What is it?
Liposuction is the removal of fatty tissue from underneath the skin using small incisions and metal cannulas. It can also be called ‘body contouring, lipoplasty or liposculpture’. It tends to work best for treating localised areas of fat that have not responded to diet. In some situations ultrasound treatment may also be used in order to assist dissolving the fat prior to removing it by suction.
Small areas of liposuction can be carried out under local anaesthesia. For bigger areas the procedure is performed under a general anaesthetic. The area of the body which has the excess fat is usually marked out prior to surgery to identify those areas that are most prominent. During surgery, small incisions are made. Some fluid is then introduced into and around the fat in order to assist removal of the fat. The fat is then sucked out. Extreme care is taken not to damage the overlying skin or underlying important structures like nerves and blood vessels. The small incisions are closed with dissolving stitches. The surgery is usually performed as a Day Case. After the operation, it is likely that the patient will need to wear an elasticated garment in order to help control the swelling and improve the overall shape. Liposuction may also be used in conjunction with other procedures such as a face-lift, in order to provide better definition of certain areas (e.g. under the chin).
Ultrasonic assisted liposuction can also be used. The ultrasound causes the fat to break up into smaller particles. The operation however, takes longer to do than the ordinary liposuction method.
Liposuction removes fat cells and though these fat cells cannot come back again, continued weight gain will remove the benefits of previous liposuction. It is important to realise that liposuction is not a treatment for obesity. A properly controlled diet and exercise regime can produce significant weight loss.
Before the Surgery
It is important in your pre-operative assessment to be aware of the quality of your skin prior to surgery. To have good results, one needs to have skin that has elasticity. Removal of the fat without skin elasticity can end up with wrinkly excess skin. In some situations it may be more appropriate to perform surgical excision of the skin and fat, for example tummy tuck.
After – In Hospital
There is likely to be some pain and discomfort in and around the are where the fat has been removed. Local anaesthetic is frequently given so this may alleviate the immediate postoperative pain. It is also important to wear an elasticated garment to provide compression to the area where the fat has been removed. This is helpful in order to minimise swelling and improve the final result. Simple painkillers, such as Paracetamol, usually alleviate discomfort after surgery. There will be swelling, bruising and discoloration of the skin. In most situations this settles down without specific treatment or can be helped by the use of massaging around the area.
After – At Home
It is important to continue to wear the elasticated garment for six weeks. Following this time it may also be useful to maintain gentle compression over the area. If the liposuction has been performed around the hips, use a pair of cycle or Lycra shorts (or equivalent). For other sites, other alternatives can be discussed with your surgeon. Swelling can persist for several months after treatment. There may be persistent numbness over the treated area.
The complications specifically with sucking out fat include residual irregularities, areas that are lumpy, areas of tenderness, insufficient removal of fatty tissue and wrinkling of the skin in the post operative phase. If liposuction is performed too close to the surface of the skin, ridging of the area can be noted and this can persist. Very occasionally damage can occur to the skin itself which can produce scab formation leading to scar formation. Bleeding can occur underneath the skin that can lead to clot formation and further potential for irregularities. Large amounts of fatty tissue can be removed using liposuction but it is important, in those situations, that controlled replacement of fluid is performed. There have been occasional incidences of heart and lung problems related to excess fat aspiration and intravenous fluid replacement. There can be abnormalities, unusual sensations where large amounts of fat have been removed but this tends to improve as time passes.
Return to normal activities depends on how much fatty tissue has been removed and to what extent there is continued soreness and problems.
If liposuction is performed as part of a major surgical procedure like a tummy tuck or a breast reduction, it may take many weeks before the patient can return to work. However, with small areas of liposuction to improve contour defects, the patient may be able to return to work very rapidly, depending on whether the surgery is performed under general or local anaesthesia.
Those with experience should only perform liposuction as significant distortion following inappropriate use can occur.