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Awake Liposuction

What Is Awake Liposuction?

Awake liposuction is a procedure which removes areas of excess fat to help slim and reshape areas of your body. This is done through very small incisions using cannulas and power-assisted suction. This can all be achieved without the use of general anesthesia, making recovery significantly easier and shorter.

Awake liposuction can also be used as a first stage for certain procedures. For example, if liposuction is needed in an area of the body, it is safer to do the liposuction first in one procedure and removal of excess skin in a separate second procedure.

Awake liposuction can be performed over many areas of the body including:

  • Abdomen and waist

  • Thighs

  • Hips and buttocks

  • Upper arms

  • Back

  • Breasts

  • Chin and neck

Am I a Good Candidate?

The best candidates for awake liposuction are patients who are healthy and within 30% of their ideal weight who have deposits of fat that won’t go away despite proper diet and exercise.  Patients should be healthy and non-smokers. Smoking can significantly affect healing after surgery. Liposuction is not a weight loss surgery and the results are not as drastic as with some of the other surgical procedures but it can help with problem areas. When the fat is removed, the surrounding skin will shrink down, but it may not in patients with damaged and loose skin (such as skin with a lot of stretch marks). In these cases, removal of the excess skin is recommended.  Liposuction is not a treatment for cellulite. During your consultation, we will discuss if you would benefit from liposuction and/or another procedure.

How is the Procedure Performed?

The procedure can be performed under local anesthesia with or without sedation. Awake liposuction is performed through small incisions which are 2 millimeters in length. A dilute local anesthetic solution is placed in the areas to be treated prior to starting the fat removal process. This allows the procedure to be performed while awake with minimal discomfort. Power-assisted liposuction is used to remove the fat.

Immediately after the procedure, you will be placed in compression garments. It is common to have some swelling, bruising, and retention of fluid right after surgery. It may take months for the swelling to go down and to see the full results of the surgery.

Why Should You Choose the Surgeons at Hill Country Plastic Surgery?

Both Dr. Farber and Dr. Shah were fellowship-trained at the most prestigious institutions and their techniques for delivering patient results and satisfaction set the standard for plastic surgeons in the field. They use the most advanced techniques and consistently achieve superior results. Their warm demeanor, genuine care, and dedication to their patients are second to none. Ultimately however, patients choose Dr. Farber and Dr. Shah for the results. Their patients look and feel their best, and so can you. Discover the difference here in San Antonio!

Limitation, risks, complications

The risks of awake liposuction are reactions to the local anesthesia or sedation, bruising, changes in skin sensation, damage to surrounding structures, blood clots, irregular contour, asymmetry, persistent swelling, rippling or loose skin, worsening of cellulite, and need for revision.

What to Expect During Your Consultation Visit

During your initial consultation with your surgeon at Hill Country Plastic Surgery, we will discuss your concerns and goals before recommending treatment options that are tailored specifically to your needs. Prior to your consultation, we recommend that you review the procedures on our website so you are familiar with the terms we will be using during our discussion.

Once we identify your concerns and surgical goals, we will discuss all of the treatment options that are available to you. Every patient is unique and we will develop a tailored surgical plan that addresses your specific goals. In addition, we will thoroughly review your medical history, surgical history, medications, allergies, family medical history, and other important details. It is very important that we obtain accurate information in all of these areas as it may impact the outcome of your surgery.

While discussing different treatment options, we will perform a physical exam and take measurements that are necessary for planning for your surgery. Pre-operative (before surgery) photos will be taken either at your initial consultation, or during your pre-operative visit.

After your consultation, you will receive access to your notes on the patient portal in addition to information about your specific surgery. If you have not activated your patient portal, this can be done at your appointment by asking any of our staff to assist you. If you have questions after your appointment, you can contact our office or message us through the patient portal. Some patients will require medical clearance from their primary care physician or a specialist or additional tests before undergoing surgery.

Once you have determined that you would like to have surgery and have completed any clearances and tests that were requested, contact our office at (210) 658-3555 to schedule a pre-operative appointment with one of our surgeons.

