Indications:

Morbid obesity defined as a BMI>40 or BMI>35 with a comorbidity is usually unresponsive to treatment with diet exercise & available drugs.

BARIATRIC Surgery not only induces major weight loss but also improves hypertension, diabetes, sleep apnoea, angina, hyperlipidemia & venous disease.

Aesthetic Surgery is used either o remove localised fat that is unresponsive to above treatment or to remove the excess skin from different areas fter the obesity has been reduced or controlled. Aesthetic surgery should not be used as a means of reducing obesity.

Suction Assisted Lipectomy (SAL)

• Single most common Plastic surgery operation in America
• Subcutaneous fat is the target organ for Insulin
• Large liposuction causes substantial reduction in serum insulin levels and weight loss that continues for about 2years post surgery (Dr.Sharon Giese study with 14 patients who had liposuction).
• Reducing fat surgically increases the motivation for exercise and patients eat less.
  

• WET Liposuction
• Dr Y G Illouz
• Super Wet Liposuction (1:1 infusion vol of fluid to fat removal)-
  - less complications
  - better penetration of sound waves

• Tumescent Liposuction(3:1 Infusion)
• Ultrasound assisted Liposuction(UAL)
  - decreases total surgery time by 40% -50%
  - reduces surgeon fatigue
  

• Mini Abdominoplasty
• -Short low horizontal incisions
• -Umbilicus not resited
• Classical Abdominoplasty
• -lower abdominal W incision
• -elevation of upper abdominal skin & fat to above the costal margin
• -Umbilicus resited
  

• Mammoplasty
  Reduction in size by excision of skin,fat & breast tissue
• Mastopexy
  Lifting & tightening of the breastbyremoving excess skin

• Thigh Reduction & Thigh Lift
• Brachioplasty
• Face Lift & Blepharoplasty
• Belt Lipectomy
  

• Today all the surgeries that we do as liposuction are “liposculpture”
• We no longer simply remove a large deposit of fat in “ideal candidate” patients.
• The procedure Liposuction is offered with its many variations to different age groups,those with differing needs and with or without combination with the various plasty procedures we strive to improve the overall shape of the body as desired by the patient.

• Liposuction is quickly becoming an effective treatment for morbid obesity
• As it is a lasting treatment for a chronic illness, insurance programmes may soon cover it.