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What is Liposuction?

Liposuction or Lipoplasty is one of the most popular procedures today. This surgical procedure removes unwanted, localized, disproportioned excess fat from different areas of the body. It is also used to slim the hips and thighs, flatten the abdomen, shape the calves and ankles or even get rid of a double chin. It has been adopted by many medical practitioners especially those without formal training in plastic surgery because of the simplicity of the concept, vacuuming of unwanted fat from areas of the body. It is important to note, however, that liposuction is not a substitute for weight loss. You should discuss with your surgeon the proper indications for the procedure, alternatives to the procedure and how to manage potential risks.

Effects of Liposuction

Getting a Liposuction will give your body a more slender, sculpted and well-proportioned look, in addition to boosting your self-confidence.

Candidates for Liposuction

Liposuction can easily improve body contours caused by excess fat. Most of the time, some areas are not responsive to diet and exercise even though you are at your ideal weight. Younger patients, whose skin is more elastic, are more likely to get the best results because the skin will smoothly re-contour after the procedure. For older patients however, whose skin may not be as elastic, a skin-tightening procedure (Abdominoplasty or Body Contouring) may be required. Contrary to belief, Liposuction cannot correct contours that are irregular for other reasons, such as muscle weakness or hernia, and it is not applicable in cases where there is excessive skin laxity (for example, the abdomen after multiple pregnancies) or “cellulite”. Although together with additional procedures, Liposuction can correct these deformities with good results. Localized accumulation of excess fatty and breast tissue in teens or adult males, also called Gynecomastia, or Male Breast Enlargement can also be treated by Liposuction.

The areas that respond well to Liposuction include:

  • Cheeks, jowls, and neck
  • Upper arms
  • Breast or chest areas
  • Back
  • Abdomen and waistline
  • Hips and buttocks
  • Inner and outer thighs
  • Knees, calves and ankles

It is important to remember that Liposuction is a Body Contouring technique, not a method of surgical weight reduction. Although in large-volume Liposuction there is usually a noticeable and often dramatic improvement of the body contours, there may be relatively little change in the patient’s weight after surgery, since fat is less dense (lighter in weight) than a comparable volume of water. Liposuction is not effective on diffuse, generalized excess fatty deposits. BHMG advises patients that a medically-supervised weight reduction program is most beneficial in such cases, in order to arrive at or near their ideal goal weight before Liposuction is done. Liposuction works hand-in-hand with a healthy, low-fat diet and a program of regular exercise, to restore your shape, or to create the shape you have always dreamed of, minus the unwanted bulges that never seem to go away, even with your best efforts at diet and exercise.

Your Consultation

You will be asked by your surgeon to point out areas that concern you and would like to see improved. Realistic expectations about what can and cannot achieve by the procedure will also be mentioned by your surgeon. Liposuction is most successful in people with normal body weight, with good skin tone and those who have isolated unwanted fatty deposits. It is important to note that Liposuction is not a treatment for obesity and usually your weight will not change abruptly after the procedure. Rather, it helps improve a patient’s body contour. If weight gain occurs after Liposuction, the fat may be deposited in areas that have not been treated. But not to worry, the procedure can be repeated if necessary. Factors like a patient’s physical condition, genetic make up, diet, exercise, smoking alcohol and skin elasticity can affect the results of the procedure. In addition to the usual consultation, BHMG’s Certified Surgeon will also carefully evaluate your general state of health, any underlying conditions which may compromise your result and any medications you maybe taking should be discussed in detail. Your surgeon will estimate the amount of fat that should be removed from each area of concern, in order to achieve the best results.

BHMG’s surgeons will select the proper technique and instrumentation necessary in a patient’s case, plus the different options and relative risks and benefits for each procedure and tailor fit it to receive maximum results.

The Liposuction Procedure

Liposuction is done on an outpatient basis and under light general anesthesia. Discreet incisions, either hidden in the patient’s natural skin fold or in a very inconspicuous place, are positioned adjacent to the areas to be treated. A small (2.5 to 5 millimeter) metal suction tube called a cannula is attached to a surgical vacuum machine or syringe, then inserted through miniscule incisions and directed below the skin into the fatty deposits requiring treatment. Liposuction usually takes over an hour, depending on the number of areas to be treated.

