Liposuction in Mexico by Dr. Manuel Gutierrez Romero

Liposuction in Mexico is the most common procedure performed by any plastic surgeon, the concept of liposuction is “to remove a number of fat cells from a specific area to correct a deformity and improve the shape.”Under no circumstances should liposuction be used as a weight loss method.  If a patient is overweight they must be transferred to a nutritionist and physical trainer, or general surgeon for one of the bariatric procedures like: lap band, gastric bypass, or gastric sleeve.  The type of procedure would vary according to the amount of weight that needs to come off.

Genetically we are all born with a different body fat distribution.  This will be a factorin where our body will store fat if we gain weight, or simply, if we have a deposit in a specific area that is too much. Whatever the case, liposuction can reshape our body and eliminate the number of fat cells from that specific area.

There are several methods available to eliminate fat from a specific area.  Some of the manufacturers of the new machines have a tendency to proclaim “ this machine is the ultimate, better results, faster recovery, minimal bruising, excellent results, no down time.”  Then in 1 to 2 years, they have another machine that promises the same thing (they need to sell more new machines). Traditional liposuction, ultrasonic liposuction, smart liposuction, and laser liposuction are all reliable methods.  Depending upon the ability and experience of the surgeon, they will provide optimal results. In the end, the most important thing is the hand of the surgeon, the expertise, and the method that is able to get you persistent good results with the least amount of complication.

Problem number one is “fat in.” The solution is “fat out!”  All of the machines eventually will do the same thing, but the expertise of the surgeon will decide the final outcome.

There are different densities of fat in our body.  Typically, the fat in the front is smoother than the fat in the back.  Depending upon the density, some methods are more ideal (more powerful machines).

THE PROCEDURE:

Most of our liposuction is with epidural or general anesthesia.  We don’t believe in local anesthesia unless it’s a very small area.  It is almost impossible to numb a large area with local, and there’s a point where the patient cannot stand the discomfort, and the procedure must be stopped.  We always utilize the tumescent method.  We inject the area with a prepared solution (bicarbonate, adrenaline, and Bupivacaina) that helps with postoperative numbing and minimizes the bleeding.  If we use ultrasonic, sound travels faster in liquid so it is better to inject more liquid.

The procedure is done thru small incisions, ¼ inch or less.  We inject the solution and begin extracting the fat. It is very important to leave a small cushion (¼ to ½ inch of fat) to prevent irregularities.  It is also important also to utilize small diameter cannulas (3 to 4 mm in diameter) and avoid superficial liposuction very close to the skin to prevent irregularities. Once the procedure is finished, we place a compression bandage.  It is expected to drain water, fluid, or blood thru the small incisions for 1 or 2 days.  Most of our patients are discharged the same day.

The most common complications after liposuction are:

Irregularities- this usually happens because the Doctor did liposuction to close to the skin, or used cannulas that are too thick, so the use of smaller cannulas is mandatory.  The second most common complication is the collection of liquid, blood, or serum, called seroma.  This collection of fluid usually happens for 2 reasons: not enough compression or too much physical activity. After liposuction the skin is detached from the muscles.  It takes up to 7 days for your body to build bridges of collagen that will attach the skin to the deep layers, so it is very important that for the first week you keep your compression tight and physical activity to a minimum.  This will prevent the creation of a seroma. Scars rarely are a problem.  Usually we try to place the incisions in a less visible area.

Postoperative care:

You must have a daily shower starting the day after the operation.  You must wear compression garments all the time 24/7 (only take it off for your shower).  For the next 4 weeks, you must avoid strenuous walking (no walking the dogs, no up and down the stairs).   No exercise for the next 4 weeks. The only movement is inside the house(kitchen, bedroom, bath room).  Take your medication as prescribed and never apply heat in the area. In order to accelerate the healing process, it is advisable to begin lymphatic drainage massages usually after 10 days.  It is recommended 3 to 5 times a week, for up to 2 months.

The massage will help improve the blood flow, the lymphatic drainage, and remove the scarring tissue. The actual result of liposuction is not before 2 to 3 months, until the swelling goes down. The patient must not ever have corrective liposuction before this time.  They must wait at least 6 months or up to 1 year to have normal tissue.