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Disclaimer This movie is an educational resource only and should not be used to make a decision on or your weight management. All decisions about or weight management must be made in conjunction with your surgeon or a licensed healthcare provider.

MULTIMEDIA HEALTH EDUCATION MANUAL TABLE OF CONTENTS SECTION CONTENT 1. Introduction a. b. Obesity b. BMI 2. areas a. Upper Body b. Female c. Male 3. a. Pre-op b. Operation c. Post-op

INTRODUCTION will reduce excessively stubborn localised fatty areas where dieting and exercise have failed. These areas are usually genetically determined areas of accumulated fat cells.

Unit 1: Introduction Introduction can also be used in combination with other procedures such as abdominoplasty (tummy tuck) where specific fatty areas can also be contoured. Facelift can also be improved by liposuction by removing fat from under the chin and neck and to enhance the jawline. (Fig. 1) (Refer fig. 1) Obesity Obesity is not a simple condition of eating too much. It is now recognized that obesity is a serious, chronic disease. Causes of Obesity Obesity could be a combination of the following: The genes you inherited from your parents How well your body turns food into energy Your eating and exercising habits Your surroundings Psychological factors Consequences of Obesity If you are obese, severely obese, or morbidly obese, you may have: Major health risks Shorter Life Expectancy Compared to people of normal weight, obese people have a 50% to 100% increased risk of dying prematurely Obese people have more risk for: Diabetes (type 2) Joint problems (e.g., Arthritis) High blood pressure Heart disease Gallbladder problems Certain types of cancer (breast, uterine, colon)

Unit 1: Introduction Digestive disorders (e.g., gastro esophageal reflux disease, or GORD) Breathing difficulties (e.g., sleep apnea, asthma) Psychological problems such as depression Problems with fertility and pregnancy Incontinence Risks to psychological and social well-being Negative self-image Social isolation Discrimination Difficulties with day-to-day living Normal tasks become harder when you are obese, as movement is more difficult You tend to tire more quickly and you find yourself short of breath Public transport seats, telephone booths, and cars may be too small for you You may find it difficult to maintain personal hygiene Body Mass Index (BMI) Calculator Body Mass Index (BMI) is measure of body fat based on height and weight that applies to both adult men and women. BMI does not differentiate between body fat and muscle mass. Therefore, body builders and people who have a lot of muscle bulk will have a high BMI but are not overweight or obese. BMI: Status: Less than 19 19 to 24.9 25 to 29.9 30 to 39.9 40 and above Underweight Normal Overweight Obese Morbid Obesity (Fig. 2)

Upper Body Unit 2: areas Please remember liposuction is not a substitute for weight loss or a cure of obesity. The diagrams show suitable areas for liposuction. Upper Arms Anterior Axillary Fold Abdomen Cheek Folds Jowls Neck and Chin (Fig. 3) Upper Arms (Refer fig. 4) (Fig. 4) Anterior Axillary Fold (Refer fig. 5) (Fig. 5) Abdomen (Refer fig. 6) (Fig. 6)

Unit 2: areas (Fig. 7) Cheek Folds (Refer fig. 8) (Fig. 8) Jowls (Refer fig. 9) (Fig. 9) Neck and Chin (Refer fig. 10) (Fig. 10)

Unit 2: areas Female Please remember liposuction is not a substitute for weight loss or a cure of obesity. The diagrams show suitable areas for liposuction. Hip Area (Refer fig. 11) (Fig. 11) Outer Thigh (Refer fig. 12) (Fig. 12) Inner Thigh (Refer fig. 13) (Fig. 13) Inner Knee (Refer fig. 14) (Fig. 14)

Unit 2: areas Calf and Ankles (Refer fig. 15) (Fig. 15) Male Please remember liposuction is not a substitute for weight loss or a cure of obesity. The diagrams show suitable areas for liposuction. Neck and Chin (Refer fig. 16) (Fig. 16) Hip (Refer fig. 17) (Fig. 17)

Unit 2: areas Abdomen (Refer fig. 18) (Fig. 18) Inner thighs (Refer fig. 19) (Fig. 19)

