Summary

Liposuction, the number one cosmetic surgery performed globally, is a procedure removing unwanted lumps, bulges, and areas of resistant fat deposits from specific areas of the body. Patients should be in good health, emotionally stable, and realistic in their expectations. Age is not a consideration, but older patients usually have diminished skin elasticity, thus will probably not achieve the same results as a younger person with tighter skin. While no method of liposuction is a substitute for proper nutrition and physical exercise, nor is it an alternative for general weight reduction, it is, however, ideal for permanently removing localized areas of fat that are diet and exercise-resistant. The most common areas for treatment include upper thighs (saddlebags), abdomen, flanks (Love handles), and upper arms. Other areas include facial fat accumulations, including a double chin, neck and jowls, breast, hips, buttocks, and knees. I can do cheeks, calves, and ankles, but results are less impressive in these areas. In men, liposuction can be used to correct gynecomastia (enlarged breasts) and, more recently as scarless breast reduction in females. In addition, liposuction is used to remove sweat glands in the underarm to reduce excessive sweating without affecting the body’s ability to cool itself. The application of external ultrasound before liposuction is a technique that applies the transcutaneous application of high-frequency ultrasonic fields delivered into the wetted fatty tissue to melt fat cells and make it easy for extraction. All types of energy (mechanical, ultrasound, laser, and radiofrequency have been combined with liposuction to reduce surgeon effort and improve the result. The “power” in power-assisted/power-tumescent liposuction (mechanical energy) refers to the use of a cannula with a back-and-forth motion of the tip passes through tissue to suction out fat in fibrous (male breast) or the back with reduced effort. Power-assisted liposuction helps skin tightening during the recovery period.

Liposuction, the number one cosmetic surgery performed globally, is a procedure removing unwanted lumps, bulges, and areas of resistant fat deposits from specific areas of the body. Liposuction is achieved using a handheld instrument (cannula) attached to a vacuum-like machine or a syringe. By pushing and pulling the cannula, fat cells are broken up and then sucked out with a vacuum. This is named traditional liposuction.

Am I the Right Candidate for High Definition Liposuction?

 Fat distribution is determined by two factors: heredity and diet. Heredity determines the location and number of individual fat cells that are fixed and unchanging after puberty. Diet can increase or decrease the amount of fat in each cell, but will not affect the total number of cells or their distribution. For example, if you have inherited large numbers of fat cells on your thighs and small amounts of fat cells on your chest, you will always have more fat on the thighs than on the chest, and strenuous attempts at weight loss can leave you with a thin upper body and persistently large thighs. The ideal candidate for liposuction is a person of average weight with relatively firm, elastic skin, except for pockets of excess fat in certain areas of their body that are resistant to diet and exercise and disproportionate to the rest of their body. Patients should be in good health, emotionally stable, and realistic in their expectations. Age is not a consideration, but older patients usually have diminished skin elasticity, thus will probably not achieve the same results as a younger person with tighter skin. The localized fat deposits are termed lipodystrophy, even if the patient is at or below his or her ideal weight. Overweight patients may also have lipodystrophy, but diet and exercise, rather than large-volume liposuction, are the mainstays of treatment for generalized obesity. Some patients must have multiple procedures if they have more fat than can safely be removed in one operation setting. While no method of liposuction is a substitute for proper nutrition and physical exercise, nor is it an alternative for general weight reduction, it is, however, ideal for permanently removing localized areas of fat that are diet and exercise-resistant.

What Areas of the Body High Definition Liposuction?

 The most common areas for treatment include upper thighs (saddlebags), abdomen, flanks (Love handles), and upper arms. Other areas include facial accumulations of fat, including a double chin, neck and jowls, breast, hips, buttocks, and knees. I can do cheeks, calves, and ankles, but results are generally less impressive in these areas. In men, liposuction can be used to correct gynecomastia (enlarged breasts) and more recently as scarless breast reduction in females. In addition, liposuction is used in the removal of sweat glands in the underarm to reduce excessive sweating, without affecting the body’s ability to cool itself.

