MD. Assoc. Professor
GAYE TOPLU

What is fat removal/shaping surgery?

There are two types of adipose tissue in our body:

• Fat tissue under the skin that thickens and thins as you gain or lose weight,

• Deeply located, genetically encoded adipose tissue that is not much affected by diet and sports.

Although it shows personal differences, lubrication often occurs on the hips, legs, hips and abdomen in women, and in the belly and waist in men. In addition, intra-abdominal lubrication is common in men, and this lubrication cannot be corrected by surgery. Elimination of this problem can only be with diet and sports.

Especially after the age of 30, the resistant adipose tissue formed in certain areas does not usually dissolve, even if the patient loses weight. As the regime and sports continue, they begin to lose tissue from places they do not want, their faces collapse, their breasts become empty, but there is no thinning in the resistant areas. In such cases, liposhaping is an effective solution.

Fat shaping surgery is the combination of liposuction and fat injection . The process of removing fat from the body is called "liposuction". Today, while the excesses are removed with oil shaping, the deficiencies are also completed when necessary. Excess fat taken from the body is used to complete existing deficiencies (such as breast augmentation, butt enlargement). The purpose of this procedure is not to weaken the patient, but to shape his body.

Am I a suitable candidate for oil contouring?

Liposuction is not a weight loss surgery. Liposuction is a procedure to remove excess fat that does not benefit from regime and sports. Therefore, ideal liposhaping patients are young, with good skin elasticity and not overweight. The procedure can also be applied to patients with excess weight, but the aim here is to provide a more shaped body at the current weight rather than weakening it.

The way of lubrication in men and women differs significantly. Fat accumulation is often in the hips, waist, inside of the legs and inside the knees, under the navel in women. In men, there is lubrication around the belly and waist, and on the breasts. Intra-abdominal fat in men is different from the fat around the navel and cannot be corrected by surgery.

Fat injections are made in the areas deemed necessary. Most often, the hips are shaped and erected. Again, fat injections can be made for the correction of leg shape, leg thickening, and sometimes for breast enlargement.

What does high-definition (Hi-def) liposhaping mean?

Hi-def liposhaping is a fat shaping surgery performed by considering the underlying anatomical structures (such as muscles, tendons). It is performed to make the underlying muscles more visible  and even by giving fat, especially in young patients who are underweight, do regular sports and have good skin elasticity. With this method, the appearance of abdominal muscles (6-pack) is created in men, a more athletic appearance is achieved by clarifying the groins in women, and even waist dimples can be made.

What does ultrasonic liposuction (VASER) mean?

Before liposuction, after liquid is injected into the skin through the 3mm-sized holes opened on the skin, rods transmitting ultrasonic energy are inserted and the fat cells are separated and reduced by the energy given. Fat clusters, which are divided into small pieces, are easily absorbed by liposuction and removed from the body.

Advantages of VASER:

• Facilitating the process by breaking down the adipose tissue, shortening the operation time

• Tightening the skin

• Reusable fats

Deciding on surgery

Whether the surgical intervention to be performed is for functional or cosmetic purposes, the choice of your plastic surgeon is very important. The patient should also meticulously follow the warnings of the plastic surgeon before and after the operation.

In the pre-operative examination, existing fat deposits, skin quality, areas with fat deficiency will be examined and questions will be asked regarding your wishes. Your plastic surgeon will explain to you what he expects from the procedure and will question your medical history. Your age, skin texture, racial characteristics and habits (diet, smoking) will be important factors. Moreover, in this first examination, an honest exchange of information will be provided between you and your plastic surgeon for a successful outcome.

After the intervention to be applied to you is planned, your surgeon will inform you about the anesthesia, hospital and the budget of the surgery, and will explain the risks of the surgery.

preoperative 

As in all surgeries, you should stop smoking three weeks before the surgery and stop using aspirin and similar drugs and herbal products that have blood thinning effects in the last 1 week.

Operation

The first and most important stage of the procedure is the pre-operative drawings. While the patient is standing, it is marked how much fat to be taken from which area and where to add fat. If Hi-Def liposhaping is to be performed, these drawings are additionally examined by examining the abdominal, chest, back and waist muscles and their shapes are revealed.

The type of anesthesia to be used in the surgery depends on the amount of fat to be taken and the area to be operated on. If it will be done in a limited area, it can be done under local anesthesia and sedatives (sedation). General anesthesia is required if working in a large area.

The duration of the procedure naturally varies according to the amount of fat deposits and additional procedures to be performed, but takes an average of 1-2 hours. However, in Hi-Def surgeries of the whole body (back, waist, abdomen, chest, legs, knees), this period may take up to 4-5 hours.

After anesthesia, first of all, liquid containing drugs (local anesthesia) and anti-bleeding (adrenaline) drugs is given to the areas where fat will be removed. Small holes are drilled. VASER is applied by inserting thin tubes (cannulas) through these holes, and then the adipose tissue is sucked with the help of vacuum. If oil is planned to be delivered, the absorbed oil is collected in a sterile environment, washed and filtered. Prepared oil is given with thinner cannulas to the areas that need to be added.

At the end of the procedure, plastic drains and urinary catheters may be required in some patients. All patients are dressed in a corset at the end of the procedure.

Postoperative 

Liposuction pain is similar to the stinging pain that occurs after very heavy sports. However, it can be easily controlled with painkillers and passes within a few days.

The patient is fed and stands up 2-3 hours after the operation. The next morning, if available, the patient's urine  catheter is taken and the patient is discharged with a prescription. If necessary, the drains are left in place for a few more days.

There are small dressings in the places of the holes. For the first 24 hours, a bloody liquid oozes from these wishes. The patient can take a bath on the second day after the operation. Three days later, he comes for a check-up, and then he can return to work and start his normal daily activities, drive a car. In the first three weeks, he should not do sports other than walking. At the end of the third week, the corset is removed. Swelling and bruises occur in the first three weeks in the areas where liposuction is performed. From the third week, edema is resolved, the skin softens and begins to take shape. Tissues take their final shape only after three months. There may be a decrease in skin sensation in the first weeks in areas where liposuction is performed.

Weight gain after liposuction

After puberty, no new fat cells are formed in the body, there is growth in existing fat cells. For this reason, if the patient gains weight after liposuction, the areas where liposuction is performed will also thicken up a bit like other body regions, but there will never be an accumulation like before the surgery.

How many liters of fat can be removed with liposuction?

Although the purpose of liposuction is not to lose weight, the highest amount of fat that can be removed without putting a patient at risk is 10% of body weight. In other words, about six liters of fat can be removed from a patient weighing 60 kilograms.