Pre-op Your Doctor will discuss carefully with you the suitability of the procedure for the various areas of concern to you. On the day prior to surgery you should eat a light diet and increase fluid intake. Showering with antiseptic soap is necessary the evening prior to surgery and again on the morning of the operation. If a girdle is considered necessary, its purchase will be arranged and you will ensure its delivery to the hospital. Two girdles will be necessary as they must be worn continuously for up to six weeks after the operation. The diagram shows the style of girdle to be worn after liposuction of the outer thighs. This gives continuous compression of the area treated. Prior to the anaesthetic, the areas to be treated will be "marked" with the patient in a standing position to more accurately locate where the liposuction is to be applied. Occasionally some shaving of the upper pubic hair may be necessary for liposuction to the abdomen. Unit 3: (Fig. 20) (Fig. 21) (Fig. 22) A careful contour diagram is developed on the areas to be treated as the shape and position of the troublesome fatty deposits changes when the patient is asleep and lying down. (Refer fig. 20 to 22)

Operation A small incision is made in the skin for each area to be treated. A narrow metal tube (cannula) is inserted through the incision into the fatty area and by working the tube back and forth, the fat is shaved off in tunnels and evacuated through attached tubing to a suction machine or suction syringe. The suctioned tunnels and spaces are then collapsed by the use of a compression garment to create the new contour. (Refer fig. 23 & 24) Unit 3: Suction to end of Cannula Cannula Skin Fat cells (Fig. 23) Muscles Layer (Fig. 24) Compression is applied to collapse tunnels and allow these to heal When fat tissue is suctioned from under the skin, it leaves small tunnels and empty pockets. The purpose of a compressive dressing or girdle is to collapse these spaces to allow healing to take place. (Refer fig. 25) (Fig. 25)

Post-op Unit 3: The area treated with liposuction may be strapped with elastic tape or a girdle will be applied. This will minimise bruising and swelling and provide a degree of support for the skin which will be relatively loose after the operation, particularly when the swelling settles down. The elasticised material of the girdle helps to keep even pressure on the areas treated, minimise bruising and swelling and "even out the skin". This process will help the skin to redistribute itself more evenly and minimises the risk of skin sagging and irregularities. The elasticised material of the girdle helps to keep even pressure on the areas treated, minimise bruising and swelling and "even out the skin". This process will help the skin to redistribute itself more evenly and minimises the risk of skin sagging and irregularities. Compressed provided by girdle (Fig. 26) (Refer fig. 26 & 27) (Fig. 27) If no support is applied, skin tends to sag and develop an uneven appearance Bruising and Swelling Following surgery you may be quite bruised and the areas can be discoloured and even purple. Your Surgeon can show you representative photographs of the healing process and the time taken for the result to develop. There can be swelling of the ankles, particularly if liposuction has been carried out in the abdomen or legs and a girdle is worn. This can be aggravated by hot weather. Minimise standing if there is swelling of the ankles and elevate your legs on a foot stool when sitting. The bruising tends to track down the leg or the abdomen and in some cases the patient can experience some swelling of the labia or scrotum. The bruising usually starts to settle after a week and is usually well faded by two weeks. It may, however, take six weeks for all the bruising to resolve. When a figure fault is sculpted away, the fullness in the area is temporarily replaced by swelling which resolves slowly. It is understandable, therefore, that the patient may underestimate the improvement in the first few weeks and wonder if the operation has been successful.

Unit 3: The fat cells that are suctioned away are gone forever and when the swelling settles the result will be noticeable particularly in previously tight clothing. Will There Be Much Pain? The amount of pain felt varies from individual to individual, depending on one's pain threshold. Generally, areas treated with liposuction are tender to pressure, but there is usually no excruciating pain when resting or in bed. There may be a feeling of stiffness when moving about, but most of the pain subsides after a few days. It is not a particularly painful operation as the muscles are not disturbed except when suction is performed on large areas of the abdomen. It is then sometimes painful to sit up for the first few days. It is our impression that ultra sound assisted liposculpture (UAL) is attended by more pain and discomfort in the postoperative period than is suction assisted lipectomy (SAL). There is no scientific basis for this observation, but it appears to be so. It is our impression that the results obtained from UAL (where indicated) justify this increased discomfort.

Unit 3: Disclaimer Disclaimer Although every effort is made to educate you on LIPOSUCTION and take control, there will specific information that will not be discussed. Talk to your doctor or health care provider about any concerns you have about LIPOSUCTION. You must not proceed until you are confident that you understand this procedure, particularly, the complications.

YOUR SURGERY DATE READ YOUR BOOK AND MATERIAL VIEW YOUR VIDEO /CD / DVD / WEBSITE PRE - HABILITATION ARRANGE FOR BLOOD MEDICAL CHECK UP ADVANCE MEDICAL DIRECTIVE PRE - ADMISSION TESTING FAMILY SUPPORT REVIEW Physician's Name : Physician's Signature: Date : Patient s Name : Patient s Signature: Date :