Summary

Patients present for thigh contouring to take care of obesity, fat collection, skin laxity, or both. The ideal patient for liposuction is the one who has localized areas of fat in the thigh but is otherwise fit and does not have skin laxity. Patients may also present with deformities after a prior attempt at thigh lift, or thigh liposuction elsewhere will benefit from thigh fat injection. Lower extremity liposuction treats lymphedema that does not entirely resolve with nonsurgical measures. There is a risk of contour deformity and skin laxity. Liposuction in the knee and thigh, therefore, must be conservative. Based on the experience of Prof Moawad for the last 20 years, he prefers syringe liposculpture of small thigh and the external ultrasound power-assisted liposuction for a large one.

Who is the Right Candidate for High DefinitionThigh Liposuction?

Lower extremity liposuction is perfect for fit patients with disproportional fat distribution in the leg. This procedure has limited results in the inner thigh and knee because the skin is relatively thin and the fat is soft, so skin retraction is less likely than in hardier areas like the outer thigh. There is a risk of contour deformity and skin laxity, resulting in the need for later thigh lift in the upper inner thigh or fat grafting in the knee. Liposuction in the knee and thigh, therefore, must be conservative. Some women have fullness in the calf, which is aesthetically displeasing and makes boots challenging to wear. Skin laxity is possible after liposuction, and if this is anticipated, it is best to discuss the potential need for second-stage skin removal—lower extremity. Liposuction may also be used to treat lymphedema that does not entirely resolve with nonsurgical measures.

What are the Risks Involved in High Definition Thigh Liposuction?

Some authors refer to this form of liposuction as “traditional” or “conventional,” Tumescent liposuction is a safe procedure on the condition that patients are carefully selected, the operating facility is adequately equipped, and the physician is adequately trained in the process. Tumescent liposuction has few significant side effects when performed by a qualified cosmetic surgeon, says Prof Moawad. Liposuction performed under general anesthesia with hospital admission carries a higher risk of serious adverse events.

Will my Skin Hang after High Definition Thigh Liposuction?

Prof. Moawad s initial assessment determines the amount of fat to be removed so that your skin re-drapes appropriately. The degree of skin change after liposuction surgery is the same as one would expect if it were possible to lose an equal amount of fat in these localized areas only by dieting. Because the small cannulas make small tunnels through the fat, there remain multiple connections between the skin and the underlying tissue. These fibrous connections contract with the healing process and maintain the skin in its natural position. After liposuction by tumescent liposuction, one does not have to worry about excessive skin folds in the areas treated by liposuction surgery. This effect is so dramatic that many patients who previously would have required surgical excision of skin, called a tummy tuck, can now have excellent results by merely having power-assisted liposuction. At MSI, we are proud to be the first center in Egypt, who offers a post-liposuction particular skin tightening program that involves vacuum, soft laser, and photodynamic therapy using LED technology and radiofrequency.  Further tightening effect can be achieved only at MSI using the FDA-approved monopolar radiofrequency device for nonsurgical skin lifts. Only those with lax musculature and loose skin with or without excess fat might require further thigh lift.

Are the Incisions of High Definition Thigh Liposuction will be Apparent?  Will I have scars?

A tiny incision (2mm) is all that is required for the insertion of the tube. Incisions are generally small, about ¼ inch. At MSI, our method of re-contouring leaves minimal scars, and Prof. Moawad strategically places incisions within the natural folds of the body.

Can Other Areas be Performed During High Definition Thigh Liposuction?

In men, liposuction can be used to correct gynecomastia. The most common areas for treatment include the abdomen, flanks (Love handles), and upper arms. Other areas include facial accumulation of fat, including a double chin, neck and jowls, breasts, hips, knees, and recently breast. In addition, liposuction is used to remove sweat glands in the underarm to reduce excessive sweating without affecting the body’s ability to cool itself.

Your Consultation for High Definition Thigh Liposuction

During the consultation, Prof. Moawad will review your medical history, evaluate your present health, and assess the current condition of your skin, considering elasticity as well as a localized fat deposition. Your current weight, and whether you plan to lose or gain, will factor within this evaluation, along with what effects, if any, prior weight loss had on the areas of your body you want contoured. I will address your expectations as to whether they can be realistically achieved, in addition to which body contouring method and procedure technique will be most suitable in your case. Prof. Moawad will discuss how factors like the general state of your health, overall condition of your skin, your weight, age, hormonal influences, and certain other factors, can all influence the outcome of your procedure.

How Do I Prepare before High Definition Thigh Liposuction?

