INFORMATION REGARDING SUCTION LIPECTOMY
You are interested in information about removal of excess fat known as suction lipectomy, liposuction, suction contouring, liposculpture, etc. This operation is the most frequent procedure by plastic surgeons in the United States.
Since 1982, the year liposuction was introduced into the US, Dr. Capuano has operated on thousands of individuals. There have been no cases of hospitalization, infection, blood transfusion, or other serious consequences. This operation has one of the highest patient satisfaction ratios of any operation by Dr. Capuano, (augmentation mammoplasty has the highest). The operation to this point has been done safely with a minimum of complications.
We have to this point (10-2008) not experienced permanent significant complications. The closest to a severe complication was an unusual situation where a clot traveled to the lung. This was noted promptly and treated promptly and the individual was able to return to work ten days thereafter. This individual was not up and around after surgery. You should be up and around the same day and each day thereafter.
We, and I say ‘we’ because our surgeries are a team effort in that Dr. Capuano and our experienced staff, have not had, as noted above, one case of infection, excessive bleeding or other major problems. There are problems of some sort. We have had situations where ‘touch ups’ are appropriate. As some surgeons say, there is always more surgery. Minor problems may include skin that is not as tight as one would like, stretch marks that show, areas of irregularities. But most are happy with the results.
More surgery happens in about one in ten to one in fifteen operations. In spite of the fact that major problems might occur (we have no reason to believe that they will), you should be aware of the possible risks and complications of surgery. These include, but are not limited to, bleeding, infection, risks of anesthesia, minor or severe wrinkling and/or depression of the skin, numbness in the areas treated, scars, increased irregularity of the tissues, collection of fluids and the need for further removal of fat among other rare complications.
Your risks are somewhat dependent on your general health, but as an example, individuals with diabetes tolerate liposuction well and in fact, insulin requirements and or blood sugar levels have improved or become normal after liposuction, especially when the abdomen has been treated. We do not know why.
If you have concerns or questions regarding these risks, please ask the Doctor or our staff about your concerns at the time of your consultation. Web users have the opportunity for a complimentary consult at www.DrCapuano.com/consult.htm .
If you should decide on surgery we have the following advice. You should refrain from taking products containing aspirin for at least two weeks prior to your surgery. Do not eat apples, as they contain an aspirin-like substance. Aspirin prolongs blood from clotting which may cause more bleeding. If you are presently taking aspirin on the advice of a physician, please let us know. Please stop herbal therapies prior to surgery. There are many herbs, eg garlic, that can thin the blood. Please be mindful of the effects of herbs. You will be given a separate information sheet about this in the office. We ask and you need to tell us about other about other ‘blood thinners’ you might be taking.
For extensive liposuction, we recommend that you take iron for at least four days before surgery. This can be purchased over the counter. You may also continue with the iron following surgery for approximately 7-10 days. The evening before your surgery, as well as the morning of your surgery, you should shower with Dial or Safeguard soap. Please do not apply lotions, creams or powders before your surgical procedure. You must not eat or drink anything from midnight the night before your surgery if you are scheduled for surgery with general anesthesia or intravenous medications.
If your surgery is done as office surgery, “walk in” surgery or ambulatory surgery, the operative procedure is usually performed in the morning. You should be able to return home late in the morning or early in the afternoon. You will be given a time to report to the office by our staff or the Ambulatory Surgery Center through correspondence from the Center.
If your procedure is to be done in the office with medications given by mouth to make you groggy, then you may have a cup of coffee and juice if you wish, before your scheduled procedure. If your surgery is later in the day then we will discuss the particulars of your surgery with you. You will need someone to drive you home if you have medication.
When large volume removal is anticipated, or an extensive area is targeted, liposuction is performed as out-patient surgery (in and out surgery) where patients undergo a general anesthetic (totally asleep). You will have an opportunity to speak with the Anesthesiologist before your surgery.
