Liposuction of abdominal area on man

This video by the Medical Director of The Loudoun Center for Plastic Surgery,Dr Michael J Brown MD, expertly details a plastic surgery liposuction on a tall man.

Male Liposuction Walkthrough

This plastic surgery video demonstrates a liposuction on a man's abdomen. This man is relatively tall and in good shape and he just can't seem to get his flanks and his abdomen to get the contour improvement that he desires. So he considered liposuction and I determined that he was a good candidate.

What you see here is some fluid being placed into the tissues that will allow me to remove more fat with greater ease and efficacy. The fluid has medications in it, one that controls bleeding and one that controls pain. This gentleman has actually had his back side already suctioned and he has been turned in is now having his abdominal area addressed as well as his anterior flank. So the back part of his flanks or love handles have already been suctioned and now he's going to have his front side love handles taken care of as well as his abdomen.

So I'm actually not removing fat right now. I'm actually just putting fluid in and so you might notice that he's actually getting fuller or what you might think of as being fatter. At this point now he's having the fat evacuated. So I'm actually taking out the fat and the fluid that I just put in. This allows me to take out more fat and cause less injury. There's typically less bruising and the patients do much better.

The bull's eye pattern that you see is drawn on the patient when he's standing up and these are areas that are the highest areas of concern for the patient. So in essence, it's kind of like a topographical map where the smallest circle in the middle is the highest point. And as I recontour these areas, I pay attention to these circles and try and blend or take out different amounts of fat in the different circles so that the contour is smooth. One of the biggest problems that you'll see with liposuction are residual contour irregularities where enough attention to detail was not paid to recontouring these areas, and you'll have an uneven amount of fat removal in certain areas.

You'll notice that my right hand is doing the majority of the work, but my left hand is playing an important role as well. It's actually feeling the fat to see how much fat is left. I'm lifting up the cannula against his skin to get a sense for how much fat is left in the area. And we call this a pinch test and you can see from the pinch test that he has a nice improvement. In an area that I didn't suction, he's much thicker than he was where I had suctioned him already. So I was satisfied with his anterior flank or anterior love handle. And now I'm recontouring his abdominal area. And you can see in the tube the color of the fat and how easily it comes out. Again, this is a relatively large man and even though he doesn't look that heavy when he stands up, he does have some contour irregularities that are concerning to him.

So my left hand again is feeling where the tip of the cannula is and also helping me appreciate what depth the cannula is, meaning is it right next to the skin or is it deeper, closer to the abdominal wall. And so I will go through these areas carefully taking fat from both the superficial area and a deeper areas. And I'll use different incisions to gain a cross hatching pattern in the areas to allow a more blended fat removal. And this will decrease the chance that he's going to have some residual contour irregularities. You have to really know what you're doing because if you're not careful, the cannula can actually go into an area that you don't want to go in, which would be inside the abdominal cavity. And so there is a great amount of expertise required to do this well.

You'll notice that I do pick up the cannula every now and then to get a sense for how thick the tissue plane is. And you'll notice with my left hand, I'm feeling where it is and that allows me to dictate if I've taken out enough fat or not. And so it's a very sequential type technique where I'm taking fat from different areas in a very stepwise fashion to make sure that I don't over suction or over resect an area and conversely under resect an area. So I can get a sense of how deep I am as well as how much fat I'm leaving behind.

So I will do this from various incisions using different angles and different depths to make sure the patient gets a wonderful result with a uniform contour that doesn't look like he's had a suction done. The incisions are very small and they heal very well.

After the surgery, the patient will have a foam placed over the area and then he'll be placed into a girdle or a garment and he will wear that girdle for about two days straight. And then he'll take it off, take a shower, and then he'll wear the garment 11 hours on, one hour off, 11 hours on, one hour off for about a week. And then I'll see him in the office, see how he's doing, and I'll probably have him only wear the garment another week, 11 hours a day basically while he's up and around. And he'll get to take it off at night. And then the third week he'll wear the garment only while he's exercising. So it takes about three weeks before I let you get back to exercising because of the swelling issues. And he'll notice that especially in that third week if he pushes it too hard that he will be uncomfortable because of the amount of swelling in the area.

Anytime you raise the blood pressure after a surgery, you're likely to get some swelling in the area. So these stitches are placed using a dissolvable stitch so you don't have to have any stitches taken out and it works very well.

You can see a nice contour improvement in the area. The topographical map has been effectively reduced to a flat area. This is the foam that will be put on all the areas where he's been contoured and this will allow a more uniform distribution of the pressure from the garment that we're going to put him in. And he'll have it put on his abdomen and his flanks both front and back and then he'll have a garment put on which you see here.

What you see here are the liposuction canisters showing the amount of fat that was taken out of this gentleman. The canister on the right is actually the first canister that's filled and then it runs over into the canister on the left. The right canister was basically filled from his flanks on the back side, and the left sided canister is what was filled from his flanks on the front side, as well as from his abdomen. And this is a fair amount of fat to be taken out of someone. This is essentially four liters of fat.

 
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