, leading to abnormal fat distribution and metabolic disturbances. Liposuction may be used as a treatment option for certain types of lipodystrophies such as Lipedema and may halt the progression of this disease to lymphedema.
Liposuction leads to a decrease in insulin resistance and inflammatory processes a few weeks after surgery.
How Can I Measure my Body Fat Content & Calculate my BMI?
There are several methods for measuring body fat content and calculating BMI. Here are some common ones:
Body Mass Index (BMI):
BMI is a commonly used method for assessing body weight and is calculated by dividing your weight (in kilograms) by your height (in meters) squared. The formula for BMI is:
BMI =
weight (kg) / height (m)2
BMI
18.5 to 24.9 is normal,
BMI
25 to 29.9 is overweight,
BMI
30 or higher is considered obese.
Skinfold thickness measurements:
This involves using calipers to measure the thickness of folds of skin at specific sites on the body, such as the upper arm, abdomen, and thigh. The measurements are then used to estimate body fat percentage.
Bioelectrical impedance analysis (BIA):
This method involves passing a small electrical current through the body and measuring the resistance to the current. This measurement can be used to estimate body fat percentage. In general, BIA devices typically use one, two, or three electrical currents to measure body composition.
Usual commercial scales use single-frequency BIA but have limited value and incorrect estimation of the body composition. Professional scales that can discriminate between muscle mass, body fluids, and fat content are three-frequency BIA devices.
Recovery Period
“A Time to get along with Corsets”
The recovery period for liposuction varies depending on the extent of the procedure, the areas treated, and the individual’s overall health and age. In general, most people are able to return to work and light activities within a few days to a week after the procedure, but it can take several weeks to fully recover and see the final results.
The extend of the procedure is the main determinant of the postoperative phase.
In small-volume liposuctions, you do not need to stay in the hospital. Light pain, swelling, bruising, and discomfort in the treated areas may occur. You may go back to work within a few days. However, in large-volume liposuctions (i.e. > 5 liters) a hospital stay for one or more days is mandatory to check and control the fluid balance of your body.
You may experience dizziness and fatigue, and stronger analgesics may be required for pain control depending on the number of areas treated. A blood count is usually performed and if necessary, a blood transfusion may be suggested. Your recovery may take 4-5 days before you go back to your daily activities.
Compression garments are an important part of the recovery period. They are essential in swelling control and body shaping. Depending on the type of procedure you need to wear a corset for 3 to 6 weeks after the liposuction. In high-definition cases, additional garments may be necessary for shaping.
Drains are usually used to reduce swelling and fluid build-up in the treated areas. During the procedure, small incisions are made in the skin and small silicone tubes, the drains, are inserted in, to allow excess fluid to drain out of the body. The drains are typically left in place for a few days to a week, depending on the extent of the procedure and the amount of fluid that needs to be drained. Drains help to remove the fluid accumulation in the dead spaces left by suctioned fat.
It’s important to avoid activities that may cause excessive movement or impact to the treated areas, such as jogging or high-impact exercise, in the early postoperative period. Early massage to the treatment area is not advised as well, as all of these activities may increase “seroma” formation.
It can take several weeks for the swelling to subside and the final results to become visible usually at the 6th week. It’s important to be patient and allow your body time to heal. You may go back to stretching exercises 2 weeks after surgery, and all forms of exercise are encouraged after 3 weeks.
To improve the results, a massage treatment with suction-assisted devices is suggested after the 5th week. LPG Endermolift®, or Velashape III® are quite useful to diminish the residual edema, soften the tissues and further tighten the skin.
It’s important to follow your surgeon’s instructions and to contact him immediately if you experience any unusual symptoms or complications during the recovery period.
How can I Improve the Results?
Massage - Exercise - Diet
There are several things that can be done to improve the results of liposuction after the surgery:
1. Follow Your Surgeon’s Instructions: It’s important to follow your surgeon’s post-operative instructions closely to ensure proper healing and optimal results. This may include wearing compression garments, taking antibiotics or pain medication, and avoiding certain activities.
2. Maintain A Healthy Lifestyle: Liposuction can remove unwanted fat, but it’s important to maintain a healthy lifestyle with regular exercise and a balanced diet to prevent the accumulation of new fat and maintain the results.
3. Stay Hydrated: Drinking plenty of water can help reduce swelling and flush out toxins, which can improve healing and enhance the results of liposuction.