You must have someone with you to drive you home from the out patient department or the office and someone needs to stay with you for at least the first twenty-four hours following surgery NYS law). If you plan on staying anywhere other than your own home following surgery, notify the office. We need to be able to contact you after surgery. If you are from out of town and staying at a hotel, make sure you call our office before 5:00 pm the day of surgery to tell us your room number and telephone number.
If you are a woman, and are having suction lipectomy of the thighs, lower legs and/or hips, we ask that you bring two pair of support stockings with you to the office for your first visit after surgery. You can use Sheer Energy, Leggs Active Support or a similar product. Buy the size you would normally wear. Men can also wear panty hose or spandex pants.
If you are a woman and are having suction lipectomy of the abdomen, we ask that you purchase a one-piece stretch body suit/girdle. This should be a size you usually wear. Make sure it is firm and conforms to your body. We also ask that you bring this garment with you to one of your office visits before surgery, so that we can be sure it is the right type of garment. In some cases this can be worn as a dressing following surgery. Men usually wear a Velcro belt for support.
After surgery you will have a dressing in place. This should remain in place until you are seen in the office. No showers should be taken until you are seen in the office. The dressing may consist of either a custom tailored dressing consisting of a type of elastic adhesive applied directly to the skin, or a fitted garment resembling a girdle. In either case this dressing must remain clean, dry and on. It is not unusual to have drainage through the dressing for the first day or so. If this occurs, you should reinforce the garment with bandages over the area. This will help dry the area also. If you are having difficulty with the dressing, please call the office.
After the dressing is removed it is not unusual to notice wrinkling of the skin. This is due to the towels, tape or garment used and the swelling in the area. This resolves itself over time. Sometimes there a residual minor problem that needs attention.
For patients undergoing this procedure in the morning and returning home in the afternoon, when you return home you should keep ice on the area as much as possible. You should rest at home, either on a sofa, lounge chair or in bed. Even though you may feel like it – no work outs please !!
You will be given medications for swelling, discomfort, and possibly antibiotics, with instructions. You should not engage in stressful activities, and if you have questions about any activity, please call the office. You should rest and relax at home. You may have visible swelling or “black and blue”. This is to be expected. If it is progressive after the first day following surgery, or if it is associated with a increasing amount of pain, ESPECIALLY IN ONE AREA, call the office. Regarding “feeling tired” following your surgery: If this occurs in your particular case, it is due in part to possibly a lower blood count that you are used to. Iron may be prescribed in certain circumstances. Please call the office if you feel unusually tired.
Many patients find that taking a multi-vitamin following surgery, along with drinking Gatorade each day helps replenish the body’s need for vitamins and minerals. This regimen can be continued for one to two weeks after surgery or until you feel up to par.
Regarding returning to work following your surgery: The estimated time away from work depends to a large extent upon the nature of your job. Under usual circumstances, one to two weeks is needed before you may resume many activities. Wearing the elastic dressing for the first week is usually quite restricting, and we encourage you to rest and relax at home for the first week. After the first week, many people may return to work with restrictions. Please discuss your job with the Doctor so you may obtain a better estimate of time away from work. Photographs and/or video taping will be done before, possibly during and after surgery. You will not be identified in these except for our office records. We ask that you purchase a “string” bikini panty for photos, which can be used both before and after your surgery.
Dr. Capuano has performed thousands of liposuction procedures and has found that the patients having the fewest problems following surgery are those who exercise regularly before surgery. Patients who do not exercise at all or who lead fairly sedentary lives (desk jobs, no regular exercise program, etc) seem to have more difficulty following this surgery. Therefore, we recommend that you begin an exercise program at least one month before surgery and gradually increase your activity level if you are in good health. You should check with Dr. Capuano and/or your medical doctor if you have any questions about this. Exercise can be aerobics, jogging, biking, etc. Begin slowly and increase gradually. Regarding the possible return of fat to the areas treated: To the best of our knowledge at the present time, once fat is removed from an adult, it will not come back.