WHAT IS LIPOSUCTION?

Lipo-suction is a technique for the removal of unwanted deposits of fat by the use of suction, using metal tubes or cannulae. These are delicate hollow metal tubes comparative in thickness to a small knitting needle varying in diameter from 2-4 mm.

WHAT IS THE HISTORY OF LIPOSUCTION?

An Italian Gynecologist, Dr Giorgio Fischer, initially developed Lipo-suction in the 1970's. The technique was later improved and popularized by a French general practitioner, Dr Pierre Fournier. The development of the tumescent technique we use today is attributed to Dr. Geoffrey Klein, and American Dermatologist, who developed the technique in the late 1980's. Tumescent Lipo-suction was introduced to Australia in the early 1990's and it has been practiced at the Ashbrooke Institute since 1994. Lipo Sculpture is a further refinement, allowing the Doctor to fine tune the procedure for a more even and shapely profile.

WHAT IS TUMESCENT LIPOSCULPTURE?

Tumescent Lipo-sculpture is the technique employed at the Rejuven8 Cosmentic Centre exclusively. Tumescent refers to the large amount of saline solution with very diluted local anaesthetic and a vasoconstrictor. The mixed solution is injected under the skin and into the fat before removal. The fat becomes swollen with the solution. Tumescent fat is softer and easier to remove and also causes less blood loss. Tumescent Lipo-sculpture is so safe and free of complications that it can be performed as a "walk in, walk out" procedure necessitating no hospital admission. In addition the anaesthetic effects of the tumescence appear to last for the first 24 hours for the majority of patients, keeping them comfortable in the immediate post-operative period. A General anaesthetic with its attendant risks is not required or used.

WHY DO PEOPLE HAVE LIPOSUCTION?

People request these procedures to improve their looks, to improve the fit of clothes, to restore body proportions and their confidence and self-esteem. Some people use Lipo-sculpture to "kick-start" a lifestyle modification program that will include a better diet and regular exercise. Other people request assistance for stubborn fat deposits that have not responded to a balanced diet and an exercise regime. When the patient is seen in consultation, the Doctor will advise the patient how to combine Lipo-sculpture to various areas of body to achieve the desired result.

WHAT IS THE DIFFERENCE BETWEEN LIPOSUCTION AND LIPOSCULPTURE?

Lipo-suction and Lipo-sculpture are performed in a similar matter, but the latter is performed exclusively under local anaesthetic. The patient remains awake and is able to stand up prior to the end of the procedure.
Thus, the operating Doctor can identify any irregularities and evaluate the body contour he wishes to sculpt. Of course this requires that the Doctor be both experienced and skillful and have the necessary artistic talents so that the benefits of this technique are passed on to his patients.

HOW MUCH FAT CAN BE REMOVED?

Unfortunately there are limits to the amount of local anaesthetic that can be used safely in any one operation. When a patient presents for consultation, the operating Doctor will advise what is possible. If large amount of fat need removal, it may be safer to stage the Lipo-sculpture into more than one session. The removal of five litres of fat is considered to be the upper limit for Tumescent Lipo-sculpture performed on a "walk in, walk out" basis. Needless to say, for a very heavy person, more can be removed in stages, and for a smaller person less is needed.

WHAT ARE THE RISKS OF LIPOSCULPTURE AND LIPOFILLING?

Complications that have been reported are infection of the operated area, allergic reactions to the local anaesthetic or other drugs administered. Other complications include unwanted collections of blood or fluid under the skin, and very rarely sloughing of skin over the operated area. However deep venous thrombosis (clot formation in the deep veins of the legs) and pulmonary embolism (escape of clots from the leg veins to the lungs) have only been reported following general anesthesia. These complications are all extremely rare. We prevent infections by the administration of antibiotics to all patients after Lip-sculpture. We monitor all patients electronically during the operation to detect the first signs of any allergic reactions and have all equipment and drugs available to deal with such an event. All operations have associated risks, however, we give all patients written postoperative instructions and we believe that if patients follow these instructions, risks will be kept to a minimal level.

Side effects: Patients may experience bruising of the skin and swelling of the operated sites. Almost all patients will experience mild discomfort but may be surprised how minimal it is. Naturally, the treated area may be a little tender. Some patients will experience temporary numbness or increased sensitivity of the skin overlying the sites of operation and if the lower legs and ankles are sculptured, some will experience ankle swelling that can last a number of months.

WHAT CAN I DO TO DECREASE THE SIDE EFFECTS?

To decrease post-operative bruising and swelling, patients are advised to follow the Doctors pre-operative and post-operative instructions as outlined on the handout sheets given to you.

* After the operation do not take any aspirin or anti-inflammatory medications without consulting the Doctor (including period remedies i.e. Naprogesic).
* If needed you may take Paracetamol tablets to control pain i.e. Panadol or Tylenol.
* Observe any dietary restrictions or advice on any supplements recommended.
* Take all medications and wear the garment according to the Doctor's instructions. These will vary according to the treated area, and are usually worn from 5 days to 3 weeks.
* Follow the specific advice given to you regarding your general activity levels, do not exceed any limits of exercise as prescribed by the Doctor.
* Lymphatic drainage will assist in the recovery. This will be discussed during the consultation.

HOW IS LIPOSCULPTURE PERFORMED?

Unfortunately the procedure is invasive and often complicated, involving a number of hours in theatre under general anaesthetic. Complications include a high risk of scarring due to the poor healing on the upper chest, altered sensation of the nipple, infection, bruising, prolonged pain, blood transfusion and inability to breast feed.

