Member of Japan Society of Aesthetic Surgery Condensed Rich Fat (CRF) Therapy Certified Physician VASER Lipo Certified Physician VASER 4D Sculpt Certified Physician
Medical institution with Dr. Hiroshi Nagano
Dr. Hiroshi Nagano, the director of "Mods Clinic", a clinic specializing in liposuction and injection. Based on the belief that "only surgery to clean up" is performed, we handle more than 7,500 cases of liposuction (2012-2019) and more than 2,600 cases of liposuction. Qualified as a certified physician for CRF therapy, VASER Lipo, and VASER 4D Sculpt. There are various places of activity such as seminar lecturers for doctors, presentations at overseas conferences, and publication of the book "Liposuction Revolution".
Liposuction is a surgical cosmetological procedure in which a tube called a cannula is inserted under the skin and the subcutaneous fat is aspirated to remove it. You can aim for the ideal face line and body line by reducing the subcutaneous fat in the areas of concern on the face and body, such as the cheeks, chin, upper arms, waist, and thighs.
Liposuction can reduce subcutaneous fat without hard exercise or dietary restrictions, so while many people are interested in it, downtime and risks are often talked about.
Of course, because surgical procedures are performed, there is a certain amount of downtime and the risk is not zero, but these days, due to advances in medicine and the development of surgical methods, the burden on the body is reduced compared to when the procedure was established. Liposuction methods are becoming widespread.
In order to eliminate troubles after surgery, it is necessary to know in advance the difference between the effects of general diet and the effects of liposuction, and the details of liposuction surgery.
In addition, it is better to understand and consider the guideline and risk of "downtime" that causes swelling and swelling due to liposuction surgery to return to the original state, and how to spend after surgery. It leads to selection.
Table of contents
Cosmetic medicine that removes fat includes "cutting" surgery that involves an incision in the skin and "non-cutting" surgery that uses a machine or drug, but liposuction is a tube called a "cannula" after making a few mm incision in the skin. Is one of the surgical operations to insert (remove) fat cells into the subcutaneous fat .
Incisive treatments using machines and drugs basically aim to reduce fat by damaging fat cells and promoting metabolism, rather than removing fat directly. Therefore, multiple treatments may be required before sufficient slimming effect can be obtained.
Liposuction, on the other hand, is a surgical procedure that physically removes fat cells, so it is quick-acting and can reduce fat in a short period of time .
There are various types of liposuction such as "VASER Lipo", "Smart lipo", "Lipomatic", "Aquicell", and "Body jet" depending on the medical institution. Varies.
There are two types of fat: "visceral fat" that adheres around the internal organs and "subcutaneous fat" that is pinched with fingers, but visceral fat is under the muscles and cannot be removed by liposuction. Liposuction removes subcutaneous fat that sits on the muscles and affects the appearance of the body line .
It is said that women are more likely to have subcutaneous fat than men, and men are more likely to have visceral fat than women.
You may hear people say, "Even though I have liposuctioned, my weight and body fat percentage do not change so much." Subcutaneous fat has a lower density and a lighter specific gravity than water, so liposuction does not have a large effect on body weight or body fat percentage, which represents the proportion of fat contained in the body.
For example, removing 1,000 cc of subcutaneous fat does not result in a weight loss of 1 kg. Liposuction does not change your weight significantly because it is not about losing weight, but about removing fat and adjusting the appearance, but the loss of fat at the treatment site will change the appearance .
|subcutaneous fat||Visceral fat|
|Characteristic||It is directly under the skin and pinched by hand||Around the internal organs, do not pinch by hand|
|Gender that is easy to attach||Female||male|
|Impact of diet||Difficult to drop||Easy to drop|
Dieting through exercise and dietary restrictions aims to reduce the size of fat by accumulating excess triglyceride ingested in the diet and reducing the size of fat cells that have grown.
Neutral fat stored in fat cells is used again as energy and consumed when the body lacks the energy required for physiological functions.
