What You Should Know About:

MICROCANNULAR LIPOSUCTION AND LIPOSCULPTURE

• Diet, exercise, weight loss and careful selection of clothing can only do so much to improve your appearance. If you have tried these methods, and are not satisfied with the way you look, you may benefit form liposuction also known as the "art of body contouring."

• This surgical procedure can give you an improved body contour with relatively little scarring. Liposuction has been performed in the Untied States since 1981, and now one of the most common aesthetic procedures performed. However, as with any cosmetic surgery, it is important to have clear objectives, realistic expectations as well as to realize that there are risks as well as benefits.
What is it? Liposuction is a surgical technique used to improve body contour by removing excess fat using thin metal tubes connected to a suction. Because very small incisions are made for these "micro-cannulas," there are no conspicuous scars. It will not cure obesity, but it will reduce excessively fatty areas that stubbornly remain despite dieting and exercising. Because of these very small cannulas, these areas can be sculpted.

What is tumescent anesthesia? This is a technique developed by a dermatologist named Jeffrey Klein in which we can safely use dilute lidocaine (numbing medication) so that the surgical site bulges. This permits safe liposuction with very little blood loss. While the patient is comfortable and awake because of this technique, we may give you a medication to further relax you.
What is liposuction used for? In addition to unwanted fatty deposits, liposuction is also used to treat many non-cosmetic fat accumulations such as lipomas (benign fatty tumors) and gynecomastia (fatty male breasts).

Where is it done on the body? It can be performed in most places where there is excess fatty deposits. Common areas include, the face, neck, chest, abdomen waist ("love handles"), upper hips, buttocks, outer thighs, knees, and ankles.

Am I a good candidate for this procedure? During your consultation, your doctor will discuss with you those factors that influence the outcome of liposuction. Generally, the best candidates are:

• In good health, and have good skin tone

• Have distinct areas of localized fat bulges that are disproportionate to the rest of their bodies.

• Have tried to eliminate bulges through diet and exercise.

• Have realistic expectations about results.

• Understand that liposuction is not a cure for obesity or a substitute for weight loss.

• Want to have liposuction for herself or himself, not to please someone else.

• Don’t expect liposuction to dramatically change their personal or professional lives.

• Understand that after their recovery, living an active lifestyle with exercise and proper nutrition will most effectively maintain their improved body contour.

What is the post-procedure period-like? Patients are usually up and walking immediately following the procedure. However, we recommend that you rest after the procedure. Patients are usually able to return to normal activities within a week, but we discourage vigorous activities for several weeks. For the first day or two, you will experience oozing of pinkish tinged fluid from the cannula sites—this is normal. You will also have some swelling and bruising, and mild discomfort. Complications are rare, however, infection, bleeding, numbness, discoloration and uneven skin surface can occur. Complications can be minimized by following the post operative instructions.

PRE-OPERATIVE INSTRUCTIONS
• Please don’t take any aspirin or aspirin containing products for at 2 weeks before the procedure.

• Please don’t take Vitamin E or C or Ginkgo Biloba for 2 weeks before the procedure.

• Please don’t take Alleve/Ibuprofen/Naproxen/Vioxx/Celebrex/Advil or any other anti-inflammatory for at least one week before the procedure.

• Please don’t drink alcohol the night before the procedure.

• Please eat a light breakfast the morning of the procedure.

• Arrange to have someone drive you home following the procedure as large amounts of anesthesia may cause drowsiness. It is suggested that you have someone else stay with you after surgery, although this is not strictly necessary.

• Wear old, comfortable clothing to the office on the day of surgery. The drainage may stain your clothing. Because we will apply elastic support garments on top of some bulky, absorbent gauze padding, your clothing should be loose and comfortable.

• Women-wear a comfortable bra that you would not mind getting stained from the drainage, and the black ink that is used to mark the areas. Men-wear jockey type underwear or "Speedo" type swim trunks, it is not comfortable or convenient to wear boxer type underwear.

• Bring in a towel or plastic sheet upon which to sit on in the car while being driven home in order to prevent any drainage from staining a car seat. Towels and plastic sheets are also useful for protecting your bed and chairs.

• Please wear minimal amounts of cosmetics, body moisturizers, perfume and no unnecessary jewelry. Wedding rings are acceptable.

• Bring warm socks to prevent cold toes during surgery. If you tend to get cold hands, you are welcome to bring mittens. If you have nay favorite music that you would like to hear, you are welcome to bring CD’s.

WHAT TO EXPECT THE DAY OF SURGERY
• Upon arriving in our office, you will be greeted and escorted to the operating room. You will then change into a surgical gown, and asked to review, and sign your consent form. Pre-operative photographs and measurements will be taken of the areas that will be treated on your body. Dr. Gladstone and the nursing staff will then mark these areas with a felt tipped pen. This is a wonderful opportunity to emphasize the exact body areas that you want to reduce.

• You will then be asked to lie on the surgical table, and a blood pressure cuff will be placed on your arm and a pulse oximetry probe will be placed on the middle finger of your left hand.

• Next, using extremely thin and short needles, we will anesthetize the subcutaneous fat. The actual injection of the anesthetic solution is almost painless. Patients usually experience a slight prickling sensation under the skin as the area becomes anesthetized. Once the area has been well infiltrated with a large volume of dilute anesthetic solution, a period of time (approximately 20-30 minutes) is necessary for the areas to be completely numb. Dr. Gladstone will then begin removing fat by liposuction.

• Following completion of the procedure, the nurses will gently squeeze around the injection sites to remove as much fluid as possible. They will then place absorbable pads on each incision site. The incision sites are small enough that they don’t require suturing. In addition, by keeping them open, the anesthetic fluid is allowed to drain which will reduce swelling, bruising and discomfort. A compression garment will then be fitted over the treated areas to allow continuous support. You will then be given your post-operative instructions.

POST-PROCEDURE CARE
• The tumescent technique minimizes post-operative discomfort. The residual local anesthesia lasts for approximately 18 hours following the procedure.

• Tylenol Extra Strength is usually sufficient to treat any postoperative soreness.

• You should expect a large volume of blood-tinged drainage for the first two days after your procedure.

• When most of the drainage has stopped, you may replace the original thick dressings with thin gauze. When a site has stopped draining for 24 hours or more, you may stop placing gauze over that drain site.

• You may place icebags over your compression garments, but not directly on the skin to help reduce the swelling.

• While you should shower at least once per day, please do not use a bath tub, jacuzzi or go into the ocean for at least 7 days following the procedure.

• You should wear your compressive garments continuously (though you may need to wash them) for 48 hours after all of your drainage has stopped. After this period, you may continue to wear them when you can in order to minimize discomfort.

• For the first 24 hours following surgery, you should take it easy. You may return to work 2 days following surgery (though you may still be draining and mildly uncomfortable). Though you should walk around beginning the day after surgery, you shouldn’t resume exercising until 3 days following surgery.

• Pleas remember to take your antibiotic medication.

• Should you have foul smelling discharge, fever, dramatically increasing pain, increased swelling and redness, pleas call our office immediately.

• Your first follow-up appointment will be 7 days following the procedure.

Please call our clinic at 650.723.6316, and ask for your surgeon. For after hours, please page your surgeon through the hospital operator.