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Liposuction surgery or tummy tuck: Dr. Cesare Cappellina answers.

When the first is indicated and when abdominoplasty is preferable.

 

Dr Diego and Cesare Cappellina are both plastic surgeons. They work in Vicenza

 

Often patients come to our office complaining of an excess of localized fat and ask for liposuction surgery as a solution. However, this surgery has precise indications, which differ from those of abdominoplasty. What are the differences? Dr Cesare Cappellina replies

Liposuction surgery or lipoaspiration is the procedure that allows you to correct local fat deposits:  Liposuction is a surgical procedure that removes localized fat. Usually the areas that benefit most from the liposuction treatment are the hips, abdomen, thighs, buttocks, back, arms and under the chin or face to improve their shape. But liposuction can also be done with other plastic surgeries, including facelifts, breast reductions, and abdominals.

It is good to make the patient understand that liposuction does not eliminate cellulite. Liposuction surgery is a procedure and like everyone it is not without its risks. For this reason it must be adequately prepared with blood tests, an evaluation by the anesthetist and an adequate post-operative procedure.

liposuction surgery
Liposuction allows to eliminate localized adiposity through specific cannulae

1) What does liposuction surgery consist of?

Through the use of specific cannulae and a negative pressure device, the fat cells are aspirated and removed from the body. Since adipocytes, that is the cells that make up fat, are perennial cells (that is, whose genetic makeup is established at birth), once removed they do not reform. Liposuction  surgery must take place in a suitable facility with qualified personnel. Before liposuction surgery begins, we mark the areas of the body that will be treated with a marker. Also important are the photos to use later for before and after comparisons. The surgery can be done under general anesthesia – which means you won’t be awake during the procedure – or “local” anesthesia, which means you’ll be awake but won’t feel any pain. The anesthetist colleague before starting the procedure injects a hypnotic, which makes the sleep deeper and the procedure less troublesome

2) Is liposuction surgert a decisive intervention?

So why do some people undergo weight changes, why do we gain weight? When we gain weight, adipocytes do not replicate but increase in volume. Consequently, when we perform a liposuction, if the patient maintains a stable weight, the fat that is removed will not reform.

3) What are the alternatives to liposuction?

Sometimes patients come to the clinic complaining of excess skin, especially in the abdomen and thighs. In this case the solution is not liposuction: think of an excess of container. If we were to empty the contents, the result would be a worsening. The patient would result in an emptied abdomen and inner thigh. In these cases the solution is surgery, understood as the removal of excess skin: abdominoplasty or thigh lift, also called inguinocrural dermolipectomy.

 

So when a patient presents after pregnancy, she often complains of an enlargement of the rectus abdominus muscles in addition to excess skin, the so-called diastasis recti. In this case, the abdominoplasty is associated with the correction by plication of the rectus muscles. A suture is performed, comparable to a double hinge, which recreates tension to the muscle wall.

4) When is a patient a candidate for liposuction surgery and when for abdominoplasty?

The moment of the visit to our office with a plastic surgeon is essential, to understand the patient’s motivations and the real needs and indications for surgery. Finally, it should be emphasized that lipoaspiration is considered a major surgery. For this reason it must be performed in a suitable environment (operating room) in the presence of an anesthetist and qualified medical personnel.