You are provided with specific preoperative instructions. I will take preoperative photographs, which are essential aids in planning out and performing the procedure, due in part to the patient being in a horizontal position during the process. Post-operative- photographs are taken at 3- and 6-months post-surgery (body photographs are faceless). If you smoke, you are advised to stop two weeks before your procedure. Smoking can affect the operation and impede healthy healing.

Additionally, you must alert our medical staff to any medication you are taking; certain drugs like aspirin, non-steroidal anti-inflammatory, and Vitamin E may increase bleeding during and after the operation. In addition, some medicines, e.g., special antibiotics, may interact with the local anesthesia. It is generally advised to stop eating and drinking at least 4-6 hours before the procedure. Pending your circumstances, you may want to arrange for someone to drive you home following your surgery, as well as to help you at home for a day or two.  It is recommended you reschedule your procedure should you develop a cold or an infection of any kind, especially a skin infection and during your menstruation.

Preoperative Instructions

• DO NOT SMOKE for two weeks before and two weeks after surgery. Smoking reduces blood circulation, slows down healing, and increases complications.
• DO NOT TAKE ASPIRIN or products containing aspirin or anti-inflammatories such as Brufen, Cataflam, and Ponstan for two weeks before or following your scheduled surgery. These medications affect your blood’s ability to clot and increase your tendency to bleed during surgery or the post-operative- period. If you need to take a mild painkiller, you can take paracetamol.
• DO NOT TAKE DIETARY SUPPLEMENTS for two weeks before and after surgery. These include vitamins, ginger, Gingko Biloba, garlic, ginseng, and fish oils. They may increase your risk of bleeding and bruising during and following surgery.
• DO NOT DRINK ALCOHOL for five days before surgery. Alcohol may increase your risk of complications as well as bruising.
• IF YOU DEVELOP A COLD, COLD SORE, FEVER, OR ANY OTHER ILLNESS BEFORE SURGERY, PLEASE NOTIFY US.
• DAY before AND DAY OF SURGERY: Please shower using only anti-bacterial soap. Males receiving abdominal or flank treatment may prefer to shave the treatment area; females receiving abdominal or thigh treatment may prefer to shave pubic areas below the hairline.
• WEAR COMFORTABLE, DARK, LOOSE-FITTING CLOTHING on the day of surgery, including a shirt that buttons up the front. Wear nothing that you must put on over your head. Slip-on shoes are recommended for maximum post-operative comfort. We suggest you safeguard your car seat and bedding with a protective cover as there will be some fluid leakage following surgery.
• LEAVE JEWELRY AND VALUABLES AT HOME. Do not wear wigs, hairpins, or hairpieces.
• AVOID WEARING MAKEUP, FACIAL OR BODY MOISTURISERS.
• SURGERY TIMES ARE ESTIMATES ONLY. You could be at the clinic longer than indicated.
• ARRANGE FOR A DRIVER TO AND FROM SURGERY. We cannot discharge you to a taxi. Put a pillow and blanket in the car for the trip home.
• HAVE A LIGHT BREAKFAST on the morning of surgery.

Is Thigh Liposuction Procedure Painful? Will I be awake?

The principal factor in determining the type of liposuction and kind of anesthesia patients should have, for example, straight tumescent method, sedation standby or sedation, are pain tolerance, the amount of fat to be removed, and the case past and current medical health conditions; all factors considered when selecting the anesthesia that will provide the safest, most effective level of comfort during your procedure. If only a tiny amount of fat and a limited number of body sites are involved, liposuction can be performed under local anesthesia, which numbs only concerned areas. The local is usually used along with intravenous sedation to keep you more relaxed during the procedure. Some patients enjoy being awake during the process, and Prof Moawad also prefers his patients to be awake to obtain optimum positioning with patient cooperation.

MARKINGS

Patients are marked standing up. Concentric circles are made at regions to be addressed, with the central ring being the most prominent area and the outer circles for transitioning into the adjacent, non-liposuctioned area. Patients should understand what is marked and confirm that the areas to be addressed are correct. The stab incisions for cannula entry may also be marked so that the patient is fully aware of where these scars will be. The cannula entry sites should lie outside regions to undergo liposuction.

The patient is brought into the operating room, and anesthesia is induced. If the outer thigh and calf are part of the plan for liposuction, then prone positioning is warranted. The patient may be intubated on the stretcher and rotated into the prone position onto the operating room table. A Foley catheter may be placed before turning the patient if 4 liters or higher aspirations are planned. Gel rolls are used to avoid pressure: a small one may be placed across the axillary regions and a larger one across the lumbar area. The arms are placed at right angles to the body, and the elbows are also placed at right angles. All pressure-bearing surfaces are padded with pillows or egg crates. An upper body-warming blanket is placed to avoid hypothermia. I may use lower extremity spreader bars. Single stab incisions are made to address the areas of concern. For the outer thigh, incisions may be formed laterally above and below the interest area and in the intergluteal fold. This incision may also be used for posterior access to the inner thigh. Incisions may also be made around the knee and calf region.

