Liposuction

Liposuction

Liposuction is a technique used to remove unwanted fat deposits. It was developed in the 1970′s and is therefore well tested and gives predictable results. It is best suited to removing localised deposits of fat from the hips, tummy, waist or thighs. It can also be used in combination with other procedures such as facelifting, to remove fat from the neck, or with a tummy tuck (abdominoplasty) to remove fat from the waistline. It is a technique for improving body shape rather than helping with weight loss.

More recent developments, known as liposculpture, have added considerable refinement to our ability to reshape the contour of the body. However it is not a substitute for a controlled diet and results are best in patients who are not overweight but who have localised collections of fat. Good results also depend on elastic skin that will adapt to a new contour when the underlying fat is removed. With age skin becomes less elastic but the condition of the skin rather than your chronological age is the most important factor.

What are the different types of liposuction?

Liposculpture

Liposculpture is an adaptation of liposuction which employs the use of much finer cannulae allowing the removal of fat in a more controlled manner. As it causes less trauma to the tissues it can be used closer to the surface of the skin therefore giving superior results.

Tumescent Liposuction

This is a technique in which a medicated solution is injected into fatty areas at the time of surgery. The fluid is a mixture of intravenous salt solution, local anaesthetic and adrenaline (a drug that constricts blood vessels). This allows the fat to be removed more easily and reduces pain following the operation. Tumescent fluid injection during surgery also helps to reduce the amount of bruising after liposuction / liposculpture.

Ultrasound-Assisted Lipoplasty (UAL)

This technique requires the use of a special cannula that produces ultrasonic energy. As it passes through the areas of fat and the energy liquefies the fat making it easier to remove.

UAL has been shown to improve the ease and effectiveness of liposuction in fibrous areas of the body, such as the upper back or the enlarged male breast.

3D-Lipo

3D-lipo is an amazing alternative to liposuction offering a powerful new dimension in non-surgical fat removal.

The treatment is pain free with instant results and no down time – a HUGE hit with celebrities who choose the non- surgical 3D-lipo rather than go under the knife.

Who is it for?

Women and men who, even though they have dieted and exercised, find that some parts of their body will simply not reduce in size and shape. Particular areas that usually respond well to the procedure are the hips, thighs, abdomen, buttocks, knees and ankles. The male problem of “feminine looking breasts” can also be corrected and the technique is extremely effective in removing a “double chin”.

The best candidates for treatment are in good health and have realistic expectations of liposuction. There is no definite age limit, nor weight limit for patients who are “good candidates” for liposuction. Most of our patients have localised accumulations of fat, however, an overweight person whose weight has been stable for many years and has certain problem areas of fatty deposits, may be excellent candidates for liposuction.

How do I prepare for surgery?

It is very important to avoid taking any Aspirin or products containing Aspirin for 2 weeks either side of the operation since Aspirin causes bleeding and has a very adverse effect on bruising. The same is true for non-steroidal anti-inflammatory drugs (such as Brufen and Nurofen).  If you are a smoker it is helpful to stop for two weeks before surgery and for a week afterwards so as to help the circulation of blood to the skin. If you are taking the contraceptive pill it may be wise to stop it and use an alternative method of contraception for one cycle before the operation as this can improve the circulation in the legs following surgery.

What type of anaesthetic will be used?

Liposuction and liposculpture is usually performed under a general anaesthetic, so you’ll sleep through the entire operation. Occasionally with very localised areas it may be possible to perform liposuction under local anaesthetic with some sedation.

What does the operation involve?

Liposuction and liposculpture is performed via small 5 mm incisions through which the fine cannulae remove unwanted fat. Before performing the liposuction, fluid is injected into the fat as this allows the fat to be removed more easily and reduces pain following the operation (tumescent technique). The small incisions usually result in scars that are barely visible once healed and which are carefully positioned to be as inconspicuous as possible. At the end of the procedure an elasticated garment is applied over the area treated.

This should be worn for 4-6 weeks in order to maximise compression and remodelling of the skin. In most cases liposuction requires one night stay in hospital depending on the volume and areas treated.

Where is the scar?

Because the incisions are so small (¼ inch/5mm) and normally hidden within a skin fold, scars are virtually undetectable. Prior to the development of the liposuction/liposculpture techniques the surgical removal of fat resulted in large and unsightly scars.

What happens after the operation?

Discomfort following the surgery varies from one patient to another but is not usually great. It is important to mobilise as soon as possible after the operation as resting in bed is not good for the circulation in the legs. You should keep the scars clean and dry until the sutures are removed between 10-14 days after surgery. Returning to work will depend on the extent of the liposuction but is usually between 10 and 14 days after surgery.

