Liposuction of a woman's abdomen

This plastic surgery video deals with liposuction of the abdomen. What you see is a patient asleep on the operating table. And I'm injecting some numbing medicine into her abdominal area in the regions where I plan on making incisions. And we call these incisions access incisions. And from these access incisions, I'll be able to insert the cannulas that I need to prepare the area to be liposuctioned, followed by the liposuction cannulas.

So these incisions are put in relatively discreet places that heal very well and typically are invisible after a few months. The technique of liposuction on the abdomen is somewhat difficult because as you can see she's breathing, so you're basically operating on a moving target. So it takes quite a bit of skill to do this well.

So the first step of liposuction is to actually put fluid into the tissues. And we do this because putting the fluid into the tissues allows the tissue planes to be separated and actually blown up or magnified if you will. And that allows us to have more control over the areas that we are working on. And so I'll be very careful that where this infusion cannula is being positioned in respect to how close to the abdominal wall and then how deep it is within the fat. So I'll place this fluid in both the superficial areas of the fat as well as the deep areas of the fat. And that will allow me to take fat out of those two tissue planes.

So the fluid has a numbing medicine in it as well as a medicine that causes vasoconstriction, which means it makes the blood vessels get smaller. So when the blood vessels get smaller, there's less bleeding. So both of the benefits medication-wise are very helpful for the patient postoperatively as well as intraoperatively. So after I fill these areas up with the fluid, the medications will take effect and I can begin the liposuction.

So at this point, she's relatively distended with the fluid and you can really get a sense of how much more rounded she is than she was when she first came in. And you can tell by the pinch test that her tissues are relatively thick. So what I'll do now is I'll take a different type of cannula and I will pass that into the tissues and go into both the superficial and deep planes and I will evacuate the fat from those areas.

So this will be done in a very sequential fashion and done in a way to prevent her from having some complications or contour irregularities after the fact. Probably the biggest issue with the surgery is going to be a residual contour irregularity, so I'm very careful to make sure that these areas are uniformly and evenly recontoured.

Her recovery will be relatively benign. She'll wake up and be pretty comfortable because of the medications that I put in. Later in the evening, she will be sore. Most of the patients relate to me that it feels like they've done a few hundred sit ups, so they have that burny, kind of achy pain in their abdomen, but for the most part it's very well tolerated. She will be placed into a garment or a girdle and she'll stay in that girdle for about 10 days. She'll get to take it off, take showers and for a little bit each day and that will allow that skin to retract back down to the abdominal wall. And you can see here she's got beautiful skin and so she should have a very nice result.

But I will sequentially treat this area before moving to another area and I'll actually revisit the area from different access incisions to make sure that all my tunnels in the areas collapsed. And you see here she's had the suction performed and you can see from the canister that she's had a fair amount of fat taken out and you can see by pence test how much thinner she is in this area.

So I'm demonstrating the one side which has been done in the other side, which hasn't. So after I'm satisfied with the one side, I will go ahead and recontour the other side in a similar fashion as described.

So there she is with all the fat removed and much thinner abdomen. At this point, her wounds will be closed, the garment will be applied, and she'll be allowed to awaken. And then she'll be transported to recovery room and she'll go home the same day. Her pain is controlled with a couple of pain pills and they do very well. It's a very nice operation.