ABOUT KNEES LIPOSCULPTURE
A small pad of fatty tissue is often present on the inside of the knee, slightly above where the bone of the knee joint protrudes, though there may be other fatty deposits as well. Liposculpture can remove this bulge, so that the knee now is defined by the bone, rather than the fatty pad above it. It is common to perform knee liposculpture at the same time as outer and inner thigh liposculpture for a well balanced procedure or with calves and ankles. This can help make the leg look slimmer and straighter.
Liposculpture is a major refinement in the technique of liposuction. Liposculpture is performed under local anaesthetic which makes it is much easier to achieve a regular, more even result to the areas treated. This is because it is possible to stand up and allow the effect of gravity to be seen on the areas treated towards the end of the procedure. This enables a much more predictable and pleasing result to be achieved.
Second, as no general anaesthetic is needed for liposculpture as opposed to a liposuction procedure, the inherent risks associated with a general anaesthetic are avoided.
Third, liposculpture involves the injection of fluid into the fatty tissues before the procedure is performed. This fluid contains the local anaesthetic (lignocaine) and also a medication which effectively constricts blood vessels (adrenaline). Adrenaline vastly decreases the amount of bruising that occurs with liposculpture while the local anaesthetic produces effective relief of any discomfort during the procedure and for up to 12 hours afterwards (sometimes longer).
Fourth, liposculpture is performed out of hospital. It is day surgery. There is no need for the person having liposculpture to stay overnight in hospital, have blood transfusions or even fluid intravenously. It is a day only procedure, and you are encouraged to remain active following the procedure, walking on the same day or soon after, and often returning to work after a few days. Time off work and normal activities is kept to a minimum. People often think they need to take holidays to have liposculpture. This is not true, one or two days off is all that is required in most cases.
Liposculpture takes time to achieve the best results. The average procedure lasts 4-6 hours, especially when multiple areas are treated. Smaller areas may only take up to 2 hours to do. In contrast, liposuction performed under general anaesthesia must be done in a shorter time as longer anaesthetic time increases anaesthetic risks. People who have had both procedures say how well they feel after liposculpture compared to traditional liposuction under general anaesthesia. The recovery period is shorter with much less bruising and there is minimal discomfort. Now liposculpture is performed by many doctors from many specialties. At our clinic, Dr Heckenberg is specially trained in liposculpture, is dedicated and will take the necessary time to get the right result for each person. Concentrating on only liposculpture, optimal results are achieved by surgeons who do the same procedure often. That goes for any surgical speciality. Allowing enough time, using microcannulas, having passion and patience is the recipe for the best results.
A landmark article in the prestigious Dermatographic Surgery journal looked at the results of over 15,000 cases of liposculpture performed in America in 1994 and 1995. Complications during the procedure were few, as were problems following the procedure, and the level of complications was much less than for conventional liposuction surgery. Bruising is minimal, but does occur in most cases. It lasts for 10 to 14 days. Infections theoretically can occur, but are fortunately extremely rare and antibiotics are given before and after the procedure. Local areas of numbness can occur in the areas treated, although these usually resolve within a few weeks of treatment, but may take a few months to get completely back to normal.
This is a very broad question. Many people will benefit from liposculpture, and a wide spectrum of Australians are interested in the technique. The number of people having this procedure performed in the USA is increasing dramatically and has increased 5-fold in the past six years to the point that is by far the most commonly performed cosmetic procedure. Australia has now overtaken USA. It has been seen on television and in the printed media, although it is only now that the benefits of liposculpture using the new tumescent technique are being understood by the general public.
Some common examples of people who can be helped by the technique are:
- Women who have had children and are concerned by the unwanted accumulations of fat that childbearing has brought – saddlebags, full thighs, hips, a ‘pot-belly’ and accumulations of fat in other areas, often resistant to the most rigorous gym workouts and exercise regimes.
- Men who have developed love handles above the hips or accumulations of abdominal fat, not necessarily related to lack of exercise, but often due to natural decline in the production of growth hormone, which occurs with age. You may be able to blame your genes for many of these deposits as the tendency to deposit fat in some areas is genetically pre-determined too.
- Women and men who want to have the streamlined appearance and have the best shape that they possibly can. For such people the permanent removal of even small amounts of fat from localised areas can make a good figure dramatically better.
- People who have been significantly overweight, have lost weight and are now near their goal, but still have problems with local accumulations that will not budge despite diet and exercise.
- Men who have unwanted accumulations of fat and breast tissue over the breasts as a result of hereditary or other factors.
The skin is a remarkable organ. An article published in Dermatologic Surgery confirms what liposculpture surgeons already know, there are few problems with looseness of the skin after liposculpture procedures, even in people at the age of 40 or beyond. This is due to contraction of the skin as a result of the liposculpture procedure itself. An experienced liposculpture surgeon can produce skin retraction that would have been thought impossible by conventional surgeons more than a decade or two ago. Skin contracts in all areas treated by liposculpture and excision of any skin at all is very rarely necessary.
