Liposuction
Liposuction is a minimally invasive surgical procedure that allows you to remove excess fat and restore your desired body proportions.
IMPORTANT. Liposuction is not a way to lose weight, but rather an aesthetic procedure that can improve body contours.
Liposuction is primarily used to improve the appearance of the body, not to improve physical health. Most people would probably achieve the same or better results with a healthy lifestyle, including a balanced diet, regular exercise and a healthy sleep schedule.
Liposuction is usually only recommended when lifestyle changes have failed to achieve the desired results.
Liposuction can help to remove fat traps or areas that are resistant to exercise and diet.
When a person gains weight, each fat cell increases in size and volume. Liposuction reduces the number of fat cells in specific areas.
What areas can be corrected by liposuction?
- Stomach;
- Back;
- Buttocks;
- Breasts;
- Inner thighs;
- Knee;
- Lower leg;
- outer and inner thighs;
- flanks;
- The area under the chin;
- Shoulders.
Who is a good candidate for liposuction?
Healthy non-smokers with a BMI of 30 or less are usually good candidates for liposuction. If you are looking for a solution to lose weight or treat cellulite, liposuction is not the best choice.
Good skin tone and elasticity are essential for the desired results, because once the fat has been removed, the skin must contract to the new contours of the body.
If the patient has good skin elasticity, she will have a truly excellent result. If the patient has poor elasticity (as in the case of a woman who has had multiple pregnancies) and the skin on her abdomen is too stretched, the skin will not contract and the patient will be left with sagging.
Tip. To check the elasticity of the skin, do a 'pinch test'. If the skin stretches quickly enough, it is likely to have enough elasticity to ensure good results.
How the procedure works
Liposuction is carried out either under local anaesthetic and intravenous sedation (for a small area) or under general anaesthetic, depending on the area and extent of the operation. Epidural anaesthesia can be used for lower body liposuction. The anaesthetic is injected into the epidural space around the dura mater, the fluid-filled sac around the spine. This causes partial numbness in the abdomen and legs. A local anaesthetic may be used for very small areas of liposuction.
The procedure takes between 1 and 4 hours and most patients see impressive results immediately after surgery. This is why many doctors and patients prefer liposuction to non-surgical procedures such as SculpSure, CoolSculpting or Vanquish, which usually require at least 2 sessions to see results.
Liposuction is usually combined with other cosmetic procedures such as abdominoplasty or mastopexy, often as part of a Mommy Makeover package.
With most types of liposuction, the removed fat can also be cleaned and transferred (lipofilling) to the face, buttocks, breasts or other areas to add volume.
In tumescent liposuction, the most traditional liposuction technique, the doctor makes one or more small incisions (0.5-1 cm) in the area to be treated and injects a small solution (a mixture of physiological solution, lidocaine and adrenaline). The fluid causes the fat cells to swell and harden, making them easier to remove. It also constricts your blood vessels, which reduces bruising and haematoma formation, blood loss and recovery time. The surgeon will then insert a thin tube (cannula) through the same incision and move it back and forth under the skin to break up the fat before it is suctioned off.
For a very small area, the procedure can take as little as 30 minutes, while liposuction 360, which includes the stomach, sides and back, takes 3-4 hours.
All variations of traditional liposuction aim to reduce tissue damage and shorten recovery time. During your consultation, your surgeon will help you decide which method of liposuction is right for you.
- Vibration liposuction (PAL) uses a vibrating cannula, also called vibro-lipo, to not only destroy fat cells, but also smooth out any remaining fat and irregularities.
- Laser liposuction (LAL), including SmartLipo, uses low-energy waves to liquefy fat and is commonly referred to as 'laser liposuction'. It should be noted that liquefied fat cannot be used for lipofilling.
- Ultrasonic liposuction (UAL) uses sound waves to break down cell walls and liquefy fat. VASER liposuction, a variation of UAL, dissipates the ultrasound energy evenly. Fat comes out more easily with VASER, especially in men where fat is more fibrous.
What is the rehabilitation process?