4. Consider Complementary Treatments: Depending on your goals and needs, your surgeon may recommend complementary treatments such as skin tightening or fat grafting to enhance the results of liposuction.
5. Be Patient: It can take several weeks or even months for the final results of liposuction to become visible as the swelling subsides and the body heals. It’s important to be patient and allow your body time to heal before assessing the final results.
It’s important to discuss any concerns or questions you may have with your surgeon, as they can provide specific recommendations and advice based on your individual case and goals.
Massage after Liposuction:
Massage devices can be used after liposuction to help improve circulation, reduce swelling and bruising, and enhance lymphatic drainage. Here are some common types of massage devices that may be recommended by your surgeon:
1. Manual Lymphatic Drainage (MLD) Massage: MLD is a type of gentle massage that helps to promote lymphatic flow and reduce swelling. This type of massage is usually performed by a trained therapist.
2. Hand-Held Massage Devices: There are many hand-held massage devices on the market, such as foam rollers, percussive massagers, and vibrating massagers. These devices can be used to target specific areas of the body and help reduce swelling and bruising.
3. Pneumatic Compression Devices: These devices use air pressure to massage the treated areas and help improve circulation and lymphatic drainage. They typically consist of a sleeve that is placed around the treated area and attached to a pump.
4. LPG, which stands for Lipomassage by Endermologie, is a type of mechanical massage therapy that is advised to be used after liposuction surgery to help reduce swelling, improve circulation, and smooth out any irregularities or lumps in the treated area.
LPG involves the use of a handheld device that uses suction and rollers to massage the skin and underlying tissues. The suction helps to lift and stretch the skin, while the rollers massage the tissues to promote lymphatic drainage and improve circulation. This can help to reduce swelling and improve the overall appearance of the treated area. LPG sessions typically last around 35-45 minutes and may be performed 1-2 times per week for several weeks following liposuction surgery. The number of sessions required may vary depending on the individual case and the extent of the liposuction procedure.
5. Velashape III is a non-invasive body contouring treatment that uses a combination of radiofrequency, infrared light, vacuum suction, and mechanical massage to reduce the appearance of cellulite, contour the body, and improve skin texture. It may be used after liposuction surgery to help enhance the results and further sculpt and tighten the treated areas.
Velashape III is typically performed in a series of 4-6 sessions, spaced 1-2 weeks apart. During the treatment, the hand-held device is used to deliver a combination of radiofrequency and infrared energy to the treated area, while vacuum suction and mechanical massage help to stimulate lymphatic drainage and improve circulation.
After liposuction surgery, Velashape III may be used to help smooth out any remaining lumps or irregularities in the treated area, reduce swelling, and promote healing. It may also be used to improve skin tone and texture in the treated area.
It’s important to consult with your surgeon before using any massage devices after liposuction, as they can provide specific recommendations based on your individual case and needs.
Exercise After Liposuction:
Generally, patients are advised to avoid strenuous exercise and activities for at least two to four weeks after liposuction surgery to allow the body to heal. Light walking is usually encouraged as soon as possible to promote circulation and prevent blood clots.
However, after the second week, a well-structured exercise program may actually help to improve your results. Muscle contractions under the liposuction areas will act like a deep-tissue massage that improves your lymphatic circulation and blood flow. It is usually advised to start with stretching exercises after the second week. This will help in preventing unwanted adhesions in certain areas.
In the following weeks, swimming, yoga, and pilates will be good choices for improving your body’s elasticity and form. Jogging and other heavy exercises may be more suitable after the fifth week. If calves are treated with liposuction, the exercise program will be much more conservative, as edema in this gravitationally unfavorable area persist longer if the standing positions are not restricted.
It’s important to follow a gradual and safe exercise program after liposuction surgery to promote healing and reduce the risk of complications.
Diet:
There is no one-size-fits-all diet program after liposuction surgery, as individual needs and preferences vary. However, a balanced diet is generally recommended to promote healing, reduce inflammation, and support overall health. An excellent example of such a diet is the Mediterranean Diet which is composed of vegetables, fruits, whole grains, nuts, olive oil, and fish.
Tips for a healthy post-liposuction diet:
Focus On Whole Foods: Choose a variety of nutrient-dense foods such as fruits, vegetables, whole grains, lean protein, and healthy fats.
Limit Processed And High-Fat Foods: Avoid processed foods, which can increase inflammation and impair healing.