Options and Alternatives

“Tumescent” Technique

In this technique, local anesthesia, wherein a dilute solution of local anesthetic is infiltrated under pressure into the fatty areas to be liposuctioned, is used in certain circumstances, either with or without a sedative. Small, localized areas can be treated with tumescent local anesthesia alone, but the injection of the local anesthetic solution itself may be uncomfortable or painful.

“Wet” and/or “Super-wet” Technique

Local anesthesia is used in most cases and involves the use of lesser quantities of similar dilute solutions of local anesthetic, usually in conjunction with light general anesthesia or intravenous sedation. This will diminish the blood loss associated with Liposuction and provide long-lasting pain relief both during and after the procedure. Because the local anesthetic solution is infiltrated after the sedation or general anesthetic, the injections themselves are painless. This is the usual technique used in cases where Liposuction of multiple areas is planned.

In addition to traditional vacuum Liposuction, there are other types of instrumentation which can be useful in certain situations.

Power-Assisted Liposuction (PAL)

This involves the use of a special mechanical hand piece that produces a rapid reciprocating movement of a standard-type cannula tip (similar to a sewing machine). used in areas of dense or fibrous fat, or in secondary Liposuction cases, passage of the cannula is easier, and the fat is simultaneously vacuumed away, as in traditional Liposuction.

Ultrasound-Assisted Liposuction (UAL)

This method involves the use of a specialized hand piece and cannula tip connected to an ultra-high-frequency sound wave generator. Vibrations above the range of human hearing (ultrasound) are transmitted to the cannula tip, and fat in the areas of treatment is liquefied and emulsified by bursting of the cell membranes. A separate cannula and low-pressure vacuum are then used to remove the liquefied fat emulsion. This technique is also applied in difficult or secondary cases, but has somewhat greater associated risks.

Autologous Fat Grafting

In this procedure, the excess fat is transferred to an area where you desire increased fullness, such as the lips, other lines in the face, or areas of cellulite dimpling. Many patients ask if this fat can be transferred to the breast; however, fat transfer to the breast is not advisable, because it occasionally can produce small areas of calcification that resemble early signs of breast cancer on mammograms. Liposuction is not the answer to the laxity of the skin in the treated areas, and in some cases may worsen the appearance of the skin. There are instances where an alternative body contouring surgical procedure may be required, most commonly in combination with liposuction of the involved areas. Abdominoplasty or Lower Body Lift may be required for areas like the abdomen and hip. While the loose skin of the upper arms may require Brachioplasty (Arm Lift) and the sagging skin of the inner thigh may require Thigh Lift. A Face or Neck Lift maybe required for a double chin in order to achieve ultimate results.

Recovery

Recovery from Liposuction is relatively easy. After the operation, a patient may feel somewhat stiff and sore but the day after surgery, the patient should be up and walking around to promote normal circulation. Swelling, possibly to the point where the treated areas appear unchanged or heavier before the surgery, may be expected. There will most likely be bruising about 2 weeks after the procedure, which maybe extensive and may involve untreated areas. The patient is advised to wear a special elastic compression garment to provide pressure on the area and minimize swelling and provide support while healing. These garments, although hot and comfortable, will also help in the retraction of the skin. Depending on a patient’s healing time, stitches will be removed within a week.

Patients can go back to work after 3 to 5 days. While more strenuous activities, like going to the gym should be done after 10 to 14 days. Patients are advised to avoid the sun and use generous amounts of sunscreen until all bruising has subsided.

The results will be recognizable immediately after Liposuction and will continue to improve once swelling subsides. The unwanted bulges will be gone, giving you a slimmer contour.

Results of Liposuction are permanent if combined with a healthy diet, moderate exercise and weight management program. In the event of weight gain following your surgery, you might note a more generalized, more even distribution of excess fat, rather than re-accumulation in the previous problem areas where treatment was performed. BHMG surgeons will recommend another procedure if necessary, to further improve the areas of Liposuction.

