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By DR. GRACE CAROLE P. BELTRAN
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Date Posted: 10:47:07 08/14/06 Mon
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Lipo: not as simple as it seems
AMAZING GRACE By DR. GRACE CAROLE P. BELTRAN
Surgical procedures like liposuction require meticulous postoperative instructions that should be followed strictly by the patient. In liposuction, small incisions appear trifling, similar to a scratch wound. Letting patients know that liposuction is not as simple as it may seem to be is of utmost importance.
Liposuction can affect a lot of tissue beneath the skin. Connecting fiber tissues attaching the skin to deeper structures are severed. Blood vessels that carry oxygen to fat cells are disrupted. Small lymphatic structures that collect waste material and excess fluid to drain them into larger lymphatic networks are also altered. These change results in a significant wounding that needs to be repaired.
The body needs to rebuild these blood and lymphatic vessels to restore the fine transport network, to reconnect and restore damaged connective tissues that serve as a link and holds your skin tightly and flexibly in place.
While the reconstruction process is taking place, these same damaged structures must work doubly hard. Disconnected, damaged tissues and clots of blood will have to be removed. Building materials will have to be summoned through chemical mediators to travel to the repair zone. Skin has to shrink to redrape to the body’s new size, and will have to tighten to a smaller shape to accommodate the changes.
During the healing process, a lot of extra blood and lymph find their way to the wound site, combined with some exit points for the fluids that are already there and show up as edema or swelling. This swelling slows down wound healing as well as the whole recovery process, as the backward force of accumulated extra fluids can block fresh supplies of oxygen and nutrients needed for the repair process.
Seromas (pockets of lymphs) or hematomas (pools of blood), while considered rare complications, can occur. If there are a lot of these, the immune system may not be able to handle its removal. And if too much fluid stays between the cells, some fluid returns to the blood, causing the heart to pump harder.
Surgeons often tell their patients to apply compression after liposuction. But patients often neglect this part of the instruction either by forgetting them or by improper application of their compression garments.
Done properly, the above complications can usually be prevented. The elastic garments push down on the skin, squeeze body fluids back toward the deeper tissues so that they do not stay long between the cells. This prevents infection from setting in and reduces edema at the same time.
Elastic garments can also lower body temperature and skin wetness that helps prevent infection, improve wound healing and improves body comfort as well. And because the skin is held firmly against the body, the skin heals without sagging, resulting in a better cosmetic effect.
***
The author is a member of the Philippine Dermatological Society, Philippine Academy of Cutaneous Surgery, Philippine Society of Liposuction and the Philippine Academy of Aesthetic Surgery
For comments or suggestions, please call 373-1558, 414-5880, (0917) 497-6261 or e-mail at gc_beltran@yahoo.com.
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Lipo: not as simple as it seems