I usually recommend that my patients take 3 to 7 days off after liposuction, depending on the number of areas treated and their pain threshold.
I prescribe a painkiller (Ketonal or Nimesil).
There will be swelling, bruising, numbness and pain to touch. The area of the liposuction may feel firmer due to the swelling. All of this should disappear within 6 weeks.
In some patients, uneven areas may appear after the swelling has gone down. This should go away after a few weeks, but wearing a compression garment can help prevent unevenness. A good compression garment is needed to minimise swelling and bruising, help the skin to lie smoothly against the underlying tissue, and speed up healing. It should be worn around the clock (with a shower break) for at least 2 weeks, then gradually reduced over 3 or more weeks. As a bonus, the compression helps to reduce discomfort.
Follow your doctor's instructions. Lymphatic massage is recommended starting about 4 weeks after surgery to help "drain" the fluid and reduce swelling.
I do not recommend self-massage, as this can affect the outcome of the operation, but seeing a massage therapist who specialises in post-operative massage will speed up the healing process and prevent problems.
Most people can return to normal activities after 3-4 weeks.
A healthy lifestyle is recommended to maintain the results of liposuction.
Liposuction is usually done for cosmetic reasons, but it is sometimes used to treat certain medical conditions:
- Lymphoedema: a chronic or long-term condition where excess fluid, known as lymph, accumulates in the tissues, causing swelling. The swelling is usually in the arms or legs. Liposuction is sometimes used to reduce the swelling, discomfort and pain.
- Gynecomastia: Sometimes fat accumulates in the chest area of men. This condition can be corrected by a combination of liposuction and breast surgery.
- Lipodystrophy syndrome: fat accumulates in one part of the body and is lost in the other. Liposuction can improve the patient's appearance by creating a more natural distribution of fat.
- Extreme weight loss from obesity: a morbidly obese person who loses at least 40% of their BMI.
- Lipomas: These are benign fat tumours.
FREQUENTLY ASKED QUESTIONS
Will the results of liposuction last forever?
If you maintain your weight after liposuction, your results should last for years. However, weight gain will increase the size of the remaining fat cells. In cases of significant weight gain, new fat cells may develop, although the area will still look better than if you had never had liposuction.
A 2011 study in the journal Obesity found that without lifestyle changes, fat accumulated in other parts of the body a year after liposuction. However, one of the researchers noted that "the participants in our study were trying to change their shape through liposuction. Despite the return of fat, their cosmetic shape was maintained and they were very happy with the results of their operations".
When will I see the results of liposuction?
You may notice an improvement in your body shape immediately after the procedure, but your results will initially be masked by swelling. The swelling should decrease significantly within 6 weeks and continue to do so for the next 6 months.
If you feel you need more liposuction procedures to achieve your desired results, wait at least 6 months for the swelling to subside and then discuss the situation with your surgeon. Remember that you will continue to be treated for a year and will continue to get better results.
Some patients choose to have repeat liposuction to correct the results of the first operation, such as asymmetry or unevenness.
What are the advantages and disadvantages of liposuction?
Pros:
- Liposuction can significantly affect so-called fat traps, to a greater extent than is possible with non-surgical treatment.
- Your surgeon can model your body with the difference in the amount of fat tissue removed. This technique is called liposculpture or lipomodelling.
- The fat removed during liposuction can be used as a filler and injected into other areas of the body to add volume. This is called lipofilling.
- Patients who have had liposuction say they feel more confident and younger. Many say it's the start of a healthy lifestyle.
Cons:
- Liposuction is surgery, so it takes time to recover. You will have up to 2 weeks of rehabilitation with some swelling, bruising, numbness and mild pain.
- If your skin is not very elastic, it may sag once the underlying fat has been removed. Significant sagging may require a further procedure to remove or tighten the excess skin.
- Asymmetry, dimpling and other irregularities may occur, especially if your surgeon is inexperienced.
- Remaining fat cells may expand or new fat cells may form if you gain weight, meaning that if you do not change your lifestyle after liposuction, it will all be for nothing!