Pre-operative Appointment

On the day of your pre-operative appointment, we will review your procedure in detail and go over the surgical plan with you. We will also address any questions and concerns you may have and measure you for your post-operative compression garments. Please read over the procedure consent prior to this appointment and have any questions ready so we can discuss them.

During your pre-operative visit, we will provide you with all of the after-care instructions as well as necessary medication prescriptions. You will also be provided with a post-operative appointment for follow up after your surgery.

Before the Day of Surgery

Please do not smoke (cigarettes, vape, or pipe) or use any nicotine products 4 weeks prior to and after your surgery. Smoking and nicotine greatly impair healing, which can cause increased risk for infection and complications, such as delayed incisional healing or wound opening which lead to worse scarring. Please stay away from second hand smoke as well, as this can also cause wound healing problems. If you use nicotine products, you will need to stop 4 weeks prior to surgery and then you will need to undergo a cotinine test prior to surgery to ensure that the nicotine is out of your system.

Please do not drink alcohol before or after your surgery (until cleared by your surgeon). In addition, please do not drink alcohol while taking pain medication, as this can have serious, and life threatening side effects.

Please leave all valuables at home. If you have body piercings, kindly remove them prior to surgery.

Please have someone available to drive you home. Due to the lasting effects of the sedation, you will be unable to operate a car after surgery. A taxi or car service is not adequate either. You will need a family member or friend who can assist you.

You may have been asked to obtain pre-operative tests at a lab facility or your primary care physician. Your pre-operative tests (labs, X-rays, EKG, etc) need to be completed at least three days before your surgery. If you have them done at your doctor’s office, the results will need to be faxed to (210) 362-1582.

The surgery facility will call you the day before your surgery to let you know what time and where you should arrive.

Shower the morning of or the night before your surgery with your normal soap and water. Do not use deodorant, lotion, cream, perfume, aftershave, oils, or makeup after bathing.

 

Do not take Advil, Aleve, Naproxen, Fish Oil, Garlic, CoQ10, Omega 3,6, Motrin, Excedrin, Ibuprofen, Aspirin, medications for arthritis or any medication that contains these medications for ten days prior to your surgery and two weeks after.

Do not eat or drink anything after midnight the night before your surgery.

Please call our office if you have an infection of any kind prior to your surgery.

Day of Surgery

On the day of surgery do not take the following blood pressure medications with generic names that end in “-pril”, “-sartan” before your surgery.

On the day of surgery, your plastic surgeon will meet you in the pre-operative area to go over any last minute questions or concerns you may have. Your plastic surgeon may make some preoperative markings and will perform extensive checks with careful attention to detail, ensuring high quality care and safety. You will meet the members of our plastic surgery operative team.

Throughout the procedure, your family will be updated of your status periodically and will be able to talk with the plastic surgeon in person after the procedure is completed. The incisions will be placed in a dressing or a compression bandage. Instructions for care on these will be given to you in your preoperative paperwork.

Aftercare

In order to make your recovery faster and more comfortable, we recommend that you prepare before your surgery. Things you can do are:
● Prepare a sleeping area that is easy to get to. For example, set up a couch downstairs instead of having to walk up to an upstairs bedroom. Keep your toiletries close by and prepare food ahead of time. Arrange for someone to be with you the first night after surgery.
● You may receive your post-operative medications at your pre-operative appointment. You should pick up these medications prior to your surgery.
● Review your post-surgery instructions given to you at your pre-operative appointment

When undergoing sedation for the procedure, you will need to have someone drive you home. You will not be allowed to undergo surgery if there is no confirmed designated driver.

Medications:

After surgery you will have discomfort and the goal of pain medications is to reduce pain, but it will not completely remove all pain. A good measure for if you need more pain control is that you should be able to take a deep breath without severe pain. Do not wait until your pain is unbearable to take the next dose of pain medication because it will take longer to get your pain under control again.

