Ways for Surgeons to Reduce Complications After Breast Augmentation

As with any plasticsurgery, breast augmentation involves some risk of complications although there are many ways to lower the chance or even prevent certain problems.  These are some of the examples:

Reducing Tissue Hardening

This complication, which is also called capsular contracture, is related to bacterial contamination that occurs at the time of breast augmentation surgery.  For this reason, plastic surgeons will make every effort to prevent this from happening.

One of the surgical techniques that prevents capsular contracture is the Keller Funnel in which the doctors use a cone-shaped nylon (where the implants are placed) and then squeeze this so the implants can be inserted into the breast pocket. 

This method can significantly reduce the risk of contamination because the breast implants are introduced into the breast pocket without having to actually touch them.

Meanwhile, some plastic surgeons recommend breast massage after implant surgery because it is believed to prevent the tissue from becoming hard.  However, this should not be performed with teardrop-shaped implants and textured implants.

Reducing Rippling

For patients choosing saline implants, overfilling them can reduce rippling although doing so may void the devices’ warranty.  Another way is to use smooth implants and avoid the textured version, especially the one with “large graininess” which has been attributed to the higher risk of traction wrinkling.

Because women with little amount of breast tissue are at higher risk of visible and palpable rippling, they are generally advised to have silicone breast implants—which are noted for simulating the feel and movement of breast tissue and fat—rather than saline implants.

And to further reduce the risk of rippling, many doctors place the breast implants under the muscle (instead over it) so there will be more coverage especially in the upper half of the breasts.

Reducing Deflation (Only Applicable for Patients with Saline Implants)

Overfilling saline implants, which usually means adding 25cc to 3occ beyond the manufacturer’s recommended amount, can reduce the risk of deflation.  But still, patients who choose this type of implant should keep in mind that natural deflation can still happen due to evaporation and other factors.

According to a study, saline breast implant has a natural deflation rate of 1 percent per year; for this reason, patients with this implant would more likely need revisions sooner than women with silicone implants.

Another advantage of overfilling saline implants is that it can reduce sloshing (which has been said to affect the implant’s stability).

Reducing Nipple Numbness

Reduced or complete loss of sensation in the nipples is one of the most common concerns of breast augmentation patients who are still considering having babies in the future.  This complication happens due to the injury to the nerves at the time of surgery.

To minimize the risk of nipple numbness, plastic surgeons avoid cutting and cauterizing the area nearest the armpit.  Instead, they may gently stretch the tissue apart so there will be enough “breast pocket” for the implants.

By stretching the tissue apart instead of cutting it, there is less risk of nerve damage.  Take note that stretched nerves are less likely to result in permanent numbness in the nipples.

Reducing Downward Displacement of Implants

Downward displacement of the implants, which leads to sagging breasts, is often caused by large, heavy implants.  This problem is more of a concern with saline implants because they are prone to sloshing unlike the silicone version.

It is really hard to tell if someone will experience downward displacement or not because the level of risk is also determined not only by the implant size but also by the breast tissue (flaccid vs firm) and its amount.

In general, women with firmer breasts with a moderate to significant amount of tissue can accommodate larger implants.  By contrast, patients with flaccid breasts are often advised to choose silicone implants filled with 300cc to 350cc to reduce the risk of downward displacement.

Postponing the Need for Revisions

There is no guaranty that breast implants can last a lifetime; for this reason, most patients will likely need revision surgery at some point in their lives.

Teenage patients in particular will need revisions sooner than those who will undergo breast augmentation in their twenties.  Women should remember that breast implants are subjected to the natural wear and tear from daily life’s activities.

According to surveys, most breast augmentation patients wait until they reach their twenties before having the procedure.

Avoiding Less Favorable Cosmetic Outcome

To achieve the most natural result, there is no universal approach because everything depends on the anatomical features (e.g., amount of tissue, chest width, waistline, etc.).  For instance, women who lack breast tissue and fat are generally advised to use silicone implants rather than saline implants.

Women with little breast tissue are not advised to use saline implants because the result is usually breasts that are too round; higher risk of palpable and visible rippling; and unnatural feel.

Also, choosing implants that are too large in relation to the body can result to the “heavy top” look.  Nowadays, the trend is the natural appearance that many plastic surgeons have noticed that more patients are seeking revisions to downsize their breast implants.