Your Consultation for High Definition Liposuction

During the consultation, Prof. Moawad will review your medical history, evaluate your present health, and assess the current condition of your skin, considering elasticity as well as a localized fat deposition. Your present weight, and whether you plan to lose or gain, will factor in this evaluation, along with what effects, if any, prior weight loss had on the areas of your body you want contoured. I will address your expectations as to whether they can be realistically achieved, in addition to which body contouring method and procedure technique will be most suitable in your case. Prof. Moawad will discuss how factors like the general state of your health, overall condition of your skin, your weight, age, hormonal influences, and certain other factors, can all influence the outcome of your procedure. Liposuction is performed at MSI as an outpatient/ in-office procedure for reasons of cost, convenience, and comfort. It’s now a well-known fact that in-office Liposculpture is safer than traditional liposuction done within a hospital setting.

What are the Risks of  High Definition Liposuction?

Some authors refer to this form of liposuction as “traditional” or “conventional,” Tumescent liposuction is a safe procedure on the condition that patients are carefully selected, the operating facility is equipped, and the physician is adequately trained in the process. Tumescent liposuction has few significant side effects when performed by a qualified cosmetic surgeon says Prof Moawad. Liposuction performed under general anesthesia with hospital admission carries a higher risk of serious adverse events.

How Do I Prepare Before High Definition Liposuction?

You are provided with specific preoperative instructions and will take preoperative photographs, which are essential aids in planning out and performing the procedure due to the patient being in a horizontal position during the process. Postoperative photographs are taken at 3- and 6-months post-surgery (body photographs are faceless). If you smoke, you are advised to stop two weeks prior to your procedure. Smoking can affect the operation and impede healthy healing. Additionally, you must alert your medical staff to any medication you are taking; certain drugs like aspirin, non-steroidal anti-inflammatory, and Vitamin E may increase bleeding during and after the operation. In addition, some medications, e.g., Certain antibiotics, may interact with the local anesthesia. It is generally advised to stop eating and drinking at least 6 hours prior to the procedure. Pending your circumstances, you may want to arrange for someone to drive you home following your surgery, as well as to help you at home for a day or two.  It is recommended you reschedule your procedure should you develop a cold or an infection of any kind, especially a skin infection and during your menstruation.

How Long is High Definition Liposuction Will Take?

The duration of the operation lasts anywhere from thirty minutes to two hours, sometimes more depending on how many areas are treated. And, although I can do multiple regions simultaneously, Prof Moawad prefers to do one site at a time to ensure the patient’s safety and a rapid recovery. Significant deformities affecting several areas of the body can be planned and done in several stages (sessions), allowing for a shorter healing period, and safe, rapid recovery.

Is High Definition Liposuction Painful? Will I be Awake?

The principal factors in determining the type of liposuction and the type of anesthesia patients should have, for example, straight tumescent method, sedation standby or sedation, are pain tolerance, the amount of fat to be removed, and the patient’s past and current medical health conditions; all factors considered when selecting the anesthesia that will provide the safest, most effective level of comfort during your procedure. If only a small amount of fat and a limited number of body sites are involved, liposuction can be performed under local anesthesia, which numbs only the affected areas. The local is usually used along with intravenous sedation to keep you more relaxed during the procedure. Some patients enjoy being awake during the process, and Prof Moawad also prefers his patients to be awake in order that they obtain optimum positioning with patient cooperation.

Are the Results of  High Definition Liposuction Permanent? Will Fat Return?

On the condition, you stay at your postoperative weight, and a proper diet and exercise become part of your routine. The liposuction results will be permanent since there are now fewer fat cells in those areas that were contoured.  Weight gain is the actual enlargement of existing fat cells, not the creation of new ones. The more significant number of fat cells there in a specific location, the more difficult it is to reduce in that area only by dieting. Dieting usually reduces the size of all fat cells proportionately but leaves the basic silhouette unchanged to no small degree. However, if you gain a few pounds, you will more evenly distribute the weight than accumulate in the same problem areas before the procedure. Doctors believe that once fat cells have been removed by liposuction, these same cells do not return.

Will My Skin Hang after High Definition Liposuction?

