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September 07, 2005
Repeat Liposuctions
By Dr. Perry Dela Cruz
Dear Dr. Dela Cruz,
Last April, 2005, I had liposuction done on my thighs, tummy, and waist. I even had several months of massage and exercises (as advised by my doctor). I am not quite satisfied with the results. Is it possible to have a repeat liposuction on those areas I’ve mentioned? Will it be safe? What are the risks? If possible, how soon can I have it done? In the meantime, should I stop going to the gym for my workouts? I am also wondering if liposuction can be used on my "heavy legs" and if the scars will be visible? Thank you and more power!
M. J. Bautista
Dear Ms. M. J. Bautista,
One of the more common post operative complications of liposuction surgery is waviness or irregular contour deformity of the skin. The massage exercises you mentioned is but one of the procedures done after surgery to smoothen these irregularities.
To prevent the formation of skin waviness, compression dressings are also applied and kept intact for several days to support the affected areas. This way, the skin will re-drape to the underlying tissues, and healing will be faster.
During surgery, the technique of suctioning out the unwanted fats is very critical, and this should be observed by the surgeon to minimize the formation of skin waviness. Nowadays, we utilize the wet or tumescent technique of liposuction. Here, a mixture of fluids called the Klein solution is injected into the areas where liposuction will be done. This minimizes bleeding and pain, and better results are obtained.
Some surgeons have tried using different techniques in liposuction to avoid these post operative complications. There is the ultrasonic technique where a machine practically breaks and emulsifies the fats for easier removal. There is also the laser technique, and more recently, the mesotherapy. Long term follow-up is still in the process to determine their advantage and safety over the other techniques.
Repeat liposuction surgery may be done safely after an interval of two to three months. This is usually done to patients where a "mopping-up" procedure is necessary.
There are several factors why a repeat liposuction is necessary. First, the physical condition of the patient. If during surgery there are significant changes in the vital signs (blood pressure, pulse rate, cardiac rate, etc.) of the patient, the operation should be stopped, and a repeat liposuction is done later. Second is the bulk of fat that should be removed. There is a limit on how much we can remove in one sitting. If it exceeds this limit, then a repeat procedure will have to be done. Third is the "touch-up" procedure. This is done to remove small amounts of fats left during the initial procedure. These are the localized fats that sometimes give a wavy appearance on the areas involved I suggest that you continue with your workouts. In fact, this is necessary for toning up your tissues even before the procedure. A well toned skin re-drapes better and you ultimately get better results.
"Heavy legs" may be corrected by liposuction up to a certain extent. Usually, it is the area around the knees and ankle joints where liposuction is done. Oftentimes, it is the well developed leg muscle (gastrocnemius) that gives the appearance of heavy leg, and this cannot be corrected by liposuction.
The resultant scars in liposuction done anywhere in the body is barely visible since the incision done is only sufficient to allow entry to the small cannulas that we use. Besides, incisions are usually done in areas that can be hidden.
Dr. Dela Cruz
The views expressed herein are solely those of the author. For more information, consult your cosmetic surgeon.
DR. PERRY DE LA CRUZ obtained his medical degree from the University of Sto. Tomas. He is a diplomate of the Philippine Board of Cosmetic Surgey; a fellow of the Philippine Society for Cosmetic Surgery, and the American Academy of Cosmetic Surgery; and a member of the Asian Pacific Academy of Cosmetic Surgery. He pioneered research on "Serial Revision of Leg Scars" in 1988.
Visit his Web site at home.pacific.net.ph/~docperry/DocPerryhomepage.html or e-mail him at docperry@pacific.net.ph.
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