Six-Packs Achievable Via Liposuction?

Liposuction is a cosmetic procedure that uses a pen-like device to suction out the unwanted fats which do not respond to rigorous exercise and diet.  But with the advances in plastic surgery, this treatment is also used to create six-packs abs.

Despite countless of hours in the gym, some people will not achieve the much coveted six-packs because of genetic predisposition.  Also the excess fats in the abdominal area tend to be stubborn that no matter how some individuals perform rigorous exercises, the bulges seem not to go away.

Abdominal etching is a special type of liposuction in which the plastic surgeons use a cannula (pen-like device) that is smaller than the one used during the traditional technique.  With this instrument, doctors strategically remove the excess fats to create grooves which in turn results to the appearance of six-packs.

Usually, doctors create several small incisions (about 1-2mm in length) which can heal quickly without causing visible scars in most cases.

Abdominal etching through liposuction surgery is typically conducted under general anesthesia, though some plastic surgeons prefer using “twilight” anesthesia which can sedate the patients but they will still remain awake.  And as a relatively simply procedure, most patients can return just a few hours following their operation.

Of course, the small incision and removal of excess fats can still lead to pain and discomfort which is the most pronounced during the first to second day following liposuction.  To control this symptom, doctors recommend over-the-counter or prescribed pain medications.

To further minimize the pain, plastic surgeons recommend compression garments wrapped around the abdomen.  By wearing them, the skin will also retract and heal closer to the body and the patients can shorten their recovery.

Ideally, compression garments are worn three to six weeks at all time even during sleep (except when bathing), depending on the surgeon’s instruction.

Because of the swelling, the grooves that create the six-packs abs will not be apparent within the first few weeks.  In most cases, it takes about six months before the patients see the muscular appearance.

But as with any cosmetic surgery, abdominal etching through liposuction has its own limitations and disadvantages.  First and foremost, it cannot create a muscular appearance for patients who are 25 pounds heavier than their ideal weight; another consideration to make is that significant weight fluctuations can totally reverse the result.

Since maintaining normal weight is the most important thing after abdominal etching, plastic surgeons consider a patient’s willingness to stick to a healthier way of life—e.g., regular exercise and moderate diet.

What Areas Can Be Treated with Liposuction Surgery?

Liposuction surgery is a body-sculpting procedure in which the excess fats are removed through a hollowed steel tube called cannula.  Meanwhile, this is often used on women who want to treat these body areas:

·         outer and inner thighs

·         buttocks

·         hips

·         waist

·         knees

·         back

·         abdomen

·         breasts

Almost any area with the excess fats can be treated with liposuction although patients should consider that it can only remove the fatty tissues close to the skin.  By contrast, the procedure cannot get rid of the deeper visceral fats (they surround organs in the midsection of the body) that cause weight-related diseases.

In some cases, a procedure will include more than one site, for instance, the back and abdomen all on the same day.  However, most plastic surgeons today limit themselves from collecting 3-4 liters of fats in one session because doing so can increase bleeding and lead to high surgical trauma.

For men, liposuction is often used to treat the body areas stated below:

·         flanks

·         abdomen

·         male breast

The procedure can be very helpful in treating pseudo-gynecomastia, a condition in which the male breasts resemble a female’s because of the excess fats.  In some cases, it is also used to remove fat tumors or lipomas, although it is more commonly applied in cosmetic body countering.

But with the advances in plastic surgery, it has now become possible to perform liposuction to remove the excess fats in the face and neck.  But this should be done carefully because over-liposuction can lead to sagging skin and gaunt appearance—problems that is hard to correct.

Because the face and neck require more precision, these areas have to be treated with cannulas smaller than the ones used when treating the body.  Typically, these hollow pen-like devices have an outside diameter of 2mm or even less, allowing plastic surgeons to enjoy greater control.

Aside from the face and neck, it is also ideal to treat body areas with fibrous fats (such as the male breast) with micro-cannula which can easily pierce through the fatty tissues.  And with this device, there would be less effort in moving it back and forth, much to the convenience of doctors.

Regardless of the treated area, the removed fats will not appear again—unless the patients will gain a significant amount of weight (10 lbs. or more).  For this reason, regular exercise and healthy diet are an important part of maintenance following liposuction surgery.