Tumescent solution is infused into the lower extremity until it is turgid. After the adequate time is given for the hemostatic effect of the epinephrine, a 3.0- to 3.7-mm cannula is used to perform liposuction. It is crucial to record the fluid put into the tissues and the fluid aspirated from the tissues to ensure that symmetrical treatment is taking place. Prof Moawad applies different liposuction techniques; syringe liposuction, PAL Power-assisted, and traditional suction-assisted lipectomy are the primary methods used. When the desired contour is achieved, liposuction is complete. The patient is then turned supine and draped in a sterile fashion. Areas that had liposuction posteriorly may be smoothed anteriorly. The patient may be placed into a compression girdle under the garment. The girdle should provide coverage distal to the areas that underwent liposuction.

What can I expect immediately following High DefinitionThigh Liposuction?

After surgery, most patients can walk out of the office without assistance. Recovery time will vary greatly depending on the individual, how extensive the procedure is, and the technique used. Generally, after the process, you will probably have some fluid drainage from the incisions and expect some bruising (bruising typically goes away in 3 weeks; swelling can last for three months depending on the amount of work done). Though tumescent liposuction is more refined, you may still experience pain, burning, swelling, bruises, and temporary numbness. With the tumescent technique, post-operative- discomfort is significantly reduced since the local anesthesia remains in the treated tissue, usually causing numbness for sixteen hours or more after surgery. If required, Extra Strength Tylenol or Tylenol with Codeine is enough to control relatively minor discomfort that may occur following your surgery. Immediately after surgery, you are transferred to our luxurious recovery room, where you are fitted with a support garment that you must continuously wear for two to four weeks. You may remove the garment to shower the day after surgery. You may feel stiff and sore for the first few days after your procedure, but you are encouraged to move about, even a little, since this will aid in blood circulation. You should avoid strenuous activity for about three weeks. Patients may return to work in one week, although many return earlier. You are advised not to take aspirin or certain anti-inflammatory drugs and not to smoke.

Dressings will be removed in several days, so Prof. Moawad and his staff can examine treated areas. You will be scheduled for follow-up visits to monitor your progress and receive an ultrasound massage, lymphatic drainage the day following your surgery, then every other day for the first week. Subsequent follow-up visits are scheduled at one month, then again at 3- and 6-months following surgery. Suppose you have any unusual symptoms between visits, for example, heavy bleeding or a sudden increase in pain or any questions about what you can and cannot do. In that case, you are advised to call MSI immediately.

Occasionally the skin may have an uneven or slightly rippled effect. The surface can sometimes be irregular or asymmetric, or pigmentation changes may occur, especially in older patients with dark skin. Scars from liposuction are usually tiny and strategically placed.  Overweight patients who have localized areas of fat removed must be willing to accept a higher chance of contour irregularities and less than ideal skin re-draping in exchange for improving the way they look in clothing.

At MSI, we are proud to be the first center in Egypt that offers post-liposuction unique skin tightening programs that involve vacuum, soft laser, and light therapy using LED  speed recovery time and ensure tight skin.  Further tightening effect can be achieved only at MSI using the FDA-approved monopolar radiofrequency device for non-surgical skin lifts.

