Photographs are taken immediately prior to surgery. Dr. Jacobs will use a surgical pen to mark all the areas to be treated on your body. You will then be taken to the operating room and prepared for your torsoplasty. “Twilight anesthesia” will be administered and you will drift off to sleep. The chest is treated first – please see a complete description of this operation in the “Gynecomastia” section of this website.
Next, attention is directed to the abdomen and love handles. Initially, a local anesthetic will be injected. Five tiny nicks in the skin are made: one is located inside the upper lip of the belly button while the other four are distributed along a low abdominal crease just below the underwear/bathing suit line. Their locations are designed to provide surgical access to all areas while allowing the scars themselves to be easily hidden.
Through these nicks, a tumescent solution is injected. This is a standard solution of additional dilute local anesthetic, dilute adrenaline (which will diminish bleeding) and saline (salt water). The injection of this fluid softens the fat and makes its removal easier and safer.
Then liposuction is performed in all areas. The goal is to provide a thin, uniform “pinch” of skin and fat over all the areas of the abdomen and love handles. Long, slender metal instruments (called “cannulas”) are used to dislodge the fat and then the loose fat is removed from the body by a high powered suction machine. Since the instruments are blunt (the tips resemble the blunt tip of a bullet), major blood vessels and nerves are literally pushed aside during surgery and are therefore preserved in the process. What remains after the fat has been removed looks like a honeycomb or a sponge, with many intact blood vessels, nerves and fibrous connections running between the deeper tissues and the skin.
Once the torsoplasty is completed, the skin “nicks” are closed with dissolving sutures which do not require removal. A snug compression garment is applied after surgery and is worn day and night (except for bathing) for at least a month (longer would be better). The purpose is to compress the “sponge-like” tissues and thereby prevent fluid accumulation. It also aids in the natural tightening of the skin itself. Drains are very rarely used.
You will then be brought to the recovery room and allowed to gradually awaken over two hours or so. Once you are fully awake, alert, steady on your feet, and have been able to urinate, you will be discharged in the care of another responsible adult. You will receive specific instructions for immediate postoperative care but it is vitally important that you drink lots of fluids during the first 24 – 48 hours after your torsoplasty!
WHAT TYPE OF ANESTHESIA IS USED?
Your torsoplasty procedure will be performed under intravenous (I.V.) sedation, better known as “twilight sleep” anesthesia. General anesthesia is used only rarely and then only in a hospital setting. A separate MD — a board-certified anesthesiologist — will monitor your vital signs for your safety and will administer small, frequent doses of a variety of medications through a vein. The result is a gentle, relaxed sleep during your torsoplasty. There is no pain and no awareness during the procedure and you will awaken quickly and comfortably in the operating room just minutes after the completion of the torsoplasty. There is usually no hangover or nausea afterward.