Liposuction refers to evacuation of the accumulated fat in one area of the body through narrow pipes which are inserted under the skin via a few millimeters incisions. Fat is discharged by infusion of ready to use solutions. Although most of our physical appearance is related to inheritance and many aspects in our appearance such as eye color, height, and hair are beyond our control, many things like weight can be controlled to a great extent. Therefore, healthy diet and exercise seem reasonable, and people who think correctly about their appearance, reasonably follow their regimes. However sometimes, despite all our efforts, localized resistant fat deposits which are usually hereditary remain and do not eliminate by diet and exercise; therefore, do not blame yourself for their existence. If applied properly, liposuction can help make you fit. Liposuction is not a tool for weight loss, rather it helps to make you fit.

Frequently Asked Questions

  • Subcutaneous liposuction refers to removal of local unwanted snob fat using metal tubes like thin straws that are called “cannula”. These localized fat deposits can occur anywhere on the body of men and women, but they are usually formed in the abdomen, buttocks, flanks, inner and outer thighs, knees, and chin.
  • Localized enlargement of fat can be observed in the chest of men. In this operation, the preparation solution is injected at the site of fat accumulation, then the cannulas are inserted within the body fat through small incisions. Subsequently vacuum is applied via a plastic tube attached to the cannula and the fat is removed from the body. Fat extraction is not an alternative to weight loss and exercise, rather it is an esthetic method to make the body thinner and leaner by removing fat which cannot be eliminated with hard and continuing work. This is currently the only method available for removal of fat cells from specific areas of the body.

  • Although liposuction is a relatively new form of cosmetic surgery, it has become the most common cosmetic surgery. Liposuction is invented by doctor Giorgio Fesher in 1974 in Italy. The method was practiced by the French plastic surgeon named doctor Illus in 1978 in Paris after which it becomes a conventional method. The method is then get better and better. For example, smaller and finer cannulas and tumescent liposuction were developed and new techniques such as ultrasonic and power-assisted liposuctions were used.

  • Only consultation will determine that whether you are an acceptable candidate for liposuction or not. Pre-operative consultation follows important goals. A complete medical history, tests, and physical examination are performed to find out your health status.
  • If you smoke, you are asked to quit smoking. Smoking constricts blood vessels and hence reduces blood flow and weakens wound healing. Aspirin, certain anti-inflammatory drugs, and other drugs can increase bleeding, therefore they should be avoided.
  • Determining whether you can do it or not greatly depends on the quality of your skin. In most cases, the skin is a dynamic organ and can shrink and adapt itself with the body new form after surgery.
  • In some patients, the skin elasticity may decrease due to loosening, sagging, or wrinkles of the skin in the operation area. In these cases, liposuction will not have desired results, therefore, you may need to remove a part of the skin along with liposuction.
  • Healthy and active people with an average weight who are about 12 to 15% heavier than the ideal weight and have a good skin stiffness and elasticity are the best candidates for the operation. Age in itself is not an important factor, and in fact, patients between 16 and 65 years can undergo the operation. You should also know that liposuction cannot improve cellulitis. 

  • The most important reform in liposuction in recent decades is probably the tumescent techniques which is devised by Doctor Klein in the United States.
  • This technique involves injecting a relatively large volume of saline solution containing a diluted local anesthetic substance and adrenaline into fat tissue. Thus it creates a safe pillow shape area in which the cannulas can be inserted. Above all, these elements can help dissolving the bonds between fat cells and facilitating their removal and extraction.
  • The presence of adrenaline decreases bleeding from blood vessels, and this allows us to remove greater amounts of fat more securely. In addition, it produces less bleeding and less bruising. Infiltration of large volumes of diluted anesthetics also makes possible the operation being performed under local anesthesia without sedation or analgesics and general anesthesia.

  • Ultrasonic liposuction is a recently registered and used equipment. It is undergone rapid changes reported even every month and some are good news and unfortunately some are not. Ultrasound means long range sound which creates movement and loosening of everything that they shake, such as new ultrasonic toothbrushes. The principle of ultrasonic is to loosen fat for faster removal from the body than other methods. Unfortunately, due to the high frequency, the ultrasonic cannulas are very hot and there are many reports of patients burning. There are reports on perforation of kidneys and gall bladder by ultrasonic cannulas even if carried out by experienced people.
  • In addition, more “seruma” is made in ultrasonic liposuction than other methods.
  • “Seruma” is a collection of fluids produced in tissues in response to injury. Finally, ultrasonic cannulas which are available now are bulky and cumbersome and this method cannot be done as an option. However, as a positive aspect, it was reported that the procedure can have better results in the removal of fatty areas like the breast tissue of men (gynecomastia) that have high rigidity.
  • According to other reports, this approach is safe and has less risk for the removal of large quantities of fat since there is less bleeding. Finally, the number of comparative cases and more than three years tracking are low in this operation. Therefore, no long and good comparison has been done with almost acceptable and patented liposuction methods. For those noted above including side effects and uncertainties, although doctor Manafi is trained to use this equipment, he recommends this method in specific and limited cases.