Prof. Moawad’s initial assessment determines the amount of fat to be removed in order that your skin re-drapes appropriately. The degree of skin change after liposuction surgery is the same as one would expect if it were possible to lose an equal amount of fat in these localized areas simply by dieting. Because the small cannulas simply make small tunnels through the fat, there remain multiple connections between the skin and the underlying tissue. These fibrous connections contract with the healing process and maintain the skin in its natural position. After liposuction by tumescent liposuction, one does not have to worry about excessive folds of the skin in the areas treated by liposuction surgery. This effect is so dramatic that many patients who previously would have required surgical excision of skin, called a tummy tuck, can now have excellent results by merely having power-assisted liposuction. Most patients require just one procedure. Less than ten percent of patients need a fine-tuning process, after the period of after least six months. At MSI, we are proud to be the first center in Egypt, offering a post-liposuction non-surgical skin tightening program involving vacuum, soft laser, and Photodynamic therapy using LED technology and radiofrequency.  The additional tightening effect can be achieved only at MSI using the FDA-approved monopolar radiofrequency device for non-surgical skin lifts. Only those individuals with lax musculature and loose skin with or without excess fat might require additional procedures like abdominoplasty (tummy tuck) or thigh lift.

Will Incisions of High Definition Liposuction be Large?  Will I Have Scars?

A tiny incision (2mm) is all that is required for the insertion of the tube. Incisions are generally small, about a ¼ inch. At MSI, our method of re-contouring leaves minimal scars, and Prof. Moawad strategically places incisions within the natural folds of the body.

What can I Expect Immediately following High Definition Liposuction?

Though tumescent liposuction is more refined, you may still experience some pain, burning, swelling, ecchymosis, and temporary numbness. With the tumescent technique, postoperative discomfort is significantly reduced since the local anesthesia remains in the treated tissue, usually causing numbness for sixteen hours or more after surgery. If required, Extra Strength Tylenol or Tylenol with Codeine is enough to control relatively minor discomfort that may occur following your surgery. Immediately after surgery, you are transferred to our luxurious recovery room where you are fitted with a support garment that you are required to wear continuously for two to four weeks (if treated calves and/or ankles, you would need to wear a support hose for up to six weeks). Generally, after the procedure, you will probably have some fluid drainage from the incisions and can expect some bruising and swelling (bruising typically goes away in 3 weeks; swelling can last for 3 months depending on the amount of work done). Most patients can walk out of the office without assistance. Recovery time will vary greatly depending on the individual, how extensive the procedure is, and the technique used.

How Will I look During After High Definition Liposuction?

You may remove the garment to shower the day after surgery. You may feel stiff and sore for the first few days after your procedure, but you are encouraged to move about, even a little since this will aid in blood circulation.  Dressings will be removed in several days, so Prof. Moawad and his staff can examine treated areas. You will be scheduled for follow-up visits to monitor your progress and receive an ultrasound massage, lymphatic drainage the day following your surgery, then every other day for the first week. Subsequent follow-up visits are scheduled at 1 month, then again at 3- and 6-months following surgery. Suppose you have any unusual symptoms between visits, for, example, heavy bleeding or a sudden increase in pain or any questions about what you can and cannot d. In that case, you are advised to call MSI immediately.

For the most part, the results of liposuction can be dramatic. Saddlebags may disappear. Legs and hips become thinner and shapelier. Stomachs become flatter and firmer, and double chins can be sucked away. Occasionally the skin may have an uneven or slightly rippled effect. The surface can sometimes be irregular or asymmetric, or pigmentation changes may occur, especially in older patients with dark skin. If you have skin dimpling (cellulite), it will still be there following your surgery. Scars from liposuction are usually tiny and strategically placed within body folds. Overweight patients who have localized areas of fat removed must be willing to accept a higher chance of contour irregularities, and less than ideal skin re-draping in exchange for improving the way they look in clothing.