Therefore, by dieting such as exercise and dietary restriction, the stored triglyceride is released and fat cells can be expected to shrink, but since the number of fat cells itself does not decrease, the fat cells become smaller by dieting. However, as the amount of exercise decreases and the amount of food eaten increases, neutral fat may be stored again and become larger. This is the "rebound".
After liposuction, the remaining fat cells may grow due to lifestyle-related habits such as overeating and lack of exercise, but the fat cells once sucked and removed will not return to their original state . Liposuction sucks and removes the fat cells of the subcutaneous fat, so the possibility of rebound is low.
In liposuction, in order to aim for a beautifully finished body line, we will design by leaving the fat that should be left in consideration of the balance of the original body shape and the texture such as firmness and elasticity of the skin. Therefore, the more fat you inhale, the more beautiful it will look.
Also, if you take too much fat at one time, it will put a strain on your body, so it is said that the amount of fat sucked in one treatment is about 3,000cc to 4,000cc . However, since the way fat is attached differs depending on the part, the amount of fat to be sucked varies depending on the part, such as 30cc to 90cc for cheek and chin face treatments, and 1,000cc to 3,000cc for fat areas such as the abdomen and thighs . ..
If you have a large amount of fat and need to aspirate more fat than you can inhale in a single procedure, the procedure is divided into multiple procedures. In that case, consider the burden on your body and wait 2 to 4 weeks.
However, it is possible to perform multiple treatments at the same time, such as the upper arm and abdomen, as long as the amount of liposuction is within the range of one treatment .
Liposuction is an operation to reduce subcutaneous fat, so it is not suitable for those who want to improve the excess of visceral fat or those who want dramatic weight loss with one operation.
Those with chronic illness or illness
If you have a chronic illness, you may need the consent of your doctor.
In addition, those who have severe diabetes or those who have kidney or heart disease may not be able to receive it, so please check with your doctor if it is okay to receive liposuction.
Those who may become pregnant / pregnant
Liposuction is not possible for those who may become pregnant or are pregnant because the anesthesia used during surgery can affect the mother.
Symptoms such as swelling and internal bleeding appear after the procedure. The period of time it takes for the symptoms to subside and return to their original state is called "downtime," but you don't have to rest all the time.
Compared to the time when liposuction was established, the pain after surgery has been reduced by devising a cannula and anesthesia. Scars can also be made less noticeable.
In the late 1970s, Dr. Illouz and Dr. Fournier of France devised a method of liposuction using a cannula, and until about 20 years ago in Japan, the same size of cannula used in Europe and the United States was used. Was there.
After that, a thin cannula was made according to the physique of the Japanese, and now the types of length, shape, and thickness are increasing, and the treatment is performed by the cannula according to the suction site and the depth of the fat layer .
The suction cannula generally has a thickness (diameter) of around 5 mm, and there are various types depending on the length and shape, etc., according to each part such as face, upper arm circumference, abdomen, thigh, etc. and individual body shape. The doctor will make the right choice.
In liposuction, it is said that the degree of conspicuousness of scars after surgery changes greatly even if the thickness of the cannula used is different by a few millimeters, and in order to aim for a beautiful finish with less conspicuous scratches, the diameter is 3 mm thinner than general ones. There are also medical institutions that use a moderate amount of cannula.
The "Tumescent Technique" developed by Dr. Klein of the United States in the 1980s has made it possible to perform liposuction with less bleeding.
The chumecent technique (chumecent method / wet method) is a method of injecting a chumecent solution containing physiological saline, a hemostatic agent, and an anesthetic (lidocaine) into the treatment site before liposuction. Tumecent fluid has a fat-soothing effect, suppresses bleeding and acts as a local anesthesia .
By diluting and injecting the anesthetic lidocaine, a large amount can be safely used, and the fat layer swells evenly, making it easier to see the fat layer .
