Liposuction is the most popular operation performed by plastic surgeons today. The simple reason for this is that IT WORKS. Arm liposuction is ideal for the patient who has localized areas of fat that don't respond to diet or exercise. Arm liposuction a very safe operation and patients often return to work and normal activities in less than a week. The incisions used for arm liposuction are almost undetectable. The most common areas treated in women are thighs (outer, inner and circumferential), abdomen, hips, buttocks, arms, knees and back. Men often have the abdomen, love handles or breasts treated. See cycles of body contouring plastic surgery

Dr. Koenig practices tumescent liposuction as well as ultrasonic liposuction. Each method has its advantages and methods are individualized on a patient by patient basis. The goal of arm liposuction is to maximize safety and optimize results.

Consultation - Arm Liposuction Surgery
The ideal patient is close to their ideal weight and in good health. Body contouring plastic surgery is only an adjunct to a healthy life style which includes good diet and regular exercise. Most people seek arm liposuction to improve their self image, to fit better in clothing and to improve areas that are out of proportion to the rest of their body. Arm liposuction is not a method of weight loss. The average liposuction patient in Dr. Koenig's practice has about 3500cc of fat removed which translates to 5-7 lbs on the scale. Some liposuction patients require greater removal to achieve the contouring needed and others require less removal. In healthy patients large quantities of fat can be removed during liposuction but when >5000 cc of fat are removed, the patient is required to stay in a overnight facility for safety purposes.

Arm liposuction removes only fat and the skin is asked to retract over the new thinner layer of fat that remains. If the skin has good elasticity this occurs predictable and patients are pleased with their new contour. If the skin has lost its elasticity the skin may be looser after the arm liposuction. This can usually be determined at the time of your consultation, body lifting procedures may be recommended depending on your clinical exam.

Fat cells are removed permanently after arm  liposuction. Normally fat cells do not multiply with weight gain, the cells simply enlarge. Therefore, if a person gains weight after arm liposuction it will not usually return to the area suctioned since these fat cells are gone and cannot enlarge, but the fat cells in other areas can still enlarge.

The Operation - Arm Liposuction
Arm liposuction can be done under general anesthesia, local anesthesia or local anesthesia with sedation. The procedure takes between 1-3 hours, depending on the number of areas treated. All patients are placed in post operative garments which are typically worn for the first 3 weeks after arm liposuction. Some patients have endermologie treatments after arm liposuction. We feel this can keep the skin smooth and help with cellulite as an adjunct to the liposuction. There is little pain immediately after arm liposuction because the local anesthetic that is placed at the time of surgery lasts about 4 hours. After the local anesthetic wears off there can be significant discomfort that requires pain medication. This usually lasts 24-48 hours.

Recovery - Arm Liposuction
Most patients return to work in 3-5 days and are encouraged to walk on day one. Exercise can be resumed as tolerated after the first week and most patients are at full activity after 3 weeks. Swelling is persistent and can remain for several months after the procedure. Swelling lasts longer in older patients and usually the patient has their final result using the formula one month per decade.

Complications-- Arm Liposuction
Like any operation liposuction has the possibility of complications. Bleeding and infection do occur but are rare. Skin irregularities can occur or loose skin can result from liposuction. Occasionally revision liposuction surgery is needed but this is quite unusual.

PRE-OPERATIVE INSTRUCTIONS

THREE WEEKS BEFORE ARM LIPOSUCTION SURGERY:

• Laboratory and EKG (if they are required) must be done. If you are having your preoperative testing at a lab other than the one we suggested, you are responsible for having the written results of this testing arrive at our office one full week before your arm liposuction surgery (our fax number is 585-271-4786).
• AMR LIPOSUCTION SURGERY WILL NEED TO BE CANCELLED IF THERE IS ANY CHANCE THAT YOU ARE PREGNANT.
• All fees are due, including surgical, facility and anesthesia.

TWO WEEKS BEFORE ARM LIPOSUCTION SURGERY:

• Do not take any products containing aspirin, ibuprofen (Advil, Motrin), non-steroidal anti-inflammatory medication or Vitamin E. Tylenol is acceptable.

