How do dermatologists perform liposuction
Unfortunately, our skin tends to sag with age. The age-related decrease in the connective tissue fibers in the skin and in the subcutaneous fatty tissue may lead to overstretching of the skin, which may be favored by strong weight fluctuations. This creates the "waving arms" on the upper arms, the "Christmas tree" on the back, the "fat apron" or the "hanging belly" on the stomach, while the thighs begin to "wobble". For a long time, effective skin tightening was only possible through a complex surgical removal of the excess skin with long skin incisions and mostly clearly visible scars.
The Bodytite method is a modified liposuction in which the skin and the subcutaneous fat tissue are evenly heated with radio waves and thus massively tightened, without the formation of large scars and without long downtimes.
Mode of action
Bodytite is a new way of additionally tightening tissue before, during or after a traditional liposuction. While the skin tightens by an average of 8% 1 year after liposuction alone, 1 year after a combination with a Bodytite treatment, the average tightening is 36%. The technology is based on the fact that with the help of radio frequency in the connective tissue of the skin and the subcutaneous tissue an even heat of 65 to 70 degrees is generated, which then leads to a shortening of the existing connective tissue fibers. As a long-term effect, the deep heat stimulates the formation of new collagen and elastic connective tissue fibers in the months after the treatment. Over the next 12 months, the skin gradually becomes tighter, firmer and more elastic.
In combination with liposuction, Bodytite is particularly suitable for problem areas in which experience has shown that traditional liposuction does not lead to adequate skin tightening, e.g. if there is too much skin on the back, on the upper or lower abdomen or on the inner thighs.
If, however, there is little fat left in the sagging skin areas, Bodytite can also be used as the sole therapy without liposuction for skin tightening, e.g. for the "waving arms" on the upper arms or to reduce the size of male breasts (gynecomastia).
Before treatment, diet and smoking cessation are desirable but not mandatory. Please refrain from taking acetylsalicylic acid-containing painkillers such as Aspirin, Godamed, Togal-ASS or Thomapyrin, and if possible also ibuprofen and diclofenac / Voltaren two weeks before treatment, in order to minimize the risk of bruising.
You should not be sober on the day of the operation. A light breakfast or lunch is desirable. Of course, you shouldn't have consumed alcohol. Please bring loose and easy-to-clean clothing (e.g. an old jogging suit and warm socks) with you to the procedure. A five-day antibiotic prophylaxis (e.g. ciprofloxacin in the morning and 1 tablet each in the evening) should be started the evening before the procedure.
Duration of treatment: three to five five hours
We carry out the Bodytite treatment on an outpatient basis and under local anesthesia, as this results in some obvious advantages over general anesthesia: less bleeding, less swelling, shorter healing time, safer operation result, elimination of the anesthetic risk, no starvation / thirst before / after the operation. In addition, there are no inconsiderable costs for an inpatient stay in a clinic. The full mobility of the patient during and after the procedure enables better control of the treatment result, e.g. by changing from the lying to the upright position. If you wish, you will receive a tranquilizer that takes away your nervousness and excitement and ensures that you experience the procedure half asleep.
Before the treatment, the treatment area is thoroughly disinfected and the areas to be treated as well as the existing skin irregularities and side differences are marked.
For local anesthesia, we use a largely painless and tissue-sparing method in which the fatty tissue is first softened with several liters of a highly diluted anesthetic solution until the area under treatment has reached a firm, elastic state (tumescent anesthesia). This significantly increases the electrical conductivity of the fat cells and thus the effectiveness of the radio frequency. In addition, the connective tissue in which the fat cells are located is stretched, the blood vessels contract (the skin turns white), and the nerves are numbed.
When large to very large amounts of fat need to be removed, we first perform traditional liposuction prior to the Bodytite procedure. For this purpose, the fat liquefied by the tumescent anesthesia is sucked out evenly over several 3 mm small skin incisions with the help of extremely thin, blunt special probes. For this purpose, each area is treated in a fan-shaped manner, overlapping from different angles, whereby attention is also paid to a harmonious transition to the adjacent areas. We use a newly developed system for vibration-assisted liposuction (vibration lipolysis or vibration lipectomy). Here the suction probes vibrate mechanically and pave their way to the fat cells according to the principle of a drill. Since the surrounding nerves, vessels, lymphatic systems and connective tissue are optimally protected, patients with this relatively new technique have fewer bruises, less pain and feel fit faster. The vibrations also stimulate the outer layers of connective tissue and thus lead to additional skin tightening.
For the subsequent Bodytite procedure, the special cannula is inserted under the skin through the same small incisions and then the deeper and then the superficial connective tissue is heated evenly until a target temperature of 65-70 degrees is reached. For reasons of safety, the Bodytite special cannula is equipped with an inner and an outer electrode. The inner active electrode is pushed under the skin through small incisions, while the outer passive electrode slides over the surface of the skin on a sterile ultrasound gel film. Radiofrequency deep heat is transferred to the fat and subcutaneous tissue via the inner electrode, while the temperature on the surface of the skin is constantly monitored via the outer electrode. Through this targeted heating of the connective tissue fibers, a direct tightening of the skin and subcutaneous fatty tissue is achieved without overheating the tissue.
