LIPOSUCTION (Liposculpture)
INTRODUCTION
Liposuction or Liposculpture is the aspiration (removal) of localized bulges of fat (fat storage areas of the body) with the aim of small cannulas. In women and men, these localized fat deposits are more commonly deposited on the abdomen, hips, flanks, inner and outer thighs, knees and chin. Liposuction is not an alternative to weight loss but a means of reshaping the body into a slimmer profile by removing the fat not responsive to the dieting.
AM I A SUITABLE CANDIDATE?
Determining your suitability will partly be defined by the quality of your skin. In most cases the skin is able to shrink to the new body contour after liposuction. In some cases however, patients may have decreased skin elasticity as witnessed by loose, hanging, or creepy skin in the affected area. In these cases liposuction alone will not produce the desired result and you may therefore require some form of skin removal instead (i.e. Tummy Tuck) or perhaps in combination with liposuction. The best patients for liposuction are those individuals who are on average or near average weight, and have reasonably good skin tone and elasticity. Age by itself is not a significant factor and in fact patients of all ages have benefited from liposuction. You should also understand that liposuction by itself will not improve the dimpled skin condition known as cellulite.
WHAT IS LIPOSUCTION WITH THE TUMESCENT TECHNIQUE?
The most significant refinement in liposuction has probably been the development of the Tumescent Technique. The tumescent technique of liposuction involves the injection of a saline solution containing dilute local anesthesia and adrenaline into the fatty tissues. It contributes to the loosening of bonds between the fatty cells, thereby facilitating their removal. As a result of the adrenaline there is a decrease in the bleeding from blood vessels thus allowing us to remove larger quantities of fat more safely. Less bleeding also means less bruising. The infiltration of large volumes of dilute an anesthesia also allows the procedure to be performed under local anesthesia with or without sedation if desired.
WHAT DOES THE OPERATION INVOLVE?
To begin the operation a number of tiny incisions (about 3-4 mm) are made in the skin in the areas to be treated. These slit incisions are made, when possible in inconspicuous places. Subsequently the areas are injected with the tumescent solution. The appropriate cannulas are inserted into the fat, and then through backward and forward stroking motions the fat is loosened and drawn off by a strong vacuum pump. Since the fat is removed by suctioning small “tunnels” through the fat, the skin remains intimately connected to the underlying muscles by multiple attachments called fibrous septa. These can be described as being the body’s “Velcro”. It is this process and these structures, which assures that the skin will not hang in loose folds after liposuction.
WHAT TYPE OF ANESTHETIC IS USED?
Liposuction can be performed successfully either with a local anesthetic alone, local anesthesia with mild sedation (twilight anesthesia) or with a general anesthetic (completely asleep).
HOW LONG DOES THE SURGERY TAKE?
This depends on the number of areas treated and the amount of fat which will be removed. Therefore this can be anywhere from 30 minutes to 2 hours.
DO I NEED TO STAY IN OVERNIGHT?
This very much depends on the number of areas treated and the amount of fat that is removed. Certainly when small areas, with less that 1.5 liters of fat are removed, day surgery can comfortably be undertaken. When the amount of fat exceeds this, it may then be preferable to decide on an overnight stay.
HOW MUCH FAT CAN YOU EXTRACT?
It is important to understand that there is a maximum safe limit to the amount of fat that can be extracted during any one operation. This is usually between 2.5 – 3 liters. In some instances therefore you may want to repeat or have more removed at another time. It is usually best to wait at least three months between procedures.
IS IT PAINFUL?
There are very few forms of surgery that are completely painless. Usually there is discomfort or soreness at the treated areas for few days.
WILL THE FAT COME BACK?
No. As fat cells have achieved their set number in any given part of the body by puberty, increased caloric intake will not lead to volume gains in the treated site. It is important nonetheless to maintain your weight afterwards by sensible eating and regular exercise.
WHAT HAPPENS IMMEDIATELY AFTER THE OPERATION?
After your surgery, an elastic compression garment will be in place. This must be worn over the treated area to control swelling and bleeding, and to help your skin shrink to fit your new contour. You will need to wear this garment compression continuously for one week (apart from taking it off for a shower) after surgery, then just in the daytime for a few weeks more.
WHAT ARE THE SCARS LIKE?
Scars are not a complication but a normal event after any surgery. Thankfully scars in liposuction surgery are tiny and almost invisible. The scars are about 2-3 mm in length. They are usually placed in natural folds of the skin and fade with time.
WHAT CAN GO WRONG?
Complications that can occur include irregularities of contour or dimpling of the area treated; unevenness or asymmetry between sides, but these are very infrequent. Despite any surgeon’s best efforts, it is possible that a small number of patients may require a secondary tidy up procedure, usually after 9-12 months, to correct or improve any residual uneven contour or shape.
HOW LONG BEFORE I GET BACK TO NORMAL?
The recovery time varies with how many areas are treated and the type of activity the patient intends to resume. Most patients resume light activities within 2-3 days and depending on their work can be back between 5 -7 days.
SUMMARY
Liposuction is the most popular cosmetic surgery procedure. It is a highly effective technique for giving you a new body contour without scarring. The results are permanent. As long as your expectations are realistic, and understand that the final results may take a few weeks before becoming apparent, you should be happy with your new shape.
