The number of linear incisions or adits (tiny round holes) that are placed in the skin is determined by a number of factors including size and location of the area being treated, and the surgeon’s technique. In general, when just a few (2 to 6) incisions are used in an area, the incisions tend to be somewhat larger (greater than ¼ inch long), and are closed with stitches. In contrast, surgeons who use small diameter microcannulas typically make multiple (4 to 12 or more) tiny adits in an area, which are so small (less than 1/8 inch in diameter) that no stitches are required.
Incisions or adits usually close up in a week or two, and become completely healed with no scabs within 2 to 4 weeks. The incision sites slowly become less and less visible over 3 to 12 months, except in patients who have darkly pigmented skin, in which case the incision sites may remain visible for more than a year or two.
Intravenous fluids are not necessary, and in fact are contraindicated with tumescent liposuction because the large volume of dilute tumescent local anesthetic fluid that is injected under the skin is sufficient to replace any fluid that is lost by liposuction.
The average patient will be in the surgical facility for 3 to 7 hours. However, the actual surgery may only require 2 to 3 hours. The length of time that it takes to complete a liposuction depends on the size of the patient, the number of areas being treated, and the type of anesthesia being used. Because it takes a certain amount of time to inject local anesthesia, it usually takes longer to do liposuction using local anesthesia than it does using general anesthesia.
Tumescent liposuction totally by local anesthesia is the safest form of liposuction. Liposuction using general anesthesia is somewhat less safe than liposuction totally by local anesthesia. The problem with using general anesthesia is that these forms of systemic anesthesia permit a surgeon to do too much liposuction on the same day and permit multiple unrelated cosmetic procedures on the same day as liposuction. If a patient desires a large amount of liposuction, or multiple unrelated cosmetic surgical procedures, it is safest to do the liposuction on two or three separate occasions, each separated by three to four weeks, and to not do unrelated surgical procedures on the same day as liposuction.
Microcannulas permit smoother results after liposuction. A liposuction cannula is a small stainless steel tube that is inserted through an incision in the skin and removes subcutaneous fat. The fat is suctioned through the cannula, then through a long flexible plastic tube that attaches the cannula to a vacuum pump.
Tumescent liposuction totally by local anesthesia requires the use of very small cannulas or microcannulas. Microcannulas have an outside diameter = 2.8 mm. Microcannulas permit a more delicate and gentle approach to liposuction than can be achieved using larger cannulas. Because microcannulas require a minimal amount of force to be pushed through fatty tissue, the surgeon can control the direction and position of the cannula with much more accuracy: The ultimate result is a greatly reduced risk of inadvertently approaching too close to the undersurface of the skin and unintentionally causing irregularities.
UAL is neither as safe nor as effective as traditional liposuction. See Risks of Ultrasonic Liposuction.
Power assisted liposuction (PAL) uses a machine-powered cannula that oscillates in and out or vibrates very fast. PAL is relatively new and somewhat controversial. Manufacturers of these devices and some surgeons are enthusiastic about PAL and believe it makes liposuction easier. Other surgeons remain skeptical and have not found there to be any advantage in using PAL.
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Dr. Milan Doshi- Founder and Medical Director of Allure Medspa, He is (M.S, M.Ch) Indian Board Certified Plastic Cosmetic Surgeon with International Expertise and qualification (Member of ISAPS- International Society of Aesthetic Plastic Surgeon). Read more..