Is Skin Elasticity Important with Liposuction?

In general, younger patients achieve a better skin appearance than older people after a liposuction surgery because their tissue is more elastic, allowing it to retract after the fatty tissues are removed.  Nevertheless, the age per se is really not the factor that affects the final outcome of the procedure.

Aside from older patients, those who had experienced significant weight gain often have poor skin quality; this is not surprising as their tissue has been stretched to its limit.  These people usually have visible stretch marks which come in purplish, whitish, or reddish color.

Stretch marks are a clear indication of poor skin quality; for this reason, massive weight loss patients will not achieve the same result enjoyed by people who have maintained normal weight throughout their lives.

However, it does not mean that massive weight loss patients cannot have liposuction surgery.  In fact, it is often used as a complementary procedure to thigh lift, arm lift, lower body lift, and extensive tummytuck, allowing plastic surgeons to perform “debulking” to help their patients achieve a more natural body contour.

Patients with poor skin quality may develop some wrinkling particularly in the upper abdomen and inner thighs.  The “crepe” appearance somewhat resembles the skin of a patient who has lost the excess fats through exercise and healthy diet.

But surprisingly, the lower abdomen is not prone to wrinkling after liposuction.  This is probably due to the structure of the tissue that allows the area to easily retract after the fats have been removed.

Meanwhile, there are some plastic surgery ads that promise to remove cellulites through liposuction.  Patients should bear mind that these are just a media hype; in fact, the procedure is known to aggravate the problem, even with the use of laser liposuction.

While laser liposuction—which uses heat to destroy and liquefy the fats to pave way for their easier extraction—can cause the skin to slightly retract, it cannot totally repair cellulites which commonly occurs in the legs and buttocks.

Fortunately, certain procedures can address cellulites, in case that they appear after liposuction.  The most popular one is the Mesotherapy, which is an effective procedure as long as the patients will complete their 10 to 25 sessions.

While skin irregularities are really a concern particularly with those with poor skin quality, plastic surgeons have found ways to reduce their risk.  One of the techniques includes the use of micro-cannulas instead of large suctioning probes.

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Life After Liposuction Surgery

While liposuction surgery aims to remove the excess fats underneath the skin, it should never be seen as promising substitute to weight loss.  In fact, a good plastic surgeon would not perform the procedure if a patient is not willing to stick to a healthy lifestyle which include moderate diet and regular exercise.

In a 2004 study, researchers found that liposuction patients are three times more likely to gain weight if they would not follow a healthy diet; they are also four times more susceptible to weight fluctuation than average individuals if they fail to exercise regularly. 

However, the good news is that the result of liposuction can last a lifetime as long as the patients will live a healthy lifestyle.  In fact, the study has suggested that patients who follow a moderate diet are twice more likely to lose weight than average people.

The finding clearly shows what many plastic surgeons have always been telling their patients: liposuction is a not a quick fix for weight loss.  To put it safely, this cosmetic surgery should only be seen as an adjunct to healthy diet and regular exercise.

The study, which involved 209 patients who had liposuction between 1999 and 2003, has focused on the respondents’ lifestyle habits, satisfaction with the final result, and treated areas.  Meanwhile, most of them had the procedure more than two years before the survey.

About 43 percent of the respondents reported gaining weight after liposuction, with most of them experiencing weight gain between 5 and 10 pounds.  Majority of these patients or 90 percent of them did not stick to regular exercise.

About 78 percent of the respondents who gained weight were also found to have unhealthy diet.

By contrast, about 57 percent who did not gain weight said they increased their exercise duration while 50 percent said they were eating a healthier diet after their liposuction surgery.

Liposuction is a cosmetic procedure that falls under the category of body contouring; this simply means that overweight and obese patients, and people who are experiencing weight fluctuations cannot enjoy its benefits.  In fact, repeating lipo in the same area is not generally recommended because it can lead to higher risk of skin irregularities, sagging, and other aesthetic problems.

Liposuction is primarily intended to reshape the body areas which do not respond to diet and exercise.  These “problematic areas” are usually the abdomen, flanks, hips, male breasts, upper arms, and thighs.

