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Liposuction; Diagnosis.

To determine if you are a candidate for liposuction (a surgical procedure that vacuums out fat from beneath the skin's surface to reduce fullness in certain areas), you first should consult with the health care professional who would perform the procedure. That health care professional may be a plastic surgeon, cosmetic surgeon or dermatologist. The physician will conduct a physical examination, and ask you questions about your medical history, what medications you are taking, your diet and exercise history and what you hope to achieve by having this elective surgical procedure. It's important that you provide an accurate medical history, including any past or present medical conditions, and what medications, including prescriptions, over-the-counter drugs, and dietary and herbal supplements, you are taking. Some types of drugs, such as steroidal medications, aspirin, ibuprofen and vitamin E, thin the blood and can interfere with clotting, and your health care professional most likely will want you to stop taking such drugs about two weeks before surgery.

You may be an ideal candidate for liposuction if you are at normal weight for your height, physically fit and healthy and have good skin elasticity, but have pockets of fat in a specific area, such as the hips, thighs, buttocks, arms, neck or chin, that don't respond to diet and exercise programs. If you are up to 30 pounds overweight with localized fat deposits in specific areas, such as saddlebags on the thighs or extremely wide hips, and good skin elasticity, you may be a candidate for liposuction of those areas to help improve your body proportions. If you are significantly overweight, such as 25 to 30 percent over normal body weight for your height, appear heavy everywhere with no specific area fatter than others and have loose skin from weight fluctuations, liposuction is unlikely to benefit you. Liposuction is a body contouring procedure; it cannot remove a layer of fat from the entire body.

Additionally, patients with serious medical problems, such as uncontrolled diabetes, heart disease, circulatory problems or lung disease, generally are not candidates for any type of elective surgery, including liposuction. If you have a medical condition, your surgeon will seek medical clearance from your primary health care professional before considering you as a candidate for liposuction surgery. In addition, liposuction is not recommended for those patients who may be pregnant, according to the American Academy of Dermatology guidelines.

In evaluating whether liposuction is for you, your surgeon may conduct a "pinch test" to assess how much fat is under the skin in the area considered for treatment, and to check the elasticity of your skin. During this test, the health care professional simply pinches the skin between the thumb and forefinger to see how much fat is in the area and see how the skin springs back after releasing the pinch. If an inch or more of fat can be pinched, the area may be reduced through liposuction. At least a half-inch of fat needs to remain after the procedure to ensure a smooth end result. Otherwise, skin would remain on top of bone or muscle, creating an emaciated look. If the skin springs back after the pinch, it has appropriate elasticity. Cellulite is a dimpling of the skin surface. While liposuction of the area may be effective in removing fat bulges and helping clothes fit better, it will not remove cellulite.

During the consultation, discuss with your health care professional:

* why liposuction can or cannot benefit you

* how the procedure would be done on you

* where the surgery will be performed

* what kind of anesthesia would be used, and your own preferences

* risks and potential complications

* confirm that the surgeon has a plan for medical emergencies, if the need arises

* expected recovery time

* what kind of results you can expect

* what the procedure will cost, since it is elective and not covered by most insurance

Additionally, to make sure you select a surgeon who is right for you, ask questions about what kind of liposuction training he or she has had, whether he or she is certified by the American Board of Plastic Surgery, the American Board of Cosmetic Surgery, or the American Board of Dermatology; and how much experience he or she has had performing liposuction. Ask to see some before and after photographs of his or her patients. You may also want to ask if you can speak with former patients about their liposuction experiences. Additionally, you may want to get a second opinion from another health care professional before deciding to schedule the surgery.

If you decide to have the procedure, you likely will have a preoperative visit with your health care professional in which before photographs of the area to be treated will be taken, consent forms signed, and blood drawn for lab testing. If you have a medical condition, your primary health care professional may order additional tests to ensure you are healthy enough to undergo surgery before giving medical clearance for the procedure.

American Academy of Dermatology. http://www.aad.org. Copyright 2003. Accessed Sept. 2003.

American Society for Aesthetic Plastic Surgery. http://www.surgery.org. Copyright 2003. Accessed Sept. 2003.

American Society for Dermatologic Surgery. http://www.asds-net.org. Copyright 2002. Accessed Sept. 2003.

American Society of Plastic Surgeons. http://www.plasticsurgery.org. 2003. Accessed Sept. 2003.

Katz, B. MD, FAAD. Director of the Juva Skin and Laser Center. Associate professor at the College of Health care professionals and Surgeons at Columbia University. Direct interview.

Gingrass, MK. MD, FACS. Nashville, TN. Direct interview.

Grazer FM, de Jong RH. Fatal outcomes from liposuction: Census survey of cosmetic surgeons. Plast Reconstr Surg 2000 Jan; 105(1):436-446.

"American Academy of Dermatology Issues New Guidelines of Care for Liposuction" American Academy of Dermatology patient information. October 22, 2001. http://www.aad.org. Accessed April 2002.

"Statistics 2002" The American Society for Aesthetic Plastic Surgery. http://surgery.org. Accessed Sept. 2003.

Editorial Staff of the National Women's Health Resource Center 2002/04/01 2005/03/16 If no amount of diet or exercise removes those stubborn saddlebags on your hips, or that paunchy spot on your stomach, you may be able to get rid of that localized area of fat through surgery. Liposuction, also called lipoplasty or suction lipectomy, is a surgical procedure that vacuums out fat from beneath the skin's surface to reduce fullness in areas such as the abdomen, hips, thighs, knees, buttocks, upper arms, chin, cheeks and neck. Cannula,Cellulite,Lipoplasty,Liposuction,Seroma,Suction lipectomy,Super-wet technique,Tumescent technique
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Publication:NWHRC Health Center - Liposuction
Geographic Code:1USA
Date:Mar 16, 2005
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Previous Article:Liposuction; Overview.
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