Aesthetic Medicine, Cosmetic Plastic Surgery

Liposuction

Introduction to Liposuction

Liposuction is a cosmetic procedure that enables unwanted fat to be removed from the body. It is usually carried out on parts of the body that it proves difficult to remove fat from including the buttocks, hips, thighs and stomach. The procedure permanently removes fat cells and changes the body shape. It’s therefore important to make an appointment with a top-rated liposuction surgeon in order that the procedure is carried out correctly and gives the desired results.

Written by Doctify Team 27/04/2020

What is the difference between liposuction and liposculpture?

Liposuction will normally be recommended when you have larger body areas that you want to remove fat from. There is a limit to the volume of fat, that can be safely removed during one procedure.

Alternatively, liposculpture removes smaller pockets of isolated fat, resulting in improved body contours. 

Liposuction and liposculpture, are both procedures that will contour your body, removing fatty deposits from specific areas. How much fat needs to be removed, will impact whether you require liposuction or liposculpture.

Both procedures will have permanent results as long as stable body weight is maintained afterward. To achieve your desired results and dependent on your skin elasticity, it may be necessary to combine liposuction with other body contouring procedures. These include, but are not limited to an abdominoplasty (tummy tuck) and removal of excess skin after significant weight loss

Liposculpture will normally be performed as a single procedure to contour the body. You may also combine liposuction or liposculpture with other plastic surgery procedures such as rhinoplasty, breast augmentation, and reduction, to name just a few. Cellulite, dimples and stretch marks will not be improved with liposuction or liposculpture

The fat may also be cleaned and processed for use in other areas such as the buttocks, breasts, and face to increase volume and enhance shape. 

What parts of my body can be treated during a liposuction procedure?

  • Abdomen, is one of the most common areas individuals want to have fat removed from. Both men and women can find it very hard to reduce fatty deposits in this area, even when you are your target weight and exercise regularly.
  • Back, flanks (love handles) and hips are areas of the body; where fatty deposits may be removed.
  • Buttocks may be reduced and reshaped. 
  • Thighs, “saddlebags,” or outer thighs, inner thighs and inner knees can also be recontoured.
  • Upper arms (bingo wings) can also be reduced and reshaped

What parts of the body can have liposculpture procedures?

All of the above areas may also be treated with liposculpture when there is less fat to remove.

Your neckline and under chin area can also benefit from liposculpture to produce more defined facial contours.

Conditions that can be treated with liposuction 

Certain medical conditions can benefit from liposuction including:

  • Lymphedema
  • Gynecomastia (fat on men’s chest)
  • Lipomas (benign, fatty tumors)

Can I have liposuction or liposculpture if I am over a certain weight? 

Liposuction and liposculpture will benefit individuals that have a BMI under 30 and do not desire a reduction in their overall weight. 

Individuals that are significantly overweight, have heart conditions, diabetes, weakened immune systems or are taking any medications, to reduce bleeding, are not suitable for liposuction or liposculpture. 

Why does the cost vary for liposuction and liposculpture procedures?

The cost of your procedure will be based on several differing factors:

  • The qualifications and experience of your surgeon
  • How many areas you’re having treated
  • Whether a general anesthetic, local anesthetic or an epidural is used

What happens during a liposuction or liposculpture procedure?

Dependent on how many body areas are treated and the volume of fat removed. A liposuction or liposculpture procedure can take anywhere between one to four hours.

Liposuction is normally performed under a general anesthetic. Liposculpture is more likely to be performed using a local anesthetic or an epidural for areas of the lower body. Sedation can be provided to help you relax. Some surgeons prefer you to remain awake, so you can stand up to ensure sufficient fat has been removed and body contours are even.

During a liposculpture procedure, there will more attention paid to contouring the body rather than just the removal of fat. Liposculpture removes smaller amounts of fat in specific areas, to enhance your contours.

Methods of liposuction and liposculpture

Liposuction techniques vary and will be dependent on your physiology, skin elasticity and the amount of fat to be removed. There are three accepted methods of performing liposuction or liposculpture.

1. Tumescent liposuction

This is a common technique with high satisfaction levels. 

Saline solution with a local anesthetic and a vessel-constrictor (epinephrine) is used to loosen the fat and make it easier to suction away with cannulas (small tubes); that are inserted into the area to be treated.

2. Ultrasound-assisted or ultrasonic liposuction (UAL) 

Ultrasound vibrations literally ‘burst the fat cells. The fat emulsifies making it easier to remove large amounts, using suction with cannulas (small tubes); resulting in less bruising and swelling.

This method is most effective in fibrous areas, such as the back and the male chest. It can also be effective for previously treated areas, where there are still remaining fat cells following tumescent liposuction or liposculpture. 

3. Power-assisted liposuction (PAS)

A mechanized cannula consistently moves back-and-forth with vibration to loosen the fat cells. They are suctioned away using cannulas.

4. Laser-Assisted Lipolysis or laser-guided lipo (LAL) 

Specialised cannulas deliver low-energy laser waves to heat the fat cells, following the insertion of tumescent fluid. It is a less invasive procedure than traditional, tumescent liposuction and causes less swelling and bruising.