Thanks to the local anesthesia we prefer to use, you can straighten up after the suction to check the symmetry. If there are any irregularities, they can be corrected immediately after they have been marked again. If the optimal result is achieved, the skin incisions are not sutured, but only provided with a cling plaster and a sterile plaster so that the liquid remaining in the cavities under the skin can drain off. Then compression pants or a corset are put on and wrapped with suction compresses.
Immediately after the treatment you are mobile and can go home. As a precaution, however, you shouldn't get behind the wheel yourself and prefer to be picked up.
The compression clothing should be worn day and night for at least 2 weeks for at least 2 weeks and then only during the day for 1-3 weeks after a Bodytite treatment on the body to immobilize the operating area and to support the adaptation of the initially somewhat too wide skin to the new contours. Since a not inconsiderable amount of anesthetic solution mixed with some blood is emptied from the deeper incisions in the first 1-2 days, you should use suction compresses at these points during this time, which we will provide you with after the procedure.
On the day of the operation, we recommend an afternoon nap or early bedtime. However, exercise is very important, as this is the only way for the remaining fluid to drain off. There is nothing wrong with taking a short walk with someone. However, you should avoid excessive physical exertion. On the day of the operation, you should drink a lot after the Bodytite treatment (fruit juices, mineral water, herbal tea), but not consume alcohol. If possible, smokers should refrain from smoking.
Mild pain, a burning sensation, and temporary numbness of the skin in the wound area are normal for a few days after the operation. The pain after the procedure is usually described as severe muscle soreness. It is important not to take any blood-thinning painkillers (e.g. Aspirin®) when you are in pain. Instead, you should take, for example, paracetamol (up to 3 times daily 500 mg) or ibuprofen (up to 2 times daily 600 mg) containing agents which, in addition to a pain reliever, also have a decongestant effect. The day after the operation you can drive again, but you should avoid long distances or stop every hour, walk around a little or do light gymnastics. Showering is allowed from the 1st day after the operation. You may notice blue lips or a slight shortness of breath on the first day after the operation, which are due to temporary changes in the red blood cells caused by the use of large amounts of local anesthetics. For this reason and to avoid venous thrombosis, you should avoid long-haul flights in the first few days after the procedure.
Until the puncture sites have healed well (around the 4th or 5th day), the plasters and sterile plasters should be changed daily. We will provide the plasters to you after the operation. After a week, the areas should be lightly massaged.
After minor interventions, many patients go back to work after a day or two. As a rule, however, you should free yourself from all professional and private obligations for about a week after the procedure. Routine postoperative checks are scheduled on the 1st day, after 4 weeks and, if necessary, after 12 weeks. Sports activities can then be resumed as soon as the sore muscles in the operating area allow it (after approx. 2-3 weeks). In the first four weeks you should avoid going to the sauna and solarium or sunbathing.
In most cases, a significant improvement in body shape can be seen immediately after the treatment. On the first postoperative day, when the remaining anesthetic liquid has run out, you can already guess the end result. In the next few days, however, the treated areas swell up again, clearly palpable and visible. These swellings and bruises take 2-4 weeks to subside. Further, not immediately noticeable healing processes and permanent tightening of the skin then extend over several months. Minor dents and slight sensory disturbances (numbness, tingling) are normal for up to three (sometimes even six) months after the operation, as the connective tissue first has to slowly reorganize. For the same reason, the final treatment result can only be assessed after about 6-12 months.
Fat cells that have been sucked off can never be reproduced again. The number of fat cells is fixed from toddler age and does not change even with weight fluctuations. When you gain weight, new fat cells do not appear, just the size of the cells that are already there. Since not all fat cells are suctioned off and the remaining fat cells can increase in size in the event of excessive feasting, a healthy, calorie-conscious diet and sufficient exercise must be ensured after the treatment. Overweight patients should see the treatment as an opportunity to further increase the success of the treatment through a consistent diet.
Risks and Side Effects
As a rule, the Bodytite treatment has few complications. Despite the greatest care, isolated incidents can occur during and after the procedure. Very rare complications as part of the Bodytite treatment are permanent skin retractions, visible scars or injuries to nerves with temporary numbness or burning sensation. There are seldom allergic reactions to the local anesthetic, such as swelling, nausea, itching or a rash. They usually subside spontaneously and usually do not require any treatment or can be treated well. Severe allergic reactions with life-threatening respiratory and / or cardiovascular disorders (shock) are extremely rare. They require intensive medical treatment and can lead to permanent organ damage as a result of insufficient blood flow (e.g. kidney failure, brain damage, seizures). Other rare side effects are bleeding or superficial infections at the skin openings and temporary or permanent pigment changes in the skin. The method usually does not leave any scars. In the case of a genetic disorder of the scar formation, however, thick, bulging, discolored, painful, itchy scars (keloids) can develop. However, timely treatment of scar changes usually helps to avoid corrective surgery.
There are only a few reasons that might prohibit a Bodytite treatment under local anesthesia: allergies to local anesthetics, pregnancy / breastfeeding, serious infectious diseases, serious diseases of the internal organs, especially of the heart and kidneys, panniculitis (generalized inflammation of the adipose tissue ), as well as a glucose-6-phosphate dehydrogenase deficiency. If you are prone to conspicuous bruises or if you have persistent bleeding after minor injuries, a coagulation disorder should be excluded by a suitable examination before the operation. Age limits do not exist with this gentle method.
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