Stay Hydrated: Drink plenty of water and avoid sugary or caffeinated drinks, which can dehydrate the body.
Consider Supplements: Talk to your doctor about supplements such as bromelain and arnica tablets for edema, omega-3 fatty acids for inflammation, and collagen to support healing.
When Liposuction is Required as a Complimentary Procedure?
Liposuction is a powerful technique to remove regional fat depositions. However, it may not be sufficient by itself, in cases with a significant skin laxity. In those cases, liposuction is combined with lifting procedures to tighten the skin. The most common example of this combination is tummy-tuck with Vaser lipo.
Liposuction may also serve as a complementary technique to improve the results of various aesthetic surgical procedures, such as the Brazilian Butt Lift (BBL), facelift, arm lift and thigh lift.
A BBL or tummy tuck is usually incomplete without liposuction, as it is the only tool to achieve a slim waistline which is essential for the success of these procedures.
In fat injections, and stem-cell procedures, liposuction is used to harvest fat from different parts of the body, however, low-pressure devices or hand syringes are preferred not to harm the fat cells.
Is Liposuction Good for Cellulite?
Simply, not!
Cellulite is a very common skin problem in women, in which the skin surface takes the appearance of an orange peel. Although several factors are known to contribute to the development of cellulite (sex, genetics, lifestyle, diet), the exact cause is not understood. Unfortunately, its occurrence is limited to the mid-torso and thighs, areas where liposuction is most commonly performed. A common question is then raised about whether liposuction will treat cellulite or not.
Liposuction does not treat cellulitis. The classical form of liposuction (SAL) may even cause deterioration of the condition as suctioned areas develop a temporary skin laxity. Therefore in cases with severe cellulite, liposuction techniques with skin-tightening properties should be preferred or an associated lifting procedure should be planned. Postoperative massage devices may be helpful, as well.
Dr. Demirkan has a specific triple surgical regimen in liposuction cases with cellulite, which aims to prevent their deterioration and even some improvement.
Lipedema
A Chronic Disease of Women
Lipedema is a condition that involves the abnormal accumulation of fat in the legs, thighs, hips, and sometimes the arms, which may be tender or painful to the touch. Easy bruising is another symptom. It is a chronic disorder that affects mostly women, and it is thought to be related to hormonal and genetic factors.
The fat accumulation in lipedema occurs symmetrically and often results in an enlarged appearance of the affected limbs, in a specific order which is also used for staging the disease.
Stages of Lipedema:
The fat accumulation starts in the thighs and sometimes in the upper arms. Then the calves are involved in stage II. Liposuction is necessary to halt the disease at this stage; otherwise, skin plications that occur above the knees and ankles in Stage III will impede lymphatic drainage and lip edema will be complicated by lymphedema which is a much bigger health problem.
It should be noted that liposuction does not cure lip edema but it halts its progression and may correct the visual deformity and sometimes the pain associated with the disease.
Lipedema is often misdiagnosed or underdiagnosed, as it is sometimes mistaken for obesity or lymphedema. Another important problem is the patient’s loss of control over weight gain after the diagnosis. Most patients misunderstand lipedema’s mechanism: they think that the disease produces fat by itself no matter what they do Depression is a common entity in lipedema patients further deteriorating their life quality.
However, in reality, what happens is that fat deposited in the legs and arms induces edema in the surroundings which make the fat volume larger and softer in consistency. If these patients do not gain weight first-hand, lipedema will not advance by itself. So weight control is the most critical factor in treatment.
While there is no cure for lipedema, treatments such as compression garments, and manual lymphatic drainage, in addition to liposuction can help manage symptoms and improve the quality of life for those with this condition.
Liposuction In Lipedema Has Different Features:
- Removal of fat from thighs is easier and faster without bleeding
- It might be wise to divide the procedure into sessions when both calves and arms are involved, to avoid postoperative difficulties.
- Calf liposuction requires special techniques and cannulas.
- Calf liposuction requires serial bandaging in addition to the corset application in the post-operative period. Mobilization should be restricted in the postoperative period to limit gravitational edema. That means a longer downtime for patients which may be as long as 3-4 weeks.
- An anti-inflammatory diet and anti-inflammatory nutritional supplements may be beneficial in some cases.
- A lifestyle with a special diet and exercise program to prevent weight gaining is crucial to keep the disease under control.