  • Power-assisted lipoplasty is a new technique introduced about 6 years ago which use an electric handle. It has the advantages of liposuction without its complications. As a result, we recommend this method.
  • Cannulas used in this technique for removal of fat are the most common type. Difference in electric handle results in mechanical action of the cannula rather than manual movement. This results in a vibration frequency of about 100 times per second, and this frequency and the generated heat is less than the ultrasound device making its insertion into the fatty tissue easier. In this regard, the surgeon can focus on removing of fat in the area and performing his job confidently and effectively, rather than manually moving the cannula back and forth performed in other methods. This method can have great benefits in all areas of the body. Power-assisted liposuction is especially helpful to remove fats is the breast area in men.
  • Although electric handle is a new interesting and promising discovery, its safe results in the future will ultimately show that whether it is an acceptable standard device or not.

  • A classic liposuction procedure using the inflation technique is described here. At first, a few number of fine incisions (about 3 to 4 mm) are made on the skin where the operation will be done. These incisions are created in areas which cannot be seen as far as possible. The already mentioned swelling solution is injected to these areas and is then allowed to penetrate the area and affect the fat (12-15 minutes). The area will be anesthetized and the blood capillaries are temporarily closed to reduce bleeding. Then suitable cannulas are inserted into the fat tissue and moved back and forth resulting in loosening of fat which is extracted by a powerful vacuum pump.
  • In this regard, the power-assisted lipoplasty method differs from the conventional methods. Back and forth movements mentioned earlier are softer and quieter due to propulsion mechanism of the electric device. Since fat is removed through suction from small “tunnels” created in the fat tissue, the remained skin is completely attached to the underlying muscles by several fibrous septa. This ensures that the skin will not loosen and sag after liposuction. Fat removal has little destructive effect on the septa which contains blood vessels, nerves, and lymph vessels. To remove the fat without much damage, it is necessary to have enough information about anatomy, dimensions, and size of the body as well as resistance against surgery.
  • Throughout this process, doctor Manafi removes deep soft fat layers attached to the skin with alertness and full information to minimize the possibility of any kind of skin folds. Also, since you lose some liquids of your body along with fat during liposuction, the anesthesiologist replaces the fluid through intravenous infusion of liquids during this process.

  • Liposuction can be successfully performed with only local anesthesia, local anesthesia with mild sleep, or general anesthesia. If you decide to undergo the operation with local anesthesia, you will feel vibration and friction during the process. You may occasionally feel the cannulas moving towards muscles. You will feel nothing if you are deeply asleep. The decision depends on the number of areas in which the operation will be done, the amount of fat that should be removed, consumption of any drug, specific and unique conditions of the individual, and the patient’s own wishes.
  • Such decisions are better to make after thorough consultation and talk with a skilled plastic surgeon.

  • The operation time depends on the number of areas on which the operation is done and the amount of fat that should be removed, and may take from 30 minutes to 3 hours.

  • This greatly depends on the number of areas treated and the amount of fat that should be removed. It also depends on preference and conditions of the patient. Some people prefer to be discharged the same day and be improved at home and others like to stay in the hospital the first night after surgery for further assurance. If the treating areas are small and the fat removed is less than 1.5 liters, the operation day is easily passed. But when the amount of fat was higher than this amount, it is preferable to stay one night in the hospital. The decision in this case will be taken during the consultation or after the surgery.

  • It is important to know that the amount of fat which can be extracted with maximum safety during the operation from a person is limited. This amount is usually 2 to 3 liters, but may sometimes reach to 5-8 liters. Thus if you decide to repeat the operation, there should be usually an interval of at least three months between the two procedures.

  • The answer is “very little”. In fact, in the first few weeks of surgery, you may found a small amount of weight gain which is related to water retention by the body. The reason for little weight loss is that removing 2.5 or 3 liters of fat is not associated with much weight loss. This is because fat cells are light. On the other hand, depending on the area treated, you will notice a significant reduction in peripheral sizes (size reduction).

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Doctor Manafi’s office hours: 16:30 to 20:30 on even days