As the public’s demand for greater efficacy and safety has grown steadily over the past decades, so has the search for and development of new liposuction technologies and techniques. Recent decades have seen the introduction of internal ultrasound-assisted liposuction, external ultrasound-assisted liposuction, power-assisted lipoplasty, laser-assisted lipolysis, and most recent radiofrequency assisted lipolysis. There are several options and techniques available at MSI. Our professional staff will help you decide which is the proper treatment approach for you, considering effectiveness, safety, cost, and appropriateness for your needs. Today, I can use several liposuction techniques to improve the procedure’s ease and enhance the outcome. Based on the experience of Prof Moawad for the last 20 years, he prefers the tumescent technique associated with a powered cannula and the most recent external ultrasound energy when indicated.  Prof. Moawad was the first to introduce these techniques in the Middle East with excellent results and safety over the last 20 years.

External Ultrasound-assisted Liposuction (EUAL)

After introducing internal ultrasonic-assisted liposuction (UAL), reports of a higher incidence of complications such as skin necrosis and seromas tempered patients and physician enthusiasm for internal UAL. The consequence has been a new interest in testing the application of external ultrasound before liposuction. Although external ultrasound has been used in the clinical setting to enhance post-traumatic and postoperative healing, external ultrasound preoperatively for liposuction is a relatively new concept. The application of external ultrasound before liposuction is a technique that requires transcutaneous application of high-frequency ultrasonic fields delivered into wetted tissue, followed by traditional aspirates liposuction, to improve the mechanical removal of the fatty cell. External UAL, during which the ultrasonic energy is applied through the skin, must be differentiated from internal UAL, during which the ultrasonic energy is used through a specialized cannula. Recently, external UAL at frequencies of 2-3 MHz and a potency of 3 W has been associated with complete fat tissue disruption, including adipose cells and collagen networks.

This new technique reported to soften or disrupt adipose tissue and (1) facilitate the task of suctioning adipose tissue and increase the amount of fat extracted (2) make the patient more comfortable during and after the procedure, and (3) improve the quality of the aspirate by decreasing the amount of blood (4) it allows superior access through scar tissue (fibrous); and (5) it is not constrained by internal structures and can, therefore, be used to treat larger areas. Ultrasound causes tissue destruction via three mechanisms: (1) cavitation, (2) micromechanical disruption, and (3) thermal damage. Ultrasound reports suggest that the disruptive biologic effects of external ultrasound are due to a micromechanical outage or tissue heating. Other reports postulate that external UAL loosens adipose cell attachments, facilitating aspiration. It disrupts membranes and affects calcium influx, which can stimulate mast cell degranulation. Ultrasound can induce fibroblast activity and enhance collagen production. It can stimulate endothelial cell activity and new capillary formation in chronically ischemic tissue. These effects make ultrasound useful for the care of chronic wounds, as well. In addition, the manifestations of the impact of external ultrasound appear to be directly proportional to the intensity delivered, with simple cellular detachment at 1 MHz to complete adipose cellular destruction at 2-3 MHz.

Power-Assisted Liposuction (PAL)

Almost all types of energy have been combined with liposuction to improve patient experience and results. The “power” in power-assisted/power-tumescent liposuction uses a tiny mechanical tube (cannula) that efficiently removes fatty tissue. The mechanical vibrations produced by the power unit are soothing and may decrease procedure time. Powered liposuction can increase fat extraction by 30% or more over non-powered liposuction. Patients love the vibration sensation of powered liposuction or traditional non-powered liposuction. Prof. Moawad was the first to use this technique in the Middle East 15 years ago. In power-assisted liposuction, a cannula with a back-and-forth motion of the tip passes through tissue to suction out fat and fibrous or scarred tissue with reduced effort. Studies that compared power-assisted to traditional liposuction found that power-assisted liposuction was superior in the ease and speed of fat extraction, faster healing and recovery time for patients, shorter procedure times with less surgeon fatigue, and lower incidence of the secondary touch-up procedure. Appropriate tissue accommodation or retraction occurred after liposuction in most treated sites, except in areas that exhibited a significant degree of tissue laxity preoperatively.  The short-powered strokes can be used more precisely than the longer “to and fro” motion of manual liposuction. The devices can also be used while holding the hand still to remove fat in difficult areas such as the peri-umbilical region.