However, anesthetic solution can also cause swelling after surgery, so nurses generally manually squeeze out the anesthetic solution remaining on the surgical site immediately after surgery.
After that, it is said that the swelling after the surgery can be further reduced by performing the procedure of compressing and fixing the surgical site and squeezing out the anesthetic solution again before returning home after the consciousness is awakened.
In some cases, the treatment is performed only with local anesthesia by the tumescent method, and in other cases, the tumescent method is combined with other anesthesia such as intravenous anesthesia and general anesthesia.
|Type of anesthesia||How to make the anesthetic work||Consciousness||Breathing||Characteristic|
|Local anesthesia||Injection into the treatment site||is there||spontaneous||Since it is a local anesthesia, the burden on the body is small.|
|Epidural anesthesia||Insert a thin tube into the gap in the spine and inject||is there||spontaneous||You may feel pain when inserting the tube|
|Intravenous anesthesia||Intravenous infusion||Absent||spontaneous||Less dizziness and nausea like general anesthesia after anesthesia is cut off|
|General anesthesia||Respiratory suction||Absent||Artificial||There are cases of dizziness and nausea after the anesthesia is cut off.|
Liposuction has a great effect of reducing fat that can be felt in one operation, but it also has risks and side effects because it is a surgical operation. Even nowadays, the safety has increased due to advances in medicine and the development of surgical methods, and depending on the knowledge and experience of the doctor in charge, the possibility of causing serious risks and complications that can be life-threatening is not zero.
Liposuction has the following risks, which can be said to be reduced by the doctor's experience .
In particular, general anesthesia puts a heavy burden on the body, so dizziness and nausea may occur after the anesthesia is cut off. In addition, the wrong amount of anesthesia or the use of an anesthetic that is not suitable for the body may cause shock symptoms and allergies .
If the number of cases of liposuction is small and inexperienced doctors are in charge, there is a possibility that the internal organs may be damaged during liposuction in the abdominal procedure.
If a blood vessel is damaged during surgery and fat gets into the blood vessel, it can cause embolus. Pulmonary embolism, cerebral embolism, and ophthalmic arteries may cause blindness due to blood vessels that have entered fat.
Although usually unthinkable, if you have surgery at a medical institution that has hygiene problems such as reusing medical equipment, there is a risk that bacteria will enter and cause infection when you make an incision in the skin and insert a cannula. there is.
Improper hemostasis or damage to blood vessels can lead to anemia and shock due to heavy bleeding . There is also a risk that blood will collect in the body and cause hematoma .
If the design does not look as desired, such as "the finish is unnatural" or "there is a difference between the left and right", or if the skin becomes uneven due to uneven fat removal, re-operation is required to correct it.
Some medical institutions accept corrections for failures such as uneven skin caused by liposuction received in the past, even if they are cases from other hospitals. However, if you do not get the desired result or if you do not feel the effect of reducing fat, you should consult with the medical institution that underwent surgery.
Since the ease of sucking fat differs depending on the part, liposuction is performed while being careful not to make it unnatural by sucking as much as possible in the part where it is easy to suck. In addition, the upper arm, waist, thigh, etc. may be asymmetrical from the beginning, so the treatment is performed with a balance in mind.
If unnatural lines, laterality , or leftover fat still occur, inject fat collected from another site or perform liposuction again to prepare it.
The incision for inserting the cannula is made in an inconspicuous position that overlaps with the wrinkles on the skin, such as the upper arm and the base of the thigh. If the scars are noticeable even after 6 months after the surgery when the swelling and swelling have subsided, other cosmetic medicines that make the scars less noticeable can be expected to improve.
Excessive fat cannot be restored and can cause the skin to sag. If the line collapses and the skin sags due to excessive fat removal, we aim to improve it by injecting fat collected from another site .
If skin sagging is expected in advance by aiming for the desired body line, combined surgery to remove the skin sagging will be considered.
