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HOME --
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Ayman Shahine,
M.D.
FACS, FACOG, FICS, MACS, FISCG
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Recipient of the American Academy of
Cosmetic Surgery. Very
experienced and skillful doctor, voted
by other doctors as "best doctor teacher
of the year". Innovator and inventor in
the field of cosmetic medicine. Top of
the line technology at really
affordable prices. We promise you will be
happy. Your beauty is our passion. |
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FACE --
BREAST & CHEST --
ABDOMEN --
ARMS & HANDS
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BUTT & GROIN AREA
-- THIGHS & LEGS
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SKIN & BODY TREATMENTS |
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ABDOMEN |
Liposuction |
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 The
abdomen is the most common area of the body to be treated by
liposuction among both men and women. Important factors that
affect the success of abdominal liposuction include: the amount
and location of abdominal fat, history of weight gain and weight
loss, history of pregnancy, and the age and the sex of the
patient.
Previous Pregnancy
A previous pregnancy tends to stretch the abdominal muscles, and
cause the lower abdomen to bulge to a certain degree. This
curvature of the abdominal wall muscles determines the flatness
or the shape of the abdominal silhouette after liposuction.
Nevertheless, the vast majority of women who have been pregnant
are ultimately very happy with results obtained by liposuction
alone, and do not require an abdominoplasty (tummy tuck).
C-Section Bulge
The Pfannenstiel incision is the name for the incision across
the lower abdomen that is typically made for Cesarian sections,
or a hysterectomy. A common but undesirable consequence of a
Pfannenstiel incision is a persistent bulge of subcutaneous fat
just above the incision. Liposuction can easily repair this
annoying deformity.
Prior obesity
Prior obesity and subsequent weight loss produce fat that is
more fibrous. This makes liposuction more difficult.
Location of Abdominal Fat
Location of abdominal fat is an important factor in predicting
the success of abdominal liposuction. Abdominal fat occurs in
two different levels: superficial and deep. Superficial
abdominal fat is located just below the skin and above the
abdominal muscles. The deep abdominal fat is located inside the
abdominal cavity on the intestines. Some people have more deep
(intestinal) fat than subcutaneous fat. Subcutaneous fat can be
removed by liposuction. Intestinal fat cannot be removed by
liposuction because it would be too dangerous. Fat on the
intestines can only be diminished by weight loss through diet
and exercise. Thus liposuction cannot remove all of the
abdominal fat. Most patients have more subcutaneous fat than
intestinal fat. Thus, most patients will see a good cosmetic
improvement with abdominal liposuction.
Successful Liposuction
This is defined and determined by the degree of a patient's
happiness with the results. Ultimately the patient's opinion of
the cosmetic results depends on multiple factors, including 1)
the patient's expectations, 2) the patient's preoperative
cosmetic deficiencies, and 3) the surgeon's technical skills and
technique. The results are never completely predictable.
Age
Age of the patient is not an important factor in the success of
liposuction. Some of the happiest patients are women who are
more than 60 of age. In a healthy older woman, liposuction can
improve an obese abdomen with little risk or discomfort.
Female Patients
Female patients have softer and less fibrous fat than men, and
therefore liposuction on a woman is easier to perform.
Fat on the Upper Abdomen
This is usually less of a concern than the fat on the lower
abdomen. However, if the upper abdominal fat is either not
suctioned or inadequately suctioned, subsequent weight gain will
enlarge the upper abdomen and give the appearance of a bulky
midriff.
The Old-Fashioned Tummy-Tuck
Tumescent liposuction of the abdomen is so effective that few
patients require the more dangerous tummy-tuck, also known as an
abdominoplasty. Patients who are obese and have a pendulous
lower abdomen, often find that tumescent liposuction will give a
better cosmetic result than a tummy-tuck.
The traditional tummy-tuck involves several surgical steps.
First, the subcutaneous fat is removed by liposuction or
excision with a scalpel; next, the surgeon excises a large piece
of skin from the lower abdomen just above the pubic area; then,
the abdominal muscles are tightened using sutures; and finally,
the large wound where the skin was excised is closed with
staples or sutures.
