Until two decades ago, people thought 'Staying Chubby is nicer and 'Staying Chunky is healthier' and so on. The fads and fancies of the 90's are however 'Stay Slim' and 'Keep Slender'. Exercise centers, weight reduction clinics, wrap centers and jazzercise tapes are seen all over the world today trying to help the people melt their fat away.

Lipectomy means removal of fat by surgery. In lipolysis, the surgeon loosens and removes the fat from an area by using long or short metal tubular instruments connected to a suction machine. The suction tubes are usually made of stainless steel. The tips are blunt. The tubes have 1 to 5 holes near the tip on one side or on different sides. The suction machines used for this purpose to create very powerful negative pressures (1 torr to 35 torrs at sea level). Lipolysis was started in France in late 70's, and since 1981 is in practice in the United States and other parts of the world.

Dr.Ramachandran uses the tumescent technique to perform the procedure. This helps to minimize the blood loss. He also uses the Power Assisted Lipoplasty machine (Microaire, U.S.A ) wherein the cannula actually vibrates inside the body at about 5000 times a minute thereby dislodging the fat easily. This technique makes it more accurate with less fatigue and larger volumes can be drawn with better contouring.

Fat collections of the hips, thighs, buttocks, abdomen, arms, under the chin, upper torso, etc, can be reduced by this procedure.

Can one's weight be reduced by this operation? Who is a good candidate for lipolysis? Lipolysis is neither a substitute for dieting nor a cure for obesity. Persons with reasonably normal weight and healthy elastic skin with extra localised fat in certain areas, get the best results from this procedure. (Healthy elastic skin has the capacity to shrink after the surgery). Eventhough lipolysis can be done on patients upto 45 to 50 years of age, it is not normally done if the skin is loose in the particular area, one could have loose skin after losing a lot of weight or after the pregnancy or due to aging. In these patients in addition to lipolysis, some of the skin should also be removed to get a satisfactory contour.

SURGICAL PROCEDURE:

Dr. K. Ramachandran finds that most patients, if given a choice, prefer to have conscious sedation when larger areas of the body are being contoured. Most of our liposuction cases are performed safely with the patient under sedation anesthesia. A small cut about 4 mm is made, a few inches away from the area to be suctioned and the suction cannulae are inserted. The cuts are usually made in the skin folds and so, the scars are not much noticeable. Depending upon the areas to be suctioned and recontoured or reduced, anywhere from 600 gms to 3000 gms of the material is removed in one sitting. If more material is removed blood transfusions may be required. The removed material usually consists of 65% to 85% fat and the remainder would be blood, plasma and serum.

AFTER THE SURGERY:

After the surgery, snug or tight dressings will be applied for 5 to 8 days to promote the shrinkage of the skin and to minimize the swelling. In most instances one is required to wear a support or a girdle for few weeks or moths during the healing time. One could feel localised areas of hardness or firmness in the suctioned areas for 1to 4 months after the surgery.

One may require oral pain medication for one to two days after the surgery. During the healing period, numbness or discomfort could be present for a varied period of time. After the surgery, there will be swelling in the areas of the surgery. Eventhough most of the swelling is gone in the first 2-3 weeks, it takes 2-4 months for all the swelling to be gone. Discoloration could last upto several weeks after the surgery.

Eventhough the patient is required to stay only one day in the hospital, one should stay within the close reach of Dr. K. Ramachandran for about 7 days for follow up care. Even after multiple area of lipolysis one should be able to be up and around in 1 to 2 days and back to most of the normal activities in 10 to 14 days.