Dr Soo-Keat Lim and a nurse will be present in the operating room. Areas containing the unwanted fat deposits are marked on the skin with a marking pen. Clinical photographs are taken to allow comparisons before and after the procedure. The patient is given oral medication and an intra muscular injection that controls any discomfort. A needle is placed in one of the veins in the arm and if needed medicine is administered to help the patient feel relaxed. The patient will feel completely at ease and drowsy but will not fall asleep. No general anaesthetic will be administered. The patient remains in total control. Various state of the art electric monitors are attached to the patient to assist the operating Doctor and nurse in monitoring the patient throughout lipo-sculpture. When the patient is relaxed, the operating Doctor after numbing the spot under a local anaesthetic will puncture the skin in appropriate places and begin infusing the local anaesthetic into the unwanted fatty deposits. The local anaesthetic causes the fat to become numb, and therefore insensitive to pain. It also causes the fat to become softer and therefore more easily removed. Ultra sound may be used at this point to cause further softening of the fat. On completion of the local anaesthetic infusion the fat extraction will begin. Fat deposits have a wide range of shapes and consistencies. The lipo-suction is therefore performed with a range of specifically designed, precision metal tubes called cannulae, which facilitate the removal of the fat. Different types and sizes of cannulae are used depending on the site on the body being treated.

Near the end of the lipo-sculpture the patient is asked to stand up so that the Doctor can identify any irregularities or unevenness of the body contour. The patient is then laid down again and the irregularities are addressed. This procedure is repeated a number of times until the operating Doctor is satisfied that the best possible result has been achieved for the patient. On completion of the operation the patient is fitted with compressive garments, which contain lycra and similar materials. Two garments are usually used, placed one on top of the other to exert adequate pressure on the lipo-sculptured areas. The patient is then dressed and discharged from the operating room into the care of responsible adult. It is illegal for a patient to attempt to drive themselves home after the lipo-sculpture due to the drugs that have been administered during the operation for adequate sedation.

HOW LONG WILL MY LIPOSCULPTURE TAKE?

The operation will take between two and 4 hours to perform depending on the extent and complexity of the operation. To assist the person who will be escorting the patient home, we suggest that their contact number be given to our nurse so that he or she can be contacted when the operation is nearly over.

WHAT CAN I EXPECT AFTER THE OPERATION?

During the first two days excess fluids will discharge from the tiny holes in the skin.

Although the fluid will be tinged with blood, the actual blood loss will be minimal. The patient will be provided with absorbent pads to place between the lycra garments to absorb the fluids. They will also be provided with a plastic sheet to place over his or her bed. The use of towels on the bed can also be beneficial. Patients are encouraged to take it easy for the remainder of the operation day but may go for short walks. Most patients can return to work the second day after the operation, many the next day. By the end of the first week most patients will feel quite comfortable, however, any bruising and swelling of the tissue will generally slowly subside over the next one to three weeks.

WHEN WILL I SEE THE RESULT OF MY LIPOSCULPTURE?

Immediately you will see up to 80% of the final result. By the end of one month most patients will look and feel completely recovered from the operation. At this stage about 90% of the final result from the lipo-sculpture will be evident. The final result will manifest at 3 months.

Some of the more specialized areas of lipo-sculpture such as calves, ankles and retraction of excess skin over a much reduced abdomen will usually show a slower recovery, with final results taking up to 6 months.

WILL I LOSE WEIGHT?

Most people will lose some weight. However, it is important to remember that Lipo-sculpture is not a weight loss program. It is indicated for the reshaping of your contours, to help them look better, to improve body proportions and to achieve better fitting clothes.

WILL I ENJOY MY LIFE MORE?

Overwhelming numbers of our patients are absolutely thrilled with the results and their ability to confidently reveal their bodies and wear with pride their old clothes or new wardrobes. The majority of patients will drop one or more dress sizes. Even if you don't change your dress size, you will certainly look better in what you are presently wearing. Some months after their procedure they can look back and know they have made the right decision to allow the Doctors at Rejuven8 to treat them. You are going to gain a tremendous amount in confidence and in your self esteem.

WILL MY HEALTH IMPROVE?

The scientific studies that have been performed are not sufficient for us to be able to answer such questions confidently. The general clinical impression is that patients undergoing Lipo-sculpture have a 30-50% probability of improving their health in some way.

Many of our patients with health problems such as adult onset diabetes, high cholesterol blood pressure and obesity, (and especially those with syndrome X) when following the program that Rejuven8 has developed, have experienced significant resolution of these conditions. However there have been no definite studies aimed at determining if Lipo-sculpture will objectively improve patient's health. Some of the questions that have yet to be resolved include:

- Will patients who undergo Lipo-sculpture live longer?
- Will they suffer less disease?

We are confident that "kick start" effective Lipo-sculpture allows the patient to experience and strengthen their resolve for a healthier lifestyle, along with a correct diet and a more positive approach to their life.

WHAT WILL HAPPEN IF I PUT ON WEIGHT IN THE FUTURE?

When lipo-sculpture is performed, most of the fat in the operated area will be removed, however, it is not possible to remove all of the fat. If a patient should really massively over indulge and have serious gain in weight in the future, they will put on any weight proportionately because the fat cells do not regenerate after puberty to any significant degree. They can be assured their new desirous shape and balance will be maintained.

WHAT IS THE COST OF LIPOSCULPTURE?

Many factors, including the amount of fat to be removed and the likely difficulty of removing it determine the cost. The range for most patients will be from $3,500 to $7,000. The operating Doctor can only determine the full and final cost of the operation after examining the patient. There are many things that can be purchased with these amounts of money, however, there are very few things that will leave an indelible improvement on the patient's self-esteem.

CAN I GET FINANCE TO DO MY LIPOSCULPTURE?

Finance may be available, please ask one of our staff and they will give full information.

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