Brazilian Butt Lift with Fat Grafting on Hips

During the previous years, the only way to augment the buttocks was to use a solid silicone implant, which does not pose risk of leak unlike the one used in   .

But after plastic surgeons have found ways to increase the survival rate of the grafted fats, using these tissues to augment the buttocks has become possible.  The procedure, which is called the Brazilian butt lift, is increasingly becoming popular in the US and other parts of the world.

However, many women with small, deflated-looking buttocks also have narrow hips which look disproportional to the body especially for those with a wide chest or large breasts.  For these patients, targeting only the derriere and leaving the hip untreated may not provide the best result.

It is important to note that injecting fats to the narrow hips and small buttocks will likely result to the much coveted figure in a woman—the hourglass.  But unfortunately, treating these two areas with fat grafting may be challenging or sometimes even impossible due to the limited amount of excess fats.

During a fat grafting procedure, plastic surgeons conduct a liposuction surgery to remove the fatty deposits from the donor site—it can be the abdomen, thighs, flanks, hips, upper arms, and other areas abundant with these tissues.  

But after liposuction, the collected fats are not immediately injected to the body as doing so can result to temporary result as they are just reabsorbed by the surrounding tissue.  To prevent this from happening, these are subjected to a purification method that separates the blood, connective tissue, and other impurities from the fatty cells.

However, a 500cc of liposuctioned fats can only provide about 60cc to 50cc of purified fats, making it challenging to augment both the hips and buttocks at the same time.

Nonetheless, the amount of excess fats from the body can still determine the possibility of treating both the hips and buttocks.  This approach is achievable for patients with a large abdominal area and narrow hips that almost result to a “barrel-shaped” figure.

While injecting fats to the narrow hips is not a well-prescribed procedure, a handful of plastic surgeons have successfully performed this on their patients.

To treat female patients with a “barrel-shaped” figure, cosmetic surgeons liposuction the abdominal area to remove the fats.  The procedure alone can significantly define the waistline and make the hips appear less narrow.

The collected fats, which are purified to increase their survival rate to at least 65 percent, are injected to the buttocks; any leftover fat is then introduced into the narrow hips to make it wider and appear proportional to the body.

Liposuction for Slimmer Legs

Title: Liposuction for Slimmer Legs

Keywords: liposuction surgery, plastic surgeons, tumescent liposuction

Almost any area of the body that has excess fats can be treated with liposuction surgery, which is traditionally performed by making 1-2mm incisions where a suction device or cannula is inserted to eliminate the fatty deposits.  And for women, this procedure is commonly performed to treat their thighs.

While liposuction’s primary goal is to remove the “unwanted” fats, it is never a replacement for weight loss surgery and healthy lifestyle.  In fact, one of the utmost requirements is to be in normal weight or at least not more than 25 lbs. overweight.

Liposuction in the legs is almost an exclusive procedure for female patients as its aim is to make them slender, a feature which is not appealing for a male body.  Meanwhile, it is important to note that the surgery is not about removing all the fats in the area but to improve its appearance; for this reason, doctors leave some fatty tissues to make the thighs look shapely and natural.

And by leaving some fats in the legs, plastic surgeons can avoid or at least minimize the risk of skin irregularities which are often caused by over-liposuction.

Compared to other areas of the body, the legs are easier to liposuction because these are mainly composed of superficial fats with no deep compartments.  However, experienced cosmetic surgeons do not treat the area behind the knee because they might injure some crucial nerves and blood vessels.

Legs are often treated using tumescent liposuction, which is the standard technique nowadays due to its notable safety.  In this approach, doctors inject the area with a solution made of saline, lidocaine (local anesthesia), and epinephrine which is a blood-vessel constricting drug that prevents excessive bleeding and prolongs the numbing effect of the local anesthesia.

Once the tumescent solution reaches the fats, doctors insert a suction device inside a few small incisions.  Using a back and forth movement, they dislodge and remove the excess fatty tissues in the legs.

The small incisions are left open after surgery to allow the anesthetic and excess body fluids to drain out, resulting to less swelling and faster recovery.  Also with this technique, patients can see the result just a few days after their treatment; this is not the case during the previous decades when people have to wait for several weeks or even six months because of the excessive swelling.

While liposuction today is considerably safer compared to earlier techniques, this is only true if the surgery is conducted by a board-certified plastic surgeon.