The two most important reasons to have a tummy tuck are 1)
extensive laxity or spreading of the abdominal rectus muscles as
a result of pregnancy, 2) excessive loose skin and excessive
stretch marks. Just because a surgeon recommends a tummy-tuck
does not mean that a tummy tuck is necessary. Some surgeons are
unaware of the excellent results that can be produced by
liposuction without resorting to the more dangerous and the more
expensive tummy-tuck. Compared to liposuction, tummy tucks are
associated with a much higher risk of serious complications,
including fatal pulmonary embolism (blood clots in the lung).
If a patient decides that a tummy-tuck is needed, it is usually
much safer to separate the traditional tummy-tuck into two
separate surgical procedures. Abdominal liposuction should be
the done initially. Then, one should wait a couple months and
evaluate the cosmetic results of liposuction before deciding to
proceed to the skin-excision part of the tummy-tuck. The
surprising aspect of using this two-stage approach to
abdominoplasty is the high degree of satisfaction that patients
find from liposuction alone. In fact, the vast majority of
patients are so pleased with the results of liposuction alone
that they decide not to pursue the second stage skin resection.
Post-operative Healing
Pain after tumescent liposuction of the abdomen typically does
not require any pain medications stronger than acetaminophen
(Tylenol). The quality of the pain is similar to the muscle
soreness and burning experienced after having worked-out too
much. The intensity of the pain is similar to that of a sunburn;
it is most intense when the skin of the area is flexed or
touched, such as getting in and out of a car, or rolling-over in
bed, or when sitting still in a chair. There is minimal
discomfort when walking or sitting.
With liposuction totally by local anesthesia, patients do not
typically need any pain medication immediately after abdominal
liposuction because the tumescent local anesthesia last for up
to 18 hours. From 36 to 72 hours after surgery, patients
experience the greatest degree of soreness and discomfort, but
rarely need anything more than acetaminophen (Tylenol).
When general anesthesia has been used for liposuction, there is
often somewhat more pain after liposuction. This is because
surgeons who use general anesthesia usually use less tumescent
local anesthesia, do liposuction of more body areas during on
the same day, use larger cannulas, and usually close the
incisions with sutures.
The use of smaller liposuction cannulas (microcannulas) requires
a little more time to complete the surgery, but they are
associated with less postoperative soreness, and allow smoother
results. Because the incisions are smaller, they do not need to
be closed by sutures; the open incisions allow more drainage of
the blood-tinged tumescent fluid. When incisions are closed with
sutures this fluid is trapped under the skin and causes
prolonged swelling, and increased pain and soreness.
Swelling and Soreness
The day after surgery, as a result of open-drainage (incisions
are not closed with sutures) of the blood-tinged anesthetic
fluid and wearing a compression garment, the degree of cosmetic
improvement is easily visible and quite dramatic. Over the next
several days, after the drainage has ceased, and as the
inflammatory healing process progresses, there is a gradual
onset of swelling which decreases over the following four to 12
weeks. This subcutaneous abdominal swelling can reduce the ease
with which the patient bends forward. For example, tying ones
shoes becomes a minor challenge. The edema that occurs after
liposuction of the abdomen typically takes longer to resolve
than edema in other treated areas. A certain degree of swelling,
firmness and lumpiness is normal for the first four to 12 weeks.
This firmness of the abdominal skin and subcutaneous tissue
gradually decrease over 3 to 4 months after surgery.
The open-drainage technique, which reduces swelling and
soreness, requires the use of special super-absorbent pads to
absorb the drainage and special garments to hold the pads in
place. See Absorbent Pads and Compression Garments.
Activity and Bathing
There is no restriction on postoperative physical activity.
Patients are advised not to remain in bed, but rather to walk
about inside their home or leave their home for a short walk on
the evening of the surgery. The patient is expected to shower at
least once or twice daily beginning the morning after the day of
surgery. |
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Many
other treatments are available but not mention here
Tell us your problem, we will help you solve it. |
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