Post-operative- instructions

• IF YOU EXPERIENCE EXCESSIVE PAIN OR BLEEDING, FULLNESS OR SPREADING REDNESS IN TREATMENT AREAS, OR FEVER, PLEASE CALL US IMMEDIATELY
• DRIVING: A family member or friend must drive you home from your surgery (it is best to have them stay and assist you for the first 24–48 h). Please do not drive if you are taking the prescription pain medication tramadol.
• COMPRESSION GARMENTS: If you had liposculpture performed on your knees, thighs, hips, arms, or abdomen, I put on a particular elastic-type garment at the end of surgery to provide comfort and support while helping your skin conform to your new body contour. The day following surgery, you may remove the garment once a day for laundering, sponge bathing, and bandage changing (if present). Continue wearing the garment 24 h a day for the first two weeks, followed by 12 h a day (remove at night) for the subsequent two weeks.
• BATHING OR SHOWERING: Sponge baths only for the first 72 h when removing the compression garment. After 72 h, you may take a shower or bath when the garment has been temporarily removed. Avoid Whirl Pools and hot tubs for at least one week (until the incision sites have healed).
• TREATMENT SITES: Please keep your dressings as clean and dry as possible, changing every day if wet to help prevent infection. Do not apply heat or ice to the surgical areas.
• You should expect significant drainage (oozing) of blood-tinged anesthetic solution at the incision sites due to fluids injected during your procedure. Although the fluid may appear red, it is primarily an anesthetic solution and saline and only 1% blood. In general, the more drainage there is, the less bruising and swelling there will be. Many patients have found it helpful to use a shower curtain or other protective covering on their mattress for the first few days after their liposculpture procedure. When your incisions stop draining, please clean with tap water and apply topical antibiotic Fucidin ointment to the incisions. Itching, pulling, pinching, hardness, tightness, and/or numbness sensations are normal. All should subside within 24 h to 1 week but sometimes can last for months. This is part of the healing process, and your patience is appreciated.
• ACTIVITY: Rest for the first 12 h. You are experiencing more than mild swelling, and discomfort may indicate that you are overdoing it. It is normal to experience light-headedness when rising or removing/changing your compression garments. Please have someone help you with this for the early few days after surgery. Take it easy for the first week, resuming regular activity as tolerated. Avoid strenuous activities, lifting over 10 Ibis, or aerobic exercise for 2–3 weeks.
• Protect incisions and any bruised areas from the sun until wholly healed; use SPF30 or higher for six months. Avoid tanning until bruising has faded, which generally takes 10–14 days. If you like, feel free to treat yourself to a gentle massage during your post-operative course. Therapeutic massage is beneficial to speed the healing process. It may be done beginning two weeks after surgery, as often as every second day, and as hard as you can tolerate.
• DIET: If you experience any postoperative- nausea, try carbonated drinks and dry crackers to calm your stomach. Take your post-operative medications with food to minimize irritation. If your stomach feels normal, start slowly with liquids and bland foods, progressing to soups, and finally, a healthy diet as tolerated. Drink plenty of clear fluids.
• ALCOHOL: As well as/In addition to refraining from drinking alcohol for at least five days before surgery, it is essential that you do not consume alcohol if you are taking over-the-counter or prescription pain medication following surgery as they may interact.
• SMOKING: We continue to stress the importance of not smoking. Smoking reduces blood circulation to skin and tissues and delays healing. Do not smoke at all during the first 14 days following the procedure.
• EXPECTATIONS: Remember, the goal of fat removal is not weight loss but for improved contour. Since the body retains fluids in response to surgery, you may notice a temporary weight gain, resolving over the first week. In addition, remember that for most people, the goal is a significant improvement, not perfection.
• Lower abdominal patients may experience significant swelling in the pubic area. Post-operative discomfort usually takes the form of deep muscle soreness and improves typically over the following 2–7 days.
• Slight temperature elevation and flushing of the face, neck and upper chest could last 48 h. You may initially experience a mild depression that should begin lifting after the first week once you see the bruising and swelling fade.
• Menstrual irregularities (premature or delayed monthly onset) are a common side effect of surgery. If you treat areas on the thighs, you might have swelling in your calves and ankles for up to 3 weeks.

POST-OPERATIVE MEDICATIONS.

Please take the antibiotics and pain medications as advised or prescribed by your doctor. If you have no allergies, you may start with regular paracetamol (1,000 mg every six h). If this does not relieve discomfort or pain, you can take the prescription pain medication in addition to the paracetamol. Do not take aspirin, Brufen, or Neurofen. If antibiotics are prescribed, you must complete the entire course.

POST-OPERATIVE APPOINTMENTS.

For maximum healing and optimal long-term results, you must follow the appointment schedule that is made following your surgery.

Are Results of  High DefinitionThigh Liposuction  Permanent? Will Fat Return?

On condition, you stay at your post-operative- weight, and a proper diet and exercise become part of your routine, the liposuction results will be permanent since there are now fewer fat cells in those areas that were contoured.  Weight gain is the actual enlargement of existing fat cells, not the creation of new ones. The fatter cells in a specific location, the more difficult it is to reduce in that area only by dieting. Dieting usually reduces the size of all fat cells proportionately but to no small degree leaves the basic silhouette unchanged. If you gain a few pounds, you will more evenly distribute the weight than accumulating in the same problem areas before the procedure. Doctors believe that once fat cells have been removed by liposuction, these same cells do not return.

Will I Need a Second Procedure after High DefinitionThigh Liposuction?  If so, when?

Most patients require just one procedure. Less than ten percent of patients need a fine-tuning process after of period of after least six months.