· Refrain from all nicotine products, including cigarettes, pipe tobacco, chew or Nicotine patch. Nicotine interferes with healthy circulation and may affect the result of your arm liposuction surgery. It also places you at higher risk of complication when receiving anesthesia.

ONE WEEK BEFORE ARM LIPOSUCTION SURGERY:

• Do not drink alcohol for 1 week before and after arm liposuction surgery.
• Please ensure that all laboratory tests and/or blood work has been completed by this time as ordered by the plastic surgeon/nurse practitioner. Our fax number is 585-271-4786.

THE DAY BEFORE ARM LIPOSUCTION SURGERY:

• Call 267-8200 to obtain your arrival time for the day of arm liposuction surgery.
• DO NOT EAT OR DRINK ANYTHING AFTER MIDNIGHT (This includes water and gum chewing). Arm liposuction surgery may be cancelled if this is not followed. A fasting state is required in order to receive sedation for surgery. The only exception is medication, which we instruct you to take with a sip of water the morning of your liposuction surgery.

DAY OF ARM LIPOSUCTION SURGERY:

• Go to suite 101 (Lindsay House Surgery Center).
• You may shower and shampoo the morning of arm liposuction surgery. Do not wear makeup, hair sprays or gels, or nail polish. You may leave acrylic nails on.
• Please wear loose fitting clothing.
• Do not wear jewelry, including body jewelry or bring valuables to your arm liposuction surgery.
• If you have your menstrual cycle, please wear a feminine napkin. Do not wear a tampon.

POST-OPERATIVE INSTRUCTIONS

COMMON INSTRUCTIONS AFTER ARM LIPOSUCTION SURGERY:

• A responsible adult must provide transportation for you after arm liposuction surgery (public transportation is not permissible).
• A responsible adult must stay with you overnight and after your arm liposuction surgery until the morning following the procedure. If you are having several procedures, you may need or prefer assistance for 1-2 days following your procedure.
• Avoid making major decisions or participating in activities that require judgment for 24 hours after arm liposuction surgery.
• Do not drive for approximately 5-7 days after your liposuction surgery or when taking pain medications.
• Avoid any activities that cause pain or discomfort. There are no restrictions on your activity or exercise.
• You are encouraged to walk around the house on the day of arm liposuction surgery and thereafter. This helps to prevent blood clots from developing in the legs.
• Move/pump your legs frequently while lying down. This also helps in preventing blood clots from developing.
• Take deep breaths often when you get home and for the first 24 hours after arm liposuction surgery. This helps to expand the base of your lungs.
• Resume activities slowly. You may feel tired for the first few days but you should be able to return to normal activities within 1 week.
• Expect to have pain for the first 24 hours. Take your pain medication before your pain becomes severe.
• Take all medications as instructed post operatively.
• Some bruising and swelling is normal. It is expected to take between 3-6 months to see your final results.
• Avoid direct sunlight to the incision for at least 1-year. Use a sunscreen with zinc oxide with a SPF of 20 or greater to help decrease the visibility of the scar.
• Drink lots of liquids after arm liposuction surgery to help replenish fluids that may have been lost during surgery.
• Use caution when getting up from a chair or bed as you may experience slight lightheadedness.
• You will go home with a compression garment in place. You will need to wear this garment at all times for three weeks after surgery. After 5 days, you may take the garment off to shower but it should be put back on afterwards.
• Expect to have a moderate amount of swelling and drainage. You may change the gauze pads over your garment as needed to help keep clothing dry. The drainage from the small incisions may be significant for the first 12 hours after surgery but should stop after 24 hours. If it persists after then, please call the office.
• After you have taken your first shower and changed into your new garment, you can then apply Dr. Koenig's Post Liposuction Oil to the areas on your body treated with liposuction. Avoid suture/incision area for at least 2 weeks.

CALL OUR OFFICE IF YOU DEVELOP ANY OF THE FOLLOWING AFTER ARM LIPOSUCTION SURGERY:

• Fever of 101 degrees F or greater.
• Pain not relieved with pain medication.
• Swelling, redness, bleeding, and/or foul drainage from an incision site.
• Persistent nausea and/or vomiting.
• Any other concerns.

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