Explore Plastic Surgery

Liposuction in Indianapolis: What to do and What you expect after Surgery

While liposuction is tremendously effective at removing fat, it does induce swelling, bruising, and discomfort that requires some time after the procedure to resolve. And because liposuction is really a ‘reductive sculpting’ procedure so to speak, it takes time for areas to settle in to see the final shape and form. While the body is primarily responsible for the healing process, there are some things that you can do that can improve the result.

The most well-known post-liposuction aid is compression garments. Squeezing the treated areas by wrapping with garments helps decrease some swelling and encourages the skin to adapt to the newly reshaped fat bed on which it rests. (you never can remove all of the fat…and if you remove too much, your skin will stick down to those areas producing unsightly dimples and depressions) These garments are always provided to you at the time of surgery and you will awake in recovery with them on. The real question is……how long after liposuction surgery should you wear them? There is no real consensus amongst plastic surgeons but most would say several weeks. My approach to liposuction garments is…….keep them on until they feel better off than one. This will vary greatly depending on each patient and the areas that were treated by liposuction. Some will wear the garments for only a week, while others will wear them for several weeks. I don’t believe that compression garments play a critical role in how liposuctioned areas look after several weeks, so there is no sense to endure them beyond a time period when they feel better on than off.

Although most patients don’t do it……either due to cost or lack of access…..post-liposuction massage or lymphatic drainage can be very helpful. Whether it is done by hand, instrument, or machine, the gentle manipulation of the liposuctioned areas promotes swelling and bruising reduction and can help smooth out irregular areas (if done in the first month after surgery) A light sports massage, stone massage, or endermologie treatments can help shape the area while it is still malleable in the first month after surgery. Short of making an incision like a facelift or tummytuck, liposuction is the next best way to loosen the skin from what lies underneath, so skin and deeper tissue manipulations can be very effective. You just don’t want to do them too soon after surgery. I don’t usually try and have my patients start until two weeks after surgery…..and your plastic surgeon needs to talk to the therapist doing the ttreatments so they don’t get too rough and know where to go. A good month of once or twice a week treatments is a good investment to optimize your liposuction results.

Working out again can usually be done in 2 to 3 weeks but only do it if it feels comfortable. Expect swelling of the liposuctioned areas to be cyclical for awhile, which is partially related to activity. At the end of the day, the treated areas will have some swelling that will be gone by the morning. This is typical and this cyclical swelling will go away after several months. This is the body healing its lymphatic channels.

Lastly, be patient. It takes a least a month to see good results and really about three months to achieve the final shape of the liposuctioned areas. It will take that long also to have small areas of residual soreness gone as well.

Dr Barry Eppley
http://www.eppleyplasticsurgery.com/
http://www.ologyspa.com/
Clarian North Medical Center, Carmel, Indiana
Clarian West Medical Center, Avon, Indiana
Indianapolis

Cellulite: Difficult Problem, No Permanent Solutions

Much like scars and stretch marks, the problem of cellulite is common and questions as to how to treat it equally so. Cellulite remains, however, an aesthetic problem that defies a single effective answer. The testament to that can be seen on the internet with hundreds of cellulite treatments and ‘cures’. I have always held to the theory that if many options exist to treat a problem, probably none of them work well. If one single treatment method was good, we would all know about it….and there would only be one treatment method, not hundreds. The large number of cellulite treatment methods exist for one simple reason…..hope. When results aren’t available, hope is the next best sales method!

The problem of cellulite is fairly well understood. These are pockets of enlarged fat that are trapped between fibers (septa) that run between the skin and the underlying tissues. The fat pockets become enlarged, due to fluid retention from lymphatic obstruction, and creates that ‘quilting’ effect much like the surface of a spring mattress. It is a phenomenon that is common in women but rare in most men. The hormonal differences have been blamed as a cause although this has never been conclusively proven. It most commonly occurs on the thighs and buttocks.

Treatment options have been plentiful but can be divided into topical creams, various forms of lymphatic massage/manipulation, and surgery. Despite many grandiose claims, few topical treatments have ever been shown to create a significant improvement. Creams containing aminophylline (an asthma medication) have been most promising, but the rest mainly moisturize and soften the skin. If they have any effect, it is likely due to the luffing or sponging of the area which is often done as part of the at-home treatment. Lymphatic massage, particularly mechanized methods such as Endermologie, definitely produce visible results, albeit temporary. By using rollers under suction, the skin is lifted, the fibers disrupted, and fluid drainage from the fat encouraged. When on a long-term program with maintenance treatments, good results are consistently seen. The only question is…..is the effort (time and money) invested worth what is achieved for not a permanent result. Most recently, a minimally-invasive procedure called Carboxytherapy, appears promising. By injecting carbon dioxide under pressure underneath the skin, the cellulitic fat is remodeled and reshaped. While promising (maybe very hopeful), long-term results and studies need to be done before we jump on this bandwagon. Surgery, specifically liposuction and a method called pickling, have not panned out to be worth the effort. Liposuction of an area with cellultite can make it look even worse if not done conservatively and at a deep level. Pickling is a surgical method where a small tube with a sharp end is run under the skin to cut the fibers loose from the underside of the skin, making it smooth. While initially promising years ago, the results are not long-term and certainly not worth undergoing surgery to do.

While the search for a cellulite cure continues, non-surgical options are best although only temporary. They cause no harm, the question is merely are they worth the expense.

Dr Barry Eppley
www.eppleyplasticsurgery.com
www.ologyspa.com
Clarian North Medical Center, Carmel, Indiana
Clarian West Medical Center, Avon, Indiana
Indianapolis