If you are considering liposuction, there may be some questions you would like answered. Liposuction is a procedure that can help sculpt your body by removing unwanted fat from specific areas, including the abdomen, hips, buttocks, thighs, knees, upper arms, chin, cheeks and neck.
During the past decade, liposuction - also known as 'lipoplasty', 'liposculpture' or 'suction lipectomy' - has benefited from several refinements. Today there are a number of new techniques (tumescent, super wet, superficial). These advanced techniques help plastic surgeons to provide selected patients with more precise results and quicker recovery times. Although no type of liposuction is a substitute for dieting and exercise, liposuction can remove stubborn areas of fat that don't respond to traditional weight-loss methods.
The following frequently asked questions (FAQs) and answers will give you a basic understanding of the procedure - when it can help, how it is performed and how you might look and feel after surgery. These may not answer all of your questions, since much depends on your individual circumstances. Your doctor will be happy to explain any further concerns you may have about the procedure.
What should I consider before having liposuction?
If you're thinking about liposuction it is essential that you have realistic expectations about what the procedure can do for you. Whilst liposuction can greatly enhance your appearance and self-confidence, it is important that your expectations are realistic. So before you decide to have surgery, please think carefully about your expectations and discuss them with your LPSA surgeon.
The best candidates for liposuction are normal-weight people with firm, elastic skin who have pockets of excess fat in certain areas. You should be physically healthy. Although age is not a major consideration, older patients may have diminished skin elasticity and may not achieve the same results as younger patients with tighter skin.
Liposuction carries greater risk for individuals with medical problems such as diabetes, significant heart or lung disease, poor blood circulation, or those who have recently had surgery near the area to be contoured.
How do I plan my liposuction?
In your initial consultation at LPSA, your surgeon will evaluate your health, determine where your fat deposits lie and assess the condition of your skin. He will also explain the body-contouring methods that may be most appropriate for you. For example, if you believe you want liposuction in the abdominal area, you may learn that an abdominoplasty or 'tummy tuck' may more effectively meet your goals; or that a combination of techniques would be the best choice for you.
Your plastic surgeon at LPSA will take into consideration the effectiveness, safety, cost and the most appropriate choice for your needs. As an experienced surgeon he will use his judgement to prevent complications, to handle unexpected occurrences during surgery and to treat any complications if they arise.
How do I prepare for surgery?
Your surgeon will give you instructions to help you prepare for surgery. These may include guidelines on eating and drinking, smoking, and taking or avoiding certain vitamins and medications.
While making preparations, be sure to arrange for someone to drive you home after your surgery and to help you out for a few days, if needed.
Where will my surgery be performed?
Liposuction surgery is performed at one of several of London's best private hospitals, according to your preference and the availability of operating time.
You will usually be admitted on the day of surgery, and stay until the early evening. Occasionally, an overnight stay will be indicated. You will need a friend or relative to accompany you home after your stay in the hospital.
What type of anaesthetic will be used?
Liposuction at the LPSA is usually performed under a general anaesthetic, for smaller areas it can be performed under sedation.
What takes place during the surgery?
There are several liposuction techniques that can be used to improve the ease of the procedure and to enhance outcome. Liposuction is a procedure in which localised deposits of fat are removed to recontour one or more areas of the body. Through a tiny incision, a narrow tube or cannula is inserted and used to vacuum the fat layer that lies deep beneath the skin. The cannula is pushed then pulled through the fat layer, breaking up the fat cells and suctioning them out by a vacuum pump or a large syringe. If many sites are being treated, your surgeon will then move on to the next area, working to keep the incisions as inconspicuous as possible.
As fluid is lost along with the fat it is crucial that this fluid be replaced during the procedure to prevent shock. For this reason, patients are carefully monitored and receive intravenous fluids during and immediately after surgery.
The basic technique of liposuction, as described above, is used in all patients undergoing this procedure. However, as the procedure has been developed and refined, several variations have been introduced.
This is a technique, in which a medicated solution is injected into fatty areas before the fat is removed, is