What scars will I have after liposuction or liposculpture?

Incisions may require dissolvable sutures or the incisions may remain open, to enable excess fluid and blood to drain away more easily. Slightly larger cannulas are used during liposuction leaving a slightly linear incision. You surgeon may also insert the cannulas through adits (tiny round holes). Linear scars will be hard to see, adits may cause dimples and or discoloured spots of skin.

How long will I take to recover after liposuction or liposculpture?

Immediately after the procedure 

The areas treated may feel numb, within a few hours soreness, swelling and bruising will start to develop. You may be able to have the procedure done as a day case and return home after being monitored for a few hours. 

When a larger volume of fat has been removed, multiple areas treated or the procedure has been combined with another procedure and you have had a general anesthetic, it is likely you will remain in the hospital for a minimum of one night.  

Recovery time after liposuction or liposculpture

The swelling will be controlled with tight bandages or compression garments. Swelling will reduce over the next couple of weeks and you will start to notice the results. Dependent on the amount of fat and number of areas treated, you will need between one to two weeks off work. You should remain active to prevent blood clots but abstain from any strenuous activities or heavy lifting. 

You will need to continue to wear your compression garment constantly, for between four to six weeks. Residual swelling will dissipate over the next 3 months and fluid may continue to leak from the incisions. The results will be fully apparent after approximately six months.

What are the side effects of general anesthetic

  • Your throat will feel sore due to the tube that is inserted down your throat to aid breathing, the area where the cannula or drip was inserted will feel sore and bruised for a few days 
  • You may also feel sick, cold, shivery, dizzy and disorientated after a general anesthetic 
  • Occasionally if you are struggling to pass urine it may be necessary to fit a catheter for between one day and a week 
  • Some people experience memory loss, however, this is rare

When can I take my compression garment off?

Your plastic surgeon will advise you on how long you must wear your compression garment. This will vary dependent on the size of the area and, or the number of areas treated and the volume of fat that has been removed. You will normally have to wear your compression garment at all times for the first month, removing it only to shower. It is likely you will need to continue wearing a compression garment for between six to eight weeks. You will normally be able to take it off to sleep in or for short periods of time.

Are liposuction results permanent?

When the fat cells are removed they do not come back. This makes it possible to retain permanent results, as long as your weight does not fluctuate up and down. Liposculpture will not stop you from putting on weight if you overeat.

How safe is liposuction and liposculpture?

In the hands of a skilled surgeon, unfavourable results are unlikely, the most common complications of liposculpture are:

  • Infection, this is normally controlled with antibiotics, when severe additional surgery may be required
  • Post-operative oedema, prolonged and painful swelling lasting longer than six weeks
  • Numbness or reduced sensitivity of areas of skin, due to nerve damage
  • Skin irregularities, your skin may appear dimpled, wavy or bumpy and areas of the skin may change in colour (hyperpigmentation)
  • Undercorrection, when not enough fat is removed from a specific area leaving a noticeable deposit of fat
  • Overcorrection, when too much fat is removed from a specific area causing con tor irregularities.
  • Laxity of your skin may increase, giving the appearance of excess and, or loose skin
  • Scarring may be visible and keloid scars can develop
  • Seromas, (a collection of fluid) can be treated with needle aspiration and occasionally may require drains
  • Haematomas, (a collection of blood) may need to be needle aspirated, larger haematomas can be drained or liposuctioned
  • Skin necrosis, when the skin cells die causing open wounds
  • Visceral perforation, (bowel perforation) can be very dangerous and result in death; however, this is extremely rare in the hands of an experienced surgeon with adequate training
  • The heart and kidneys can be damaged due to the increase in the body’s fluid levels, again this is rare and the risk is reduced by limiting the amount of fat removed during a single procedure 
  • Pulmonary embolism may occur if fat enters the blood vessels and travels to the lungs, this can result in a fatality
  • Pulmonary Oedema may occur when the fluid injected accumulates in the lungs
  • In extremely rare cases it is possible to end up in a coma

Risks of any surgical procedure

  • Thrombophlebitis, DVT (blood clots) can develop in the veins, if left untreated this can result in death, although this is extremely rare
  • Allergic reaction to the anesthetic
  • It is estimated in every 100,000 cases, a general anesthetic can result in a fatality (death)

What questions should you ask before having a liposuction or liposculpture procedure?

  • How many liposuction and liposculpture procedures, have you performed in the last 12 months?
  • What method do you advise I have and why?
  • How much fat will you be able to remove?
  • How many areas can you treat during one procedure?
  • Have any patients needed intensive care after the procedure and how is this arranged?
  • What is the percentage of patients that have experienced serious complications after surgery?
  • How many patients have needed further surgical procedures to correct complications?
  • Do you charge for any type of revision surgery when it is needed?
  • How can I access aftercare and is this limited to a set amount of time after the procedure? 
Summary
  • There are four common methods of liposuction
  • Results are fully apparent after about 6 months of recovery time
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