Liposuction and Liposculpture
Liposuction is a process by which fat is permanently removed through a suctioning process. It is not a substitute treatment for weight loss but, rather, a method of reshaping the body’s contours.
As we advance in life, the body tends to remap the areas where it deposits most of the excess fatty tissue. The flanks, lower abdomen and thighs become common targets in women; the abdomen flanks and chest in men. In some people, even at a young age, there are stubborn fatty tissue deposits, mostly around the thighs, which seem to be genetic.
Liposuction is the removal of fat from deposits beneath the skin using a hollow stainless steel tube called a cannula and a powerful vacuum. A procedure chosen by both men and women, it is not a method of weight reduction. Rather, it is a way to remove stubborn fatty deposits that remain despite dieting, exercise or massage.
In the early days of liposuction, the procedure involved using relatively large cannulae and was associated with extensive bruising and a higher risk of irregularities. Today, liposuction uses much finer cannulae that cause less trauma to the tissues and allow fat to be removed in a much more controlled manner. These finer cannulae can be used closer to the skin surface to provide a superior result.
An earlier approach, call Dry Technique Liposuction is no longer considered effective. Today, the world-wide standard of care is the Tumescent Technique.
In tumescent liposuction the area to be treated is injected with a buffered salt solution before any fat is removed. This solution contains adrenaline to control bleeding and a long-acting local anaesthetic to minimise discomfort after the procedure.
A more recent addition to the armamentarium of body sculpting surgery, is the impressive LipoSelection technology termed VASER®. Based on an ultrasonic-assisted system, it allows for a carefully controlled and gentle surgical process to dissolve areas of fatty tissue deposition and can be used just as safely around the face, neck, body and limbs. The benefits of the technique include reduced bruising and swelling post-operatively, faster recovery and a smoother surface even after more intense contouring. Because of its ability to reduce irregularities, the process has been reliably used in abdominal etching and has also given rise to the concept of high-definition liposuction.
Your Consultation: Deciding if Liposuction is Right For You
During your consultation your Surgeon will ask about your general health, any conditions that might interfere with liposuction, your goals for the surgery and the specific areas where you want fat removed.
It is important that you discuss your goals fully with your Surgeon so he can advise you as to whether the results will meet your expectations. He may tell you that you could require more than one liposuction session to achieve your goals without unacceptable risk. Your Surgeon may also recommend an alternative procedure such as an Abdominoplasty (tummy tuck), if the abdominal skin has become too loose. If you have loose skin and/or dimpling (cellulite) you are probably not an ideal candidate for liposuction. Indeed, liposuction could make these conditions worse. In these situations, Abdominoplasty, thigh lift or body lift may be a better procedure for you. As part of your consultation, your Surgeon will perform an exam, explain the details of the procedure and develop a specific plan for surgery and recovery with you.
In most cases you Surgeon will require that you be relatively close to your ideal body weight but this is not an absolute requirement. Rather, it reflects the fact that there is a surgically safe limit to the volume of fat removed that can be removed at any time, and a limitation on how much your skin will shrink after large volume liposuction.
For these reasons, if you are contemplating liposuction as part of a more extensive diet and exercise program aimed at losing 5 or more kilograms of weight, your Surgeon will recommend that you lose the weight before your surgery. It is fair to say that the results of liposuction often motivate people to adopt better diets and more extensive exercise, however you should not rely on making these changes after your procedure.
If you are diabetic you may still have liposuction. In some cases you may find that the removal of fat will reduce your insulin requirements. Please note, however, that this is not a treatment recognised by insurance companies or medical professionals in general as a complement to diabetes control.
Your Operation: What to Expect
Liposuction may be performed under general or local anaesthesia, depending on the part of the body being treated and the amount of fat that is to be removed. It can be the sole procedure done or performed along with another procedure like a face lift, breast reduction or abdominoplasty. In all cases, it is normal for your anaesthetist to give you intravenous fluids to replace those lost during your procedure.
Liposuction surgery takes between 30 minutes and several hours depending on the number of areas treated and the volume of reduction. Less extensive liposuction may be performed as a day case and for larger volume reductions or multiple areas treated, an overnight hospital stay is sometimes recommended.
After Your Surgery
Immediately after your liposuction the parts of your body that were operated on will be dressed. These dressings must remain in place for one week. Showers and baths may still be possible during this period.
The most important aspect of treatment after your procedure is the wearing of pressure garments. These may be needed for up to six weeks: three weeks day and night, three weeks night only.
It is important to understand that although only tiny incisions are made, liposuction creates a large wound hidden under the skin. How fast you recover depends on how extensive your procedure was.
- Tenderness, bruising and swelling are normal after your procedure but should subside in the following weeks. These symptoms may be lessened by taking Arnica for one week prior to surgery and two weeks afterwards.
- In general you should walk around as soon as possible to reduce swelling and restore the circulation to normal. This reduces the risk of clots in the leg veins (deep vein thrombosis).
- You will need adequate rest in the days and weeks after your procedure as well as regular, gentle exercise.
- Discomfort after your surgery may be relieved by mild analgesics such as Paracetamol. Aspirin should be avoided as it can promote bleeding.
- Depending on which areas have been treated, you should be able to return to work in 7-14 days.
- You may experience some leakage of fluid from your incisions and a small drainage tube may need to be put under your skin for a few days.
- Numbness and itching of the area treated may be expected after surgery but should disappear gradually. Permanent areas of numbness are rare.
- Infection after liposuction is rare and easily treated by antibiotics.
As You Recover
During the first few weeks after your procedure you may need to take antibiotics and wear a compression garment over the treated area to reduce swelling. During this time your stitches will dissolve or be removed and your swelling should begin to go down. Indeed, most swelling will disappear after three weeks or so, although some may remain for several months.
Once the swelling has subsided, temporary patchy firmness of the treated area is usual.
- Massage at this stage helps soften and flatten the area.
- Do bear in mind, though, that it may take several months for the area to return to normal.
- Some people feel discouraged after liposuction surgery, especially in these first few weeks when the swelling creates the impression that the results are less than expected. This is quite normal and will pass.
Using today’s equipment, experienced Plastic Surgeons are able to remove fat in a way that minimises post-operative skin irregularities or asymmetry. It is possible, however, that some difference in fat removal will be apparent. If this occurs, a minor, secondary liposuction procedure may be needed, usually after six months.
If large amounts of fat are removed, loose skin may be a problem depending on your skin and the area of the body where the surgery was performed.
- If you have elastic skin which contracts well this may not be an issue.
- If your skin is not elastic (usually true of people with stretch marks) you may require skin-tightening procedures in addition to the liposuction.
- These skin tightening procedures may include thigh and abdominal tucks.