Immediately after the treatment, swelling and swelling make it difficult for the treatment effect to appear. After about 3 months, when the swelling develops, check it, and if it is judged that there is a leftover, liposuction will be performed again .
Liposuction is not covered by insurance, so you will have to pay for it yourself.
The fee for liposuction varies depending on the medical institution, but the market price is about 200,000 to 400,000 yen per treatment for one site . However, depending on the medical institution, the items included in the cost will differ.
For example, after surgery, it is necessary to compress and fix the treatment site with a bandage or supporter, but whether the cost of compression supporter is included, and whether other treatments are included as post-surgery care, etc. Please check with each medical institution about what is included in it.
In addition, if you wish to perform the entire abdomen, you may have to perform 3 sites, upper abdomen, lower abdomen, and waist, but in that case, it may be counted as 3 sites.
Some medical institutions recommend hospitalization if you have a lot of fat, but more and more medical institutions are available on a day trip to meet the needs of those who have difficulty taking time off or who wish to have a short treatment.
(1) Counseling / examination
We will provide counseling with the doctor in advance regarding body shape problems and desired treatments. In order to get the desired body line to be designed, it is important to share the finished image firmly with the doctor through counseling.
It is a good idea to check the surgery time and downtime required for your surgery so that it does not interfere with your life. Also, make sure that you do not have any anxiety or doubts about what to do when the pain after surgery is strong, how to spend after surgery, costs and risks, etc.
(2) Blood test
The blood test may be done on a different day before the procedure, not on the day of the procedure.
We will perform blood tests and check the medicines you are taking to check for infectious diseases and your health condition.
After deciding where and where to perform liposuction, imagine the finish and mark (design) where and how much fat to remove with a pen.
Local anesthesia by the tumescent method, or intravenous anesthesia or epidural anesthesia is used in combination with the tumescent method.
(5) Treatment / squeezing out anesthetic solution
When the anesthesia is fully effective, make a few millimeters of incision in the skin and insert a cannula to suck in fat. The treatment time varies depending on the location and range of liposuction, but it is generally about 1 to 3 hours.
(6) Suture / compression fixation
After liposuction, the incised skin is sutured. After liposuction, use bandages or girdles to compress and fix to promote the discharge of waste products and reduce swelling and internal bleeding. Compression fixation reduces downtime such as subcutaneous bleeding, swelling and swelling.
(7) After surgery
From anesthesia to cold eyes, rest at a medical institution.
Spend a leisurely rest on the day of the procedure. If it is desk work, it is possible from the next day. Please consult with your doctor to confirm your physical activity during the examination on the third day.
For about a week after surgery, refrain from strenuous exercise, drinking alcohol, or irritating the affected area.
You can take a shower from the day of the surgery, but since the compression fixation is continued for 3 days after the surgery, you can take a shower except for the area where the compression fixation is done. After the examination on the 3rd day, you can take a full-body shower because you can remove the compression fixation during the shower.
In the case of liposuction of the face, make-up will be possible from the next day or two days depending on the progress after surgery.
|On the day of treatment||Don't work, stay calm|
|next day||Pain peak Take painkillers as directed by your healthcare provider|
|3 days later||Pain peak ★ Remove compression fixation at a medical institution and undergo a follow-up examination|
|1 week later||★ Remove the thread at a medical institution. You can take a bath after removing the thread. The swelling begins to pull. The skin may become stiff and "contracture" may occur.|
|3 weeks later|
A guideline for swelling to begin to subside and internal bleeding to subside
Reduce contracture with massage and stretch
|1 month later||★ Scars undergoing follow-up examinations at medical institutions become less noticeable|
|3 months to 6 months later||Swelling and pigmentation subsides Eliminates hardness and unevenness at the treatment site|
The ★ mark in the table is the timing of hospital visits, but the above schedule is for reference only, and the actual progress may vary from person to person. Follow the instructions of the medical institution undergoing surgery for the actual outpatient schedule and how to spend after surgery.
