Liposuction

The author of the article: Dr. Orel Govrin and Dr. Jacky Govrin

Ideal Liposuction PatientMethodPreoperative PreparationsAnesthesiaInstrumentsLiposuction SurgerySide EffectsSummary

Wide and well-padded hips were once admired as one of the distinguishing characteristics of a beautiful woman. This is reflected quite prominently in the works of various Renaissance artists. Nowadays, the appearance of ‘abundance’ has made way for skinny and fit, with people going to great lengths to achieve this look through diet, exercise and even liposuction from various areas of the body: stomach, thighs, etc.

It is important to note that there is a significant difference between liposuction and losing weight through diet. When dieting, the body uses fat molecules stored in fat cells for energy, but while these cells become smaller they are still there. If such time comes and the person gains weight once again, these cells will fill up with fat, resulting in a chubby appearance in the same area.

In liposuction, unlike dieting, the fat cells themselves are also suctioned out in addition to the fat molecules. Since fat cells do not multiply, once they are removed during liposuction they will not return to the same area, and therefore even if the patient gains weight the fat will not find its way to the surgical site, from which most fat cells have been removed, but rather it will disperse more symmetrically across the body.

Liposuction is not a weight loss treatment for the obese, and it does not prevent weight gain from overeating. However, in case the patient does gain weight, the fat will not build up in problematic areas as it will disperse evenly across different areas of the body.

Liposuction combined with RENUVION technology - before and after photos

Before After

All before and after photos

Ideal Liposuction Patient

The ideal patient for liposuction is thin, with local buildup of fat (in the neck, stomach, buttocks, hips, knees and ankles). Generally, the less fat removed and the more elastic the skin, the better the result.

In cases where a lot of fat is removed and the skin is not elastic, liposuction must be combined with a skin tuck to make the skin look smooth and tight.

Method

Surgeons such as Teimourian, Kesselring, Schrudde and others have made attempts to surgically remove fat from various areas of the body, but the man who developed the method that eventually made the idea possible was Dr. Illouz, a Jewish plastic surgeon from Paris. In many women, various body parts, especially the hips, buttocks, and thighs, have a disposition to store fat.
As Dr. Illouz puts it, most of these women suffer from ‘violin deformity’, a term that describes a sort of body shape where the upper body is narrow and the lower body, from the hips down, is wide and fat. Repeated attempts by these women to lose weight usually end in disappointment when they lose weight from their upper body and their lower body remains unchanged.
The exact reason this happens is unclear, but it is thought to be a result of hormonal regulation by catecholamines and insulin in the metabolism of fat in these areas.

Liposuction is thought to be a procedure for overweight people, but herein lies the paradox – it is actually a procedure for thin people.

Dr. Illouz’s liposuction method does not work for overweight people who have excess fat stores around their entire body, but it is ideal for people who have concentrated fat stores in a certain area – neck, stomach, buttocks, hips, knees and ankles.

The main benefit of this method is that it can remove the fat storing cells in these areas directly, resulting in a more symmetrical and even appearance of the body, without any long and unattractive scars associated with obsolete fat removal procedures.

Preoperative Preparations

As with any surgery, the patient will undergo a series of tests to verify their health.
When a large amount of fat is to be removed, units of blood are also needed, often taken from the patient themselves (autologous donation).

Exact information about which tests you need to undergo before the procedure and whether you will require units of blood will be given to you during the consultation.

Before surgery, fashion a compression garment made of elastic material and wear it for a month around the intended surgical site.
For maximum comfort, make sure it has a zipper so that it is easier to remove.

Anesthesia

Anesthesia during liposuction surgery may be either local, regional or general.

Local anesthesia is possible when small amounts of fat are removed, such as from the neck.
When dealing with liposuction from the hips down, regional or general anesthesia is preferred as it results in a painless procedure and significantly less pain during the first few hours after surgery.

Instruments

Liposuction instrumentation comprises a strong pump and several thin tubes.
The tubes are inserted through a narrow incision, measuring only a few millimeters, into the intended area under the skin and when connected to a strong pump it is possible to then suction out the fat from that area.

Liposuction Surgery

Before the surgery, the surgeon will mark the areas to be treated.
Liposuction takes between half an hour to an hour to complete.
During surgery, fat cells are removed along with their contents.
After the surgery, the patient wears a compression garment that applies slight but consistent pressure to the surgical site, to prevent excess swelling of the area and allow the skin to better compress. The sutures dissolve over time.

Side Effects

The most common side effects following liposuction are pain, swelling and bruising during the early stages, followed by loose skin, skin irregularities and asymmetry during later stages.

Pain – The surgical site will be tender and painful during the first few days after surgery, but these symptoms subside significantly each passing day and are completely gone by the time one week has passed since the procedure.
There is significantly less pain when using regional anesthesia.
In any case, pain can be relieved using any over-the-counter analgesics.
Swelling – This happens immediately after surgery.
The patient might feel more bloated than before the surgery.
The swelling associated with liposuction is caused by excess fluid trapped in the surgical site (edema).
The swelling gradually subsides on its own and in most cases completely subsides 4 – 6 weeks after surgery.
Only then can the results of the procedure be observed. Note that changes in the appearance of the surgical area occur for up to 6 months after surgery.
Over this time, any residual swelling subsides, and the surgical site continues to compress.
Bruising – Usually appears around the surgical site after the surgery and subsides within two weeks.
Loose Skin – This can happen whenever the skin is not elastic enough and therefore does not compress after surgery.
It is more common in women over the age of 35 – 40, whose skin was already a bit loose before the procedure, though it can be mitigated by removing limited amounts of fat from the intended areas.
Skin Irregularities – Small lumps or dimples in the skin are what is known as cellulite.
This is usually present before the procedure and it does not just disappear after surgery. However, new lumps or dimples may appear after the procedure.
Asymmetry – Certain asymmetry between body parts is only natural, but it may appear or become exacerbated following surgery.

Summary

Liposuction is a very popular and successful procedure in Israel and around the world.
Thousands of liposuctions are performed each year, to great satisfaction.
Liposuction makes it possible to remove excess fat from specific areas of the body, which could not otherwise be removed through regular diet or exercise. Liposuction may be performed in addition to other procedures, such as facelifts or neck lifts, or more complex surgeries, such as an abdominoplasty.

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Dr. Jacky Govrin

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A specialist plastic surgeon, one of the most senior and prominent plastic surgery specialists in Israel.
Dr. Govrin is a graduate of the Technion Medical School in Haifa, completed his residency at Rambam Hospital and trained at leading medical centers in Europe and the USA.

Dr. Orel Govrin

Expert plastic surgeon

A specialist plastic surgeon and groundbreaking researcher, a second generation of excellence in plastic surgery.
Dr. Govrin, a summa cum laude graduate of the Faculty of Medicine at Bar-Ilan University, specialized in the Department of Aesthetic and Reconstructive Plastic Surgery at Ichilov Medical Center, Tel Aviv.