Preparation for liposculpture is remarkably straight-forward. After an initial consultation, some blood tests are ordered to ensure that there is no problem such as anaemia or blood clotting problems. It is important that aspirin and anti-inflammatory medications (Nurofen, Feldene, Voltaren etc.) not be taken for two weeks before the procedure. They decrease the effect of platelets in the blood and can increase the amount of bruising and chances of bleeding. An antibactrerial soap is used for two days prior to the procedure. Antibiotic tablets are started the night before the procedure to minimise any chance of infection. After the procedure, a garment is worn over areas treated for one to two weeks (sometimes longer). This is quite a light, comfortable garment and easy to wear under normal clothes, so no-one should be able to notice.
After the saline anaesthetic solution is introduced into the tissues through small holes in the skin, and the local anaesthetic drug plus the blood-vessel-constricting effect of the adrenaline has had enough time to work, small tubes or cannulas are introduced into the fatty layers (the layers between the skin and the muscle). Suction is applied to the cannulas while they are gently moved through the tissues and the unwanted fat is removed in a progressive fashion until the desired result is achieved. Most cannulas used are 2mm to 3mm in diameter, and are substantially narrower than the cannulas used in conventional liposuction. It may take longer to get the fat out using the narrower cannulas, but the results are smoother. The back and forth movement of the blunt cannulas is required to strip the soft-liquid-like fat cell away from its connective tissue. The suction merely takes the fat cell away from its site of disruption. This is why the procedure can take quite a few hours to do. It is not like a vacuum cleaner. A fat cell is a living cell and needs to be taken away from its blood supply and connective tissue to come out. A light sedative injection is given at the start of the procedure and this makes you feel very relaxed and time appears to go very quickly, so although procedures may take 4-6 hours, it doesn’t seem that long.
Liposculpture may be used to help people who are overweight to reduce localised problems over the abdomen and other areas. This may help with the way that overweight people dress and make them feel better about their bodies or put them into better proportions. Many such people describe the liposculpture as a ‘kick start’ and go on to continue to lose weight, especially when these central abdominal fat cells are removed. But it is important to note that liposculpture is not designed as a weight loss tool. It is purely a body sculpting tool, hence the terminology of liposculpture rather than liposuction. For overall weight loss for obesity, procedures such as gastric sleeve, gastric banding, or gastric bypass may be more appropriate.
As the cannulas used in this technique are very small, the incisions used can often be concealed in the natural creases of the body. The holes in the skin are not sutured after the procedure and heal to a fine skin-coloured line approximately 3-5mm in length within a few months of the procedure. Not suturing these incisions actually decreases the risk of scarring. It is unlikely that anybody will guess from these healed incisions that you have had liposculpture, unless, of course, you tell them. Sometimes, darker skinned individuals may develop a darker scar, or those at risk of scarring generally, but fortunately these entry points are very small. There is no alternative to getting into the fatty tissue so they are necessary to the success of the procedure.
Some people often mistakenly call local fatty accumulations over the thighs cellulite, and these can definitely be helped with liposculpture. True cellulite (localised dimpling of the skin especially over the thighs and buttocks) is due to the distribution of fibrous bands within fatty tissue. Attempts to divide these fibrous bands have been tried, but the level of success is variable, so at present no technique can reliably treat this problem, although in situations where excess fatty tissue is also a problem, removal of this may well improve overall appearance by making specific dimples less obvious.
Using modern cannulas much of the fat removed can be repositioned to the body to improve overall shape, and correct defects under the skin. A common use is to reduce a depression that can be present just below the skin. Transfer of fat to the face is particularly popular and in contrast to some other filling agents, it is cheap and permanent. Transferred fat, however requires a new blood supply to survive and it is unpredictable whether it will survive or not.
There are abundant “stem cells” in fat. A stem cell is a natural regenerative cell found in adult adipose (fat) tissue that has the ability to repair damaged tissue when injected into a specific area of the body. These cells are unspecialised which means that they do not yet have a purpose. The fantastic thing about the stem cells being ‘blank’ cells is that they are able to differentiate (transform) into another bodily cell such as a muscle or nerve.. Scientists are doing more studies on stem cells in this exciting area of medicine.
For people who live busy lives the timing of their procedure is paramount. At Be Sculptured we realise that you may only have a specific time to have your procedure. As all the procedures are performed at the clinic, it is usually possible to have a liposculpture procedure within 2-6 weeks of consultation. The Australian Medical Board, in October 2016, advised a mandatory 7-day cooling-off period from the time of consultation to the time of cosmetic surgical procedures. You can consult online for possible times but a consultation is absolutely necessary at least 7 days prior to the procedure.