It is important to wear an elasticated garment to apply light pressure over the treated area for 4-6 weeks following liposuction. This helps to reduce the swelling and encourages the skin to conform to its new shape. Vigorous exercise should not be resumed until all bruising has settled which usually takes 3-4 weeks. After 4-6 weeks you will have a good idea of the result, but this continues to improve for 3-6 months as the skin and fat becomes softer and smoother. The best results are obtained in slim people with localized fat deposits, as the tighter the skin the better it will adapt after fat removal.

Will the fat come back?

If you maintain a steady weight the short answer is no. People are born with a fixed number of fat cells in the body and fat is laid down in proportion to their distribution. After liposuction fat cells are removed and so if you gain weight it will preferentially be laid down elsewhere rather than at the site of your liposuction. However if you are careful with your weight and diet, the change in contour will be permanent.

Will I lose weight?

The cosmetic success of liposculpture relies on removing inches rather than pounds. For example, removing an amount of fat equivalent to a half a pound of butter from each outer thigh of a woman’s saddlebag area or from a man’s love handle area would result in a dramatic change in silhouette, but would not significantly change the person’s weight.

What will I look like immediately? When will I look good?

The area treated will be covered by a snug elastic dressing, girdle or body stocking. This will be removed one week after surgery by which time the area will be reduced in size although some bruising and swelling will still be evident. You will need to wear the garment during the day for a further three weeks, if possible. The bruising will normally disappear within two weeks.

How is the skin affected?

The degree of skin change after liposuction is the same as one would expect if it were possible to lose an equal amount of fat in these localised areas simply by dieting. Because the cannula/syringe simply makes tunnels through the fat, there remains multiple connections between the skin and the underlying tissue. These fibrous connections contract with the healing process and maintain the skin in its natural position.

After liposuction one does not have to worry about excessive folds of skin in the areas treated. This effect is so dramatic that many patients, who previously would have required surgical excision of skin called a tummy tuck, can now have excellent results simply by having liposuction.

Operation details

There are different types of liposuction. In Liposculpture, a much thinner cannula (tube) allows fat removal which is less traumatic to the surrounding tissues and is used closer to the skin. Tumescent Liposuction involves a medicated solution, made up of intravenous salt solution, local anaesthetic and adrenaline, being injected into fatty areas at the time of surgery. The fat can then be removed more easily and pain and bruising is reduced following surgery.

Ultrasound-Assisted Lipoplasty (UAL) uses a cannula which uses ultrasonic energy to liquefy the fat, which makes removal easier. This technique is particularly effective for the removal of male breasts (gynaecomastia correction). All of these types of liposuction are performed under a general anaesthetic. Small incisions are made for the insertion of the cannula, and these are barely visible once healed so scarring is minimal.

Can I drive myself home?

No. Because of the medications used during surgery you cannot drive for 24 hours. We have a number of patients who travel from out-of-town and from abroad for treatment. Upon your request we will be happy to send you information about special arrangements for our out-of-town patients.

Post-surgery

An elasticated garment is used on the treated area following surgery and this should be worn for 4-6 weeks. This procedure usually only requires an overnight stay in hospital. Some discomfort will be experienced following the procedure and scars will need to be kept clean and dry until sutures are removed (usually 10-14 days after surgery). This procedure usually requires between 10 and 14 days off work. An elasticated garment is worn over the treated area for 4-6 weeks following liposuction and exercise should be avoided for this time. The final result can take up to 6 months to show as the skin and fat becomes softer and smoother but there is an indication of the end result after around 4 weeks.

Potential risks

Complications as a result of liposuction are extremely rare, but after effects can include: 

Infection.

Irregularity in the skin. In the period following surgery some unevenness in the contour of the skin occurs and is usually related to swelling. This normally resolves over 2-3 months.

Bruising and swelling. Some people bruise more easily than others but bruising is normal and doesn’t last long.

Deep venous thrombosis (blood clot in the deep leg veins). This is a potential risk of any operation, but can be lowered by moving around regularly after surgery.

When can I return to normal activities?

There is no limitation to physical activity other than what common sense would dictate. Some are able to return to jogging and light aerobic exercise within a day or two after surgery. Some patients do find the soreness after surgery more significant than others, but on average most are quite surprised at how quickly they are able to return to normal activities.

How much will it cost?

Cosmetic Surgery is usually a life-time investment. Our patients are treated as individuals, and costs do vary from person to person depending on their individual needs. Following your consultation, a package price will be provided to you in writing.  This cost will include the surgeon’s fee, anaesthetist’s fee and hospital costs.  It may not include extras such as post operative support garments.

Should I have liposuction?

Only you can answer that question. Be sure you are doing it for the right reasons: your own sense of self confidence and self esteem. No matter what anyone else thinks, if you are happy with your appearance there is no reason to change it. So before making that decision, attend a consultation, get the facts. Be realistic in your expectations and make an educated decision that is right for you.

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