Liposuction to knees and inner thighs

Cosmetic plastic surgery video by the Medical Director of The Loudoun Center for Plastic Surgery, Dr Michael J Brown. This liposuction video explains and expertly shows how liposuction is skillfully performed.

Leg Liposuction Walkthrough

This medical video is about liposuction of the legs, specifically her inner thighs, inner knees and outer knee areas. This patient is asleep on the operating table and has marks on her which demonstrate the areas I'm going to be recontouring. The tip of the cannula you see there, has holes in it, and I'm using this to inject fluid into her fatty tissue layer. This will allow me to remove more fat more efficiently. The fluid also has two medications in it: one will cause her blood vessels to constrict down and the other one will make her tissues more numb. This will be providing additional anesthesia, then she is receiving while asleep. This will also help her post-operatively which you will see as as I fill these areas with fluid they will descend and get tense.

This will aid in the vessel constriction of the blood vessels and allow the areas to not bleed as much. This will also diminish the amount of bruising that this patient will have. All of these incisions are very small, they heal very well and are essentially very difficult to see. The wetting solution is being placed into the superficial and deep planes of these areas. Some areas are better to re-contour than others. What you see here is the whitening of her tissues. This pale effect is because of the constructive effects of the medication. The tip of this cannula is somewhat aggressive, it has three different holes in it that allow me to evacuate fat.

My left hand is controlling and feeling where the cannula is not only as far as how deep it is going, but also what tissue plane it is at. This is very important especially when you do inner thigh suctioning because there are a lot of blood vessels and being in the correct plane is very important. You can see that she's having a wonderful result because the fat is coming out a nice yellow color. The fluid that I put in will also be coming out during this procedure. The area will be treated through the small incisions. On occasion it is necessary to add accessory incisions to get more fat out that I cannot reach from the one incision site. The nice thing about the cannulas that I use is that they are bendable, and I can actually bend them a little bit to get around curved surfaces. This allows me to use less access incisions yet still get a superior result.

This area will be recontoured in both the superficial and deep areas and I will constantly check the position of the leg to see if the contour is improving. You can see that she's getting close to being done on this side because the fullness that I created is essentially gone. I will then feather the area that I suction to make sure that there is a smooth transition from the area that was aggressively recontoured to the area that is not. You can see there that she has a nice contour to her inner thigh. Again, I will repeatedly check the area and assess the area from different angles and different positions during the surgery. Once I am satisfied with the area, I can use a second cannula which has a little different tip configuration, that also is smaller and this will also help the transition areas to become less noticeable.

Once I'm satisfied with the area, I will typically go to another area and begin to re-contour. The technique I'm showing you here is the pinch technique and I use that to assess the thickness of her tissues, and you can see in the area that was not suctioned, how fat she is versus the area that I did re-contour. You can tell the degree of soft tissue in that area is much less. You can also visualize that as well. The knee is a difficult area because it typically swells a great deal and great care has to be taken in recontouring this area. This is a relatively small tip cannula, and this area typically does not require a lot of fat removal to have a nice result. Doing a lot of secondary suctioning. This is one of areas that I have to try and correct when they have been over suction.

At this point I will bend the cannula to try and get around her knee a little bit. So, again I can control how much fat and what tissue plane I'm actually taking the fat out of. This is a relatively small area to suction. At this point, I am starting to feather the area to try and diminish any noticeable contour areas. Now, I will straighten the cannula back out and begin with the inner thigh. The inner thigh is a difficult area because of the skin flaccidity. Everything that people don't like about their inner thigh characteristics are what make it hard for the area to be well contoured. She is a good candidate because she has beautiful skin and she should have a lovely result.

Care has to be taken at what level the liposuction is performed because the deeper layers of this area of the leg have a lot of blood vessels in them. You can see by the aspiration of the fat which is in the tube that I am in the correct plane and she is not experiencing any significant bleeding. You can see by pinch test how her lower inner thigh is done but the upper thigh is not. You can see by pinch test again, these areas are relatively comparable, she's had a very nice result. She will then have the other leg done in similar fashion. The wounds will be closed with dissolvable sutures, reinforce with steri strips and then she will have foam placed on all the areas that she had suctioned to add extra pressure to minimize the swelling and minimize the bruising. She will then have a compressive garment applied to reinforce the pressure and improve her recovery and result. The canister you see has the fat in it and that is what was taken out from her legs.