Immediately after surgery, the swelling and swelling may appear to be temporarily fat, but the swelling and swelling will subside in proportion to the number of days, and you will be able to feel the slimming and small face effects.
There are individual differences in pain after anesthesia is cut off.
In addition, the degree of pain varies depending on the part to be treated, and it is easy to feel pain in a wide range of parts such as the thighs and abdomen, and there is pain like muscle pain. It is said that it is easy to feel pain when the body vibrates, such as when standing or sitting, walking, or going up and down stairs, so it is necessary to perform each movement with more margin than usual.
However, if the surgery is performed using the latest equipment in addition to devising a cannula and anesthesia, the surgery can be performed without damaging the fibrous tissue around the fat, so there is almost no pain that makes it impossible to walk.
Since each person feels pain differently, some people will go to work the next day if they are doing work that does not move much, such as desk work, but depending on a wide range of treatments and fat mass, rest at home for several days. Some medical institutions recommend it. The peak of pain lasts 2-3 days, but gradually turns into mild pain .
You should rest immediately after surgery, but it is recommended that you start self-care with a massage about 3 weeks after the swelling and pain subside.
After surgery, cells that are not accustomed to the state where some fat is lost cause a phenomenon called "contracture" in which the skin becomes stiff as if it were torn, but it is expected to be alleviated by massage. I can do it.
When performing a massage, loosen the skin by pinching and pulling on the unevenness of the skin. Stretching that gently stretches the skin is also effective. If you neglect to massage, your skin may remain stiff or uneven.
Compression fixation is performed for 3 days after surgery, and compression fixation is performed from the 4th day except when showering . After that, it is recommended to continue for about 1 month after surgery to prevent swelling .
Items for compression fixation may be prepared by a medical institution, or you can purchase commercially available items yourself. There are face supporters for compression fixation when liposuction around the face, inner type for the upper body, waist nippers for the waist, girdle type for the thighs, and other compression fixation items for each treatment site. ..
If you buy it yourself, it's a good idea to consider how easy it is to put on and take off so that it doesn't interfere with your daily life, such as choosing a garter belt over stockings for thigh compression.
Proper compression fixation will help prevent skin irregularities and skin irritation and pigmentation, so check with your healthcare provider.
There are "Indiva" and "Endermology" that perform high frequency treatment to relieve contractures that make the skin hard after liposuction. For post-surgery care, some medical institutions offer plans that include indiva and endermology treatments in advance.
Indiva can be expected to reduce internal bleeding, swelling, swelling, pain, skin stiffness and unevenness after liposuction by irradiating the sucked area with high frequency waves, which is the energy of electromagnetic waves , and can be expected to reduce injuries to athletes. It is also used for scar recovery.
Endermology is a treatment method that uses a roller to loosen fat, and can be expected to have the effect of softening hardened fat . It regulates blood circulation and lymphatic flow, enhances metabolism, and discharges waste products, so it can be expected to be effective in alleviating swelling.
Both indiva and endermology are performed about 3 weeks after liposuction surgery and after the swelling and pain have subsided.
The result of liposuction treatment depends greatly on the skill of each doctor. It goes without saying that the machine used for liposuction is used properly, but the most important thing is how many cases are accumulated.
Cases with large changes look good to see, but it is important to ask a doctor who presents many cases of various body types, not limited to such cases, to perform the treatment in order to meet a "good doctor". It's important.
In addition, it is important to always judge with your own eyes and feet. Although the amount of money and reputation can be a hint for choosing a medical institution, it is not always the case that a medical institution with a high word of mouth or evaluation will perform the treatment you desire. To avoid regrets after surgery, visit multiple medical institutions and check for any of the following:
Also, be sure to understand and understand how to correct the problem if you make a mistake before receiving liposuction.
Professor Hiroshi Nagano, who supervised the article, taught me about liposuction.