Liposuction is a surgical procedure that is designed to remove stubborn pockets of fat that cannot be removed through exercise or diet. The procedure is commonly performed on the abdomen, hips, arms, thighs, back, face, breasts or buttocks, but it may also be used as part of a tummy tuck or facelift. Liposuction can enhance the body’s contours, but it will not remove stretch marks, cellulite or dimples. Since liposuction is considered elective or cosmetic surgery, few health insurance policies will pay for the procedure. In many countries, including the Dominican Republic, Columbia and the Philippines, the advertised rates for liposuction procedures are significantly less than what qualified cosmetic surgeons in the United States charge. This has led to a dramatic increase in what is commonly called lipotourism; people travel to a foreign country for what is often a one-week vacation to have the procedure performed. Unfortunately, many patients find that reality differs from their expectations.
Lipotourism and Potential Problems
Researching the record and credentials of a hospital or physician in the United States is relatively simple. Stringent regulations, watchdog groups and the abundance of information online can help patients feel confident that they are choosing a qualified cosmetic surgeon and a reputable clinic for their liposuction procedure. However, they will find far less information on foreign clinics and doctors. In some cases, the person performing the liposuction does not even have a medical license.
Furthermore, liposuction is a surgical procedure, and like all surgeries, it carries certain risks. One risk that is of major concern is the risk of postoperative infections. For example, between 2013 and 2014, the Centers for Disease Control identified 21 patients in six states who had contracted Mycobacterium abscessus — a rapidly growing species of bacteria that is resistant to multiple antimicrobials — after having liposuction in one of five clinics in the Dominican Republic.
Foreign cosmetic surgeons are often willing to perform liposuction on patients who are not suitable candidates. Although American doctors seldom perform liposuction on patients with diabetes, weakened immune systems, coronary artery disease or a history of deep vein thrombosis, such patients are often accepted in other countries.
Another critical risk is that patients often do not receive manual lymphatic drainage treatments after liposuction or only receive one or two treatments before returning home. Their surgeons may or may not recommend that the patients seek these treatments once they return to the United States.
Why Manual Lymphatic Drainage Is Critical Following Liposuction
Even though liposuction is usually considered minor surgery, it is still an invasive procedure that can damage or traumatize tissue. Fat is not just an inert lump of stored calories; it is living tissue that is comprised of adipocyte cells, connective tissues and abundant lymphatic vessels and blood vessels. Liposuction damages all of these components, allowing lymph and blood to accumulate in what is now a more spacious area. Although the circulatory system can rely on the heart to help drain the pooled blood, the lymphatic system has no pump. Lymph can be trapped in an isolated area, leading to swelling, discomfort, potential complications and longer recovery times. Furthermore, fibrosis can occur, and these hardened areas of internal scar tissue can affect the appearance of the treated area.
Manual lymphatic drainage is a specialized massage technique that gently encourages lymph to leave the tissues and return to the lymphatic vessels. Patients report that it is much gentler than a traditional massage, and most people find it extremely relaxing and pleasant.
Since every patient’s situation is different, there are no blanket recommendations for beginning manual lymphatic drainage or the number of treatments required. However, most surgeons recommend that treatments start within five days of the liposuction procedure to obtain the best results. Many patients see at least some benefits after just one treatment, but others may need several treatments to achieve noticeable benefits. Typically, just a handful of treatments will be enough to maximize the benefits. The number of treatments will be based on the patient’s response to the therapy, the amount of swelling present throughout the treatments and the patient’s commitment to practicing self-care techniques between treatments.
The Spurgeon Method
The Spurgeon Method was developed by Sally Spurgeon, the founder of Therapie. Sally’s goal was to use her knowledge and experience to develop massage techniques that would help others who needed assistance. Her method has been gathering a great deal of momentum among health care practitioners and is approved by the National Certification Board for Therapeutic Massage and Bodywork.