Liposuction is a cosmetic surgical procedure for removing excess fat from areas around the body to give a more aesthetically pleasing body shape. It is not a treatment for obesity nor does it treat cellulite but can remove stubborn areas of fat that fail to respond to traditional weight loss methods.
The main areas where liposuction is used are in the tummy, hips, thighs, buttocks, upper arms and the chin region (usually combined with a face or necklift procedure). Men can develop fatty swellings behind the nipples which look like breasts (gynaecomastia) and this may also be treated by liposuction. When applied to several areas the term liposculptureis frequently used.
The tumescent technique involves infiltrating the fat with a large volume of fluid and this allows us to provide the patient with more precise results and a quicker recovery time.
You should have realistic expectations about what can be achieved with liposuction which can improve your appearance and self-confidence but may not necessarily change your appearance to match your ideal.
The best candidates for liposuction are people close to their ideal weight with firm, elastic skin who have pockets of excess fat in certain areas. Your age is not a major consideration except that older patients tend to have reduced skin elasticity and therefore may not achieve the same result as a younger patient with tighter skin. The amount of fat that can be removed from a localised area is limited and it may not be possible to slim down an area as much as you may wish. Further treatments can be carried out on the same area about six months later.
Pre-operative advice
Smokers have a higher risk of developing complications. It is therefore advised that smokers should stop smoking two weeks prior to surgery and for two weeks after surgery.
Aspirin and similar anti-inflammatories should be avoided for a similar time period due to the increased risk of bleeding during surgery.
Patients on oral contraception (not HRT) should stop taking the pill for approximately six weeks prior to surgery. During this period alternative forms of contraception will be required.
People with medical problems such as diabetes or significant heart or lung disease are at greater risk and will need to be carefully assessed before surgery.
Admission to hospital
Most patients are admitted on the day of their operation. Patients will be seen by their surgeon and by the anaesthetist who will check that they are fit enough for the operation and discuss any special considerations they may have. Pre-operative photographs will be taken and the areas to be treated will be highlighted with a marker pen. Patients must ensure that all the areas they would like treated are highlighted.
At this time, just before surgery, a detailed discussion about the operation is not appropriate,so patients should ensure that they are fully informed about the procedure, the recovery time, their expectations and the potential complications before they are admitted in their initial consultation with their surgeon. If necessary you can request a second consultation or ask further questions over the phone.
The operation
Liposuction can be performed under local or general anaesthetic depending on the size of the area to be treated. The operation may take from thirty minutes in simple cases and up to four hours in extensive cases. Very small skin incisions are made around the area to be treated usually in areas where the small scars will be concealed.
The area to be treated is then infiltrated with a large volume of saline solution containing small amounts of adrenaline and local anaesthetic which have the effect of reducing blood loss and enabling a more precise, even distribution of fat removal.
As mentioned before, this is known as the tumescent technique. The fat is removed using a variety of liposuction cannulas (tubes) and the amount of fat removed from the various locations is measured.
A dose of intravenous antibiotic is usually given during the operation to reduce the risk of infection.
What to expect after the operation
After liposuction a pressure garment should be worn day and night for the first two weeks, then as much as possible for the next four weeks. This helps to reduce the swelling and aids in the recontouring of the treated areas.
The amount of swelling and bruising is variable and depends on the treated areas, the extent of the treatment and the response of the tissues to the trauma of liposuction, which varies considerably between patients. The swelling is usually at its worst 48 hours after surgery and tends to resolve within seven to ten days though in some circumstances it may take several weeks to settle completely. You will be prescribed analgesics before your discharge from hospital.
Fluid may ooze out of the small incisions for the first two to three days following surgery. This may be quite marked and may also be blood-stained. This is entirely normal after tumescent liposuction. Your pressure garment will get messy so it can be removed in order for it to be washed, but it should be replaced as soon as possible. You will be able to shower the day after surgery but you should avoid soaking the treated areas for at least five days.
Following extensive liposuction you may need to have a blood test on the day after your operation to check your blood count. If we find that you are anaemic you will be probably be prescribed a course of iron supplements.
After hospital discharge
You should arrange for someone to drive you home after the procedure and perhaps help you at home for a day or two as you may feel stiff and sore. It is not unusual to feel a bit low in the days or weeks following your operation but these feelings will subside as you begin to look and feel better.
At the initial consultation you will have been given advice about when you can return to work and for how long you should avoid strenuous activities and driving. You are encouraged to mobilise as much as possible following surgery as this helps to reduce the swelling and reduces the risk of a thrombosis in your legs.
What problems may I encounter?
The potential risks and complications will be fully discussed at your initial consultation. Minor problems may include localised areas of lumpiness (which is due to deep bruising and should be treated by massage if still persistent after several weeks) and some numbness around the treated areas. Most of your bruising and swelling should have settled down within three weeks, but some swelling may remain for six months or more. We will arrange follow-up visits to monitor your progress.
Ultimately you should find that you are more comfortable in a wider variety of clothing and feel more at ease with your body. By eating a healthy diet and taking regular exercise you can help to maintain your new shape.
The tumescent technique involves infiltrating the fat with a large volume of fluid and this allows us to provide the patient with more precise results and a quicker recovery time.
After liposuction a pressure garment should be worn day and night for the first two weeks, then as much as possible for the next four weeks. This helps to reduce the swelling and aids in the recontouring of the treated areas.