Liposuction recovery is uncomfortable for a few people, but in general a person is back to his or her work table in a matter of a week to ten days. The extent of care a person takes in the post-operative phase reflects directly on the pace of the recovery. Pain medications are advised in the first week after surgery and should be discontinued thereafter. Exercises may be resumed after a gap of at least a month post surgery as there is risk of moisture-retained infection and opening of stitches. This being said, you will most likely need help in caring for your child. This is a surgery and your body needs time to recover. You are under medication so you will most likely need to find someone to take care of your child because you will be needing to take care of yourself. Follow your surgeon's post-operative instructions very carefully.

Posted by Jennifer Michaels Patient Advisor to Dr. Siporin

The midface lift is just one variation of a face lift procedure. These face lift variation procedures are becoming more and more popular because they avoid the full amount of surgery required in a total face lift, which basically means it reduces the length of the incision, the time for recovery, and the amount of surgery to the patient. The midface lift essentially addresses two frequent areas of concern to both men and women, which is the loss of fullness in the upper and mid-cheek region due to sagging, as well as the creation of jowls. The incision with the midface lift is through the sideburn and then usually extends into the ear and then wraps around just behind the ear lobe. Through the incision, the deep tissues can be elevated as in a full face lift so that there is a long-lasting result and then the incision is reapproximated. Most of these face lift area procedures are performed under local anesthesia with some oral sedation, rather than full twilight sleep, and recovery is significantly shorter with the midface lift, typically four to five days versus a full eight to ten day with a face lift.

Posted by Jeffrey S. Epstein, MD, FACS

Tummy tuck surgery does not have to involve liposuction but it often does. A tummy tuck or abdominoplasty is about contouring the abdominal wall. A standard or "full" abdominoplasty addresses the abdominal wall from the pubic region, where the incision is usually made, to the lower edge of the ribs below the breasts and laterally to the edge of the rectus abdominis muscles. Liposuction is often used to compliment the contouring accomplished by an abdominoplasty by treating adjacent areas. This allows the surgeon to contour the pubic region and the hips at the ends of and beyond the abdominoplasty incision. It is important to avoid liposuction in the center of the abdomen above the incision. Liposuction in this area during an abdominoplasty greatly increases the risk of healing complications and of necrosis of skin between the belly button and the incision. Sometimes after an abdominoplasty the fat layer in this area remains thick. In such casefs, it is safe to return for a staged liposuction procedure after healing from the abdominoplasty to further improve the contour of this area. There is a variation on the standard abdominoplasty procedure known as a lipo-abdominoplasty. With this procedure, liposuction is performed on the entire anterior abdominal wall and a mini-abdominoplasty is also performed. With a mini-abdominoplasty, it is safer to perform extensive liposuction at the same time, including on the areas of the central and lower abdomen, because the skin is only mobilized or separated from the muscles from the incision line to the belly button. Determining which one of these options would be best for each individual case is based on the amount and location of extra skin and fat and of the abdominal wall and on the quality of the skin in the treatment areas.

The concerns about flying after a major surgical procedure are related to the risk of developing deep venous thrombosis, or DVT, and the related complication of pulmonary embolism, or PE. Flying in itself is a risk for these conditions. Sitting for prolonged periods, with the ability for leg movement limited, causes pooling of blood in the lower extremities. This increases the risk of clot formation in the deep veins of the legs. Anyone in a hypercoagulable state from illness, medications or recent surgery is at an increased risk for this disorder. Any major surgical procedure induces some degree of a hypercoagulable state through trauma to tissues and small blood vessels. In plastic surgery, procedures that most significantly contribute to this state include abdominoplasty and liposuction. Following either of these procedures, or any other major surgery, it would be best to avoid air travel for a minimum of 10 to 14 days. With air travel shortly after this period, prophylaxis against DVT and PE should be considered only through consultation with your surgeon. Medications used for prophylaxis would include subcutaneous heparin injections as well as aspirin and other platelet inhibiting agents.

A double bubble after breast augmentation describes a deformity that sometimes results where two different convex curves are visible at the lower part of the breast separated by a narrow tightened band. Sometimes during breast augmentation, the surgeon intentionally releases connective tissue along the bottom of the breast. This is described as "lowering the fold". The inframammary fold may be lowered to allow proper positioning of the implant so that the nipple is located centrally over the implant and is directed forward. Failure to lower the fold when indicated may result in the implant sitting too high, causing excessive fullness of the upper part of the breast and leaving the nipple positioned over the bottom part of the implant and directed downward. When performing an augmentation and correction of sagging or ptosis is also needed, the fold may be lowered to enhance the lift effect of implant placement.