Risks

There are very rare complications after Liposuction but occasional complications may occur. Although permanent problems are quite rare, potential short term complications include bleeding, infection and reactions to the anesthesia. While depressions or wrinkling of the skin, discoloration of the skin, asymmetry when comparing one side to the other, scar tissue, tape burns, and collections of blood (hematoma) or fluid (seroma) under the skin are some of the cosmetic complications that may need additional surgical procedures.

Uncommon complications include loss of sensation or movement in a body area, skin breakdown or loss requiring skin graft or reconstruction, and fat embolism or blood clots in the lower leg veins which may travel to the lungs (pulmonary embolism). Serious infection, or shock requiring hospitalization and blood transfusion, are very rare. Some bleeding and fluid shift is expected during Liposuction. This is the reason why there is a limit to the amount of fat removed. If BHMG’s surgeons anticipate a large volume of fat to be removed (beyond the safe limit of a single operation), they will recommend that the overall operation be divided into multiple stages separated by several weeks or months of recuperation, in order to safely accomplish the desired goal without the need for blood transfusion.

FAQs

How much weight will I lose after Liposuction?

In the case of younger patients, their skin has sufficient elasticity and resilience so it can shrink and contract nicely over the areas of fat that have been removed. If the skin has been stretched beyond recovery by years of localized fatty excess, Liposuction may need to be combined with another Body Contouring procedure to remove the excess.

What is the maximum volume of fat that can be removed in one operation?

Five liters is the maximum safe volume of fat that can be removed during Liposuction. The actual safe volume may be greater or less than that amount, depending upon the amount of bleeding observed or other factors such as changes in the patient’s vital signs during the procedure.

Is a blood transfusion required for patients undergoing Liposuction?

No. If it is anticipated that there may be a greater risk of blood loss during the procedure (secondary liposuction, large volume liposuction in men), BHMG may suggest that you donate a unit of your own blood (Autologous Blood), which can be given to you during the procedure. In general, blood transfusions (even Autologous Blood) should be discouraged, to avoid the risk of transfusion errors and transmission of blood-borne illnesses skin.

If I gain weight after Liposuction, will the fat be deposited in other locations?

Since the fat deposits your body previously used to store excess fat have been reduced, you may find that fat would accumulate in other areas of the body after Liposuction. Generally, this tendency of the fat to shift to other areas is minimal, but you should obviously avoid regaining the weight.

How long do I need to wear the elastic compression garment after Liposuction?

The elastic compression garment is used to diminish the amount of swelling and bruising in the treated area. It also prevents accumulation of excess fluid (serum or blood) under the skin, and helps to maintain the contour of the treated area. It should be worn continuously, 24 hours a day, 7 days a week (except while showering) for the first 3 to 4 weeks. After that time, it can generally be used for support and comfort during the daytime only, for an additional 3 weeks.

When can I shower or bathe after Liposuction?

You may shower after the first office visit / dressing change, generally within 24 to 48 hours after surgery. You must not bathe or immerse the incision sites under water in a bathtub, hot tub, swimming pool, etc. until the incisions are completely healed. The doctor will instruct you when bathing is permitted.

When can I resume driving?

Most patients may resume driving after approximately 48 to 72 hours. You should not drive if you are taking narcotic pain medication, sedatives or muscle relaxants.

When can I resume exercise?

Patients are encouraged to begin walking immediately after surgery. You may resume more strenuous walking on a treadmill, or mild upper extremity weight training after 7 to 10 days. Most patients resume full, unrestricted exercise after approximately 4 weeks.

When can I return to work or normal social activities?

Most patients are able to return to work or resume normal social activities after 3 to 4 days. If your work involves sitting for extended periods, you are encouraged to take frequent breaks to stand and walk, in order to promote circulation and deep breathing. You will need to wear loose-fitting clothing which will hide the presence of your compression garments, as long as necessary.

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