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Liposuction (Lipo sculpture)

The skin surrounding the surface of the body has great elasticity and contractibility as demonstrated by weight fluctuation and pregnancy.  This characteristic is greatly influenced by subcutaneous body fat.  Body fat is a source of nutrition and energy storage and it serves as insulation.  In addition, body fat moulds the external appearance of the body around the muscles and skeleton.  As the body ages, muscle mass is replaced by fat deposition.  It is in the fat cells that morphological changes take place with obesity; too little fat results in cachetic apperance (thin – weak).  The number of fat cells remains constant with individual cells increasing in size, as with moderate obesity, or the total number can increase and become excessive as with massive obesity.  Moderate obesity may be defined as body weight more than 120% and less than 170% of the reference body weight.  Body weight of more than 170% of the reference weight is considered morbid obesity.

Skin is attached to the deeper structures by fibrous septa.  These can be described as being the body’s “Velcro”, holding the skin to the body.  Between the septa are globules of fat.  The principle of Lipoplasty is to remove fat, and do as little damage as possible to the septa, which contain blood vessels, nerves and lymph vessels.  For this fat to be removed without serious damage requires an excellent knowledge of the anatomy, an appreciation of body proportions and of course, surgical and metal fitness.

Most patients interested in Lipoplasty know that fat is removed through tubes known as cannulae.  It is through these tubes the fat has to travel when leaving the body.  They come in varying sizes and shapes, can be disposable or reusable, made of plastic or metal (stainless steel) and have single or multiple holes at the tip.  Despite the many varieties of cannulae available to surgeons, all cannulae share a common requirement: they must be non-cutting, i.e. free of sharp openings or small burrs which are damaging to the fibrous septa, blood vessels and nerves.  Almost all-superficial body fat is accessible to the surgeon’s cannula.  This fat is to be found as a layer between the skin and the underlying fascia.  Small canulae are used for the face and extremities, and larger ones are used for the trunk and thighs.  Many different types and styles of cannulae are available, but only a few are really effective. Possibly the most effective most effective of all cannulae are the Grams – Grazer Mercedes type preferred by us.

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