Anesthesia and Liposuction Procedure Safety
Unlike many facilities that perform the liposuction procedure under general anesthesia, Dr. Rapaport performs virtually all of his liposuctions under IV sedation, also called “twilight” (anesthesia). During this type of anesthesia, the patient has an IV and Dr. Rapaport’s Board Certified Anesthesiologist delivers sedating medications via the IV. The patient is breathing on his or her own, and is responsive to verbal input but typically has no memory of the procedure. Following the procedure, the patient feels relaxed and comfortable. Dr. Rapaport’s chief anesthesiologist, Dr. John Grillo, is a master of IV sedation, and he has been working with Dr. Rapaport for the past 10 years. This lighter technique virtually eliminates risks associated with general anesthesia, including the risk of blood clots and the risk of airway complications. “Because liposuction is performed using the tumescent technique, with gentle infiltration of numbing medicine to the treated area, it simply does not require anything more than intravenous sedation,” says Dr. Rapaport.
Liposuction of limited areas, such as under the chin (submental liposuction), inner knees, or in some patients arms, inner thighs or lower abdomen, may be treated using only local anesthesia. In such cases, the patient would have no IV at all, and no anesthesiologist present. Instead, the patient would either rely completely on Dr. Rapaport’s injections to numb the area, or could take oral medications to provide relaxation and mild sedation for the procedure. This is, of course, all reviewed with Dr. Rapaport at the time of the individual consultation to plan the procedure in a way that is best suited for the preferences and priorities of each individual patient.
Liposuction Scars: To Suture or Not to Suture
Although liposuction scars are small, on many areas of the body if they are left unsutured, they will heal as circular indented marks, resembling chicken pox scars.
On the other hand, if the liposuction scars are sealed shut with sutures, they will not be able to drain and patients will have more swelling and bruising from their procedure. For this reason, Dr. Rapaport generally places a single suture in each incision to allow it to heal as a fine line, while also allowing the drainage of fluid. Depending on the patient’s skin type, Dr. Rapaport may elect to use dissolvable sutures. If he chooses removable sutures, they will be removed at the first post-operative visit, approximately 1 week following the procedure.
One of the aspects of liposuction that make it extremely appealing is the fact that scars are truly very small, depending on the area treated, the scars will range in size from 2-5 mm (a pencil eraser is about 5 mm across). Generally, these liposuction scars are hidden in inconspicuous places. For example, for outer thigh liposuction, scars can be hidden under the buttock crease, rendering them truly invisible.
Approximately 95% of Dr. Rapaport’s liposuction patients are comfortable returning to work within 3 days of their procedure.This means that if a patient undergoes their procedure on a Friday, they will be removing their garment and showering on Sunday, and can return to work on Monday. They can similarly return to the gym, to regular sexual activity, and to drinking with moderation that same week. Patients typically describe the discomfort following liposuction as similar to that following a strenuous workout.
In terms of bruising, submental liposuction usually comes with minimal bruising. Liposuction of the body typically does have bruising, and that bruising is generally much improved after 2 weeks, and completely gone 3 weeks after the procedure.
Though prescription pain medicine is prescribed just in case it is needed, most patients do not take it.
As part of planning for liposuction, a garment is ordered based on the areas treated and the patient’s size. This garment will be applied over absorbent pads by Dr. Rapaport’s assistants following the liposuction procedure, and should be worn continuously for 48 hours. The compression of the garment allows fluid to drain out of the body, thereby reducing swelling and promoting healing. Following the required 48 hours, the garment may be worn to reduce post-operative swelling, but will not impact the long-term result of the procedure.
Contour improvement from liposuction will be apparent at 48 hours when the garment is first removed. For the next several days, there will actually be some increase in swelling, partly because there is no longer a firm compression garment, and partly because this is the nature of how the remaining fatty tissue recovers from liposuction. The vast majority of swelling will be resolved by about 1 month following the procedure, with all swelling generally gone by 3-4 months following the procedure. Liposuction of low areas such as the calves may take up to 6 months for all swelling to resolve. Similarly, secondary or revisional liposuction may have some swelling, usually mild, for up to 6 months.
If you have questions concerning liposuction plastic surgery, or would like to schedule a liposuction consultation with the Board Certified Plastic Surgeon, please phone David P. Rapaport’s Manhattan, New York Plastic Surgery office at 212.249.9955 or email the NYC Plastic Surgeon at email@example.com.