You may resume your home medications after surgery except blood thinners and as determined by your surgeon.  We will give you a prescription for a pain medication.  If you are prescribed medications that contain acetaminophen (tylenol) it is important that you not exceed 3500 milligrams of acetaminophen (tylenol) per day. Do not drive, operate heavy machinery, or make important decisions while taking narcotic pain medications.

Narcotic medications may cause constipation. Ensure you have adequate (>25 grams/day) of fiber in your diet and drink at least 64 oz. of water daily. You may also wish to take an over the counter stool softener such as Miralax or Colace once or twice daily.

You can alternate your narcotic medication with Ibuprofen 600mg every 6 hours. Take ibuprofen with food to protect your stomach from irritation.

If you have a history of nausea or vomiting after anesthesia, you may be prescribed an anti-nausea medication (Ondansetron) which can be taken as needed.

Before prescribing any narcotic medications, we are required to check the Texas controlled substance history database (Texas Prescription Monitoring Program).  If you currently have a pain medication contract with another physician or are currently on narcotic medications, we will have to coordinate your medications with that physician.

We will prescribe pain medications for recovery after surgery, but do not prescribe long-term pain medications and do not do more than one refill for any pain medications. If you have pain that is beyond what is usually anticipated for your surgery and there is no surgical reason that can be found, we will help by referring you to one of the many pain management specialists that we work with.

Surgical Site Care:

You may shower 48 hours after your surgery. Do not scrub the incisions, just let the water run over them and gently dab them dry afterwards. Apply gauze over the surgical site daily as needed for light drainage. Do not immerse your incisions in baths or hot tubs until at least 2 weeks after surgery.

Please Call Immediately if:

Please call if you have the following signs/symptoms:

  • temperature greater than 100.5 F
  • bleeding or pus draining from the wound site. If you have bleeding, apply direct pressure to the area for 20 minutes
  • increasing pain that is not controlled on oral pain medications
  • increasing redness or size at the surgical site
  • if your wounds come apart
  • Any other concerns

For non-emergency questions:

During business hours (8 AM – 430 PM): call (210) 658-3555.

After hours and on weekends/holidays: call (210) 658-3555 and you will be forwarded to the on call surgeon.

If you are having any serious problems or symptoms such as difficulty breathing or chest pain, call 911 or proceed to your nearest emergency room.

Activity restrictions:

No vigorous activity: no pushing, pulling, bouncing, housecleaning, yoga, running, heavy lifting greater than 5 lbs until your follow up appointment.  Avoid activities that raise your blood pressure or heart rate. You are encouraged to walk around and you can climb stairs after surgery. You should not lay in bed and not move.

Follow-up Clinic appointment:

Your clinic appointment will be scheduled at your pre-operative appointment before surgery.  If you need to change your appointment time or date, please contact our clinic at (210) 658-3555.

The surgeon may adjust any of the above guidelines and instructions based on the patient and type of surgery performed.

Liposuction FAQs

The procedure is done in an accredited surgical center.

You will wear compression garments after surgery. You will be measured for the garments prior to your surgery so you have them available. As the swelling goes down and your new figure is revealed, you may need a newer, smaller garment.  The garment is usually worn for at least 6 weeks, but it can be worn longer if needed.

Most of the results are permanent if you maintain stable weight and fitness.

Awake liposuction removes excess fat but does not treat the skin. If you have hanging skin, liposuction may make it worse.  It is possible to do liposuction to improve the contour of the area and then remove the skin in a separate procedure.

You can start light exercise two weeks after surgery when most of the swelling and bruising has gone away. You can return to all activities without restrictions 6 weeks after surgery.

The cost of Awake liposuction depends on the number of areas to be treated, how much is to be removed, and the facility. You will get a quote on how much the procedure will cost after consultation with your surgeon.

The cost of awake liposuction depends on the number of areas to be treated, how much is to be removed, and the facility. You will get a quote on how much the procedure will cost after consultation with your surgeon.

Interested?

Are you interested in learning more about this procedure? To schedule a consultation, please fill out the form on this page or call us today. Our team members are here to help you and will reach out promptly.

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