Liposuction

My dearest patient,    

Below follows a description of what you can expect during your liposuction procedure.

Liposuction is a surgical technique to remove unwanted deposits of fat from specific areas of your body. It is not a weight loss technique but an adjunct to assist the removal of diet and exercise resistant fat or to sculpt areas, giving a more pleasing contour.

Who should have Liposuction?

The best candidates for liposuction are patients that are near their ideal body weight and whom have excess fat deposits in particular body areas. Having firm elastic skin will allow a better result as the skin contract and helps to create the desired contour.

Fat in specific body areas are biochemically different. Generally the superficial fat has beta-1 receptors and is more metabolically active and can be reduced with diet and exercise. The deeper fat over some areas, such as the inner and outer thigh, buttock, lower abdomen and lateral flanks or “love handles” predominantly has alpha-2 receptors which makes these areas more diet resistant. These areas are also more sensitive to glucose and tend to rapidly accumulate fat and decrease at a much slower rate.

There may also be fatty deposits in and around the breast which responds very well to liposuction in fact liposuction has been described as a method of breast reduction.

Skin that has diminished tone due to stretch marks, massive weight loss, ageing and smoking tend to respond poorly to liposuction. Patients that are overweight are also not good candidates for liposuction. In these patients not much of a difference will be noticed and fat will re-accumulate in an unsightly manner. There is also a limit to the amount of fat that can be removed safely. Thus large volume fat reduction is not safe.

Theoretically the fat cells that have been destroyed during liposuction should be permanently eradicated, although this is not seen in practice. Once you pick up weight again fat will start to re-accumulate and may in fact look worse than before.

The reason for that is that when you perform liposuction you rely heavily on a type of scarring and scar tissue to contract and give a firmer appearance. The major effect of liposuction is the contraction created over time and not the fat removal. The contraction may be permanent and should you gain weight these areas may remain retracted with surrounding bulging. The contraction or scar formation takes time to develop thus the true effect of liposuction can only be appreciated 6 or so month’s after the procedure provided there is no weight gain. It is thus also important to wear the compressive garments for up to 6 weeks after the procedure in order to facilitate the contraction.

There are many types of liposuction from suction assisted, vacuum assisted, power assisted to laser liposuction. All these techniques produce the same end result. I prefer vacuum assisted liposuction as this technique has less burn associated injuries.

One Month prior to surgery and 2 weeks post-surgery…

-Avoid aspirin, blood thinning agents, green tea, herbal preparations and garlic.

-Please stop smoking, smoking results in poor wound healing, infections and skin death.

 How is the Procedure is Done,

Liposuction is usually performed under a general anaesthetic in theatre but it may also be performed under local anaesthetic with sedation in the rooms. The procedure may take anything from 10 minutes to 2 hours depending on the amount of fat to be removed, the areas treated and additional procedures performed.

Small 5 mm cuts are made to pass a cannulas with which the fat will be removed. Fluid may be infiltrated first to assist the fat removal. It is this fluid that may drain or leak after the procedure for 24 to 72 hours, this in completely normal. Once the fat has been removed and the desired contour achieved the small cuts are closed with a stich which will be removed 7 to 10 days later.

You will be strapped with compressive dressing or placed in compressive garments after the procedure. These dressings or garments should be worn continuously for 4 to 6 weeks except when showering as the garments will assist the contraction process.

Liposuctions associated with a fair amount of swelling and bruising which may persist for 4 to 6 weeks. You will experience moderated pain, tingling, burning and numbness in the area that was treated. The numbness may be permanent. The initial pain and swelling is surprising but with improve quickly.