Sometimes after lowering the fold, bands of rigid connective tissue may remain superficial to the implants. These bands may restrict the expansion of the implant and of the overlying breast tissue, resulting in the double bubble deformity. Correction of this deformity requires revision surgery. When the implant is properly positioned, then release of the restricting bands or breast tissue should correct the deformity. If the implant is positioned too far inferiorly, then repositioning the implant higher up, with or without additional release of the restricting bands, should correct the deformity.

There are a variety of methods available for the treatment of keloid scars or hypertrophic scars. The timing and severity of scar formation determine which approach is most appropriate. Silicone sheeting, or silastic, vitamin E and topical corticosteroids are used to prevent and treat early keloid scar formation within the first few months after surgery. Keloid scars that persist or worsen following topical treatment may be treated with injections of corticosteroids, or other anti-inflammatory agents, directly into the scar. This approach usually results in flattening of the scars and decreased redness, tenderness and itching. The overall appearance of keloid scars, however, may not significantly improve after corticosteroid injections. In order to significantly improve their appearance or to treat chronic scars or scars that do not otherwise improve with non-surgical treatments, surgical excision may be the best option. With true keloid scars, there is a high incidence of recurrence after surgical excision. For this reason, surgery should always be combined with either corticosteroid injection into the new wound edges or with low dose radiation of the wound after surgery.

Symmastia is a complication of breast implant surgery where the breasts have the appearance of being fused in the middle. The area of cleavage between the breasts is obscured by a bridge of tissue that seems to connect the breasts in the middle. Symmastia results from the surgeon dissecting too far medially or too close to the center of the chest when creating the pocket for the implant at one or both breasts. This allows the implants to lie very close together in the middle of the chest and at times the implant spaces may even communicate. This problem is corrected with revision surgery. Capsular tissue or graft material is used create a barrier between the two implant spaces and any communicating space is obliterated.

There are many different liposuction techniques available today, with more and more of them seemingly promoted everywhere as the best and only way to do liposuction now, or at least until the next device comes along. In the hands of a good surgeon (properly educated, trained and experienced), traditional liposuction can be equally, or even more effective, in almost all patients than any of the more advanced technologies available today.

Advanced liposuction technologies include ultrasound devices (LySonix, VASER), laser devices (Smart Lipo, SlimLipo), power assisted devices (MicroAire), and water jet devices (AquaLipo), among others. The primary advantages of these technologies over traditional liposuction are that they add an energy source, separate from the mechanical energy of the surgeon with traditional cannulas, which allows the surgeon to more efficiently and perhaps more accurately and effectively reduce and sculpt fat in the treatment areas. Because energy sources other than the simple mechanical energy of traditional liposuction contributes to the removal of fat, these technologies can make liposuction less traumatic to tissues, preserving structures such as nerves and blood vessels and possibly resulting in less pain, less bruising and swelling and a more rapid recovery time. Devices such as ultrasound or laser that utilize thermal energy or heat may also promote, at least temporarily, greater skin contraction and an improved contour.

The most important factor in achieving the results that you desire from liposuction is not choosing the right device or technology, but it is choosing the right surgeon and whatever technique that he or she is most comfortable using for your procedure.

Liposuction is a procedure designed to improve body contour irregularities by reducing areas of localized fat accumulation. In the abdomen, the thickness of the fat of the entire abdominal wall may be excessive. The largest accumulation of fat, however, is usually at the central lower abdomen and around the belly button, which contributes to the pot belly appearance.

If liposuction was performed one month ago and the pot belly shape has been corrected, then it sounds like the primary goal of the procedure has been achieved. If the entire abdominal wall fat layer still seems thick, then this could be at least partially still due to swelling. With continued use of compression garments and massage, any residual swelling should resolve over the next four to six weeks. Beyond that time, persistent thickness of the abdominal wall could be due to residual subcutaneous fat or to fat within the abdominal cavity that is not accessible to liposuction. Residual subcutaneous fat can be improved with weight loss or with repeat liposuction. Caution should be observed by patients and practitioners against overdoing liposuction. Sometimes, in attempts to make good results better, we can end up with complications such as surface irregularities from over-aggressive or too superficial liposuction treatment.

Tummy tuck or abdominoplasty procedures are performed sometimes in a hospital setting with overnight stay and sometimes in a surgical center on an outpatient basis. Drain tubes are almost always used with tummy tuck surgeries and can be left in place for anywhere from five to ten or more days. The drain reservoirs must be emptied once or twice daily. The incisions at the belly button and lower abdomen should be cleaned and dressed daily with simple bandages. Pressure garments of a girdle type are used initially to help secure bandages and are vital once the drain tubes are removed to prevent accumulation of fluid or seroma formation beneath the abdominal skin. Garments are worn at least part-time for four to six weeks or more. This promotes the skin contraction and resolution of edema that will give the abdomen its smooth and flat final contour.

I typically see tummy tuck patients for follow-up one day, one week, two weeks and one month after surgery. I then ask them to return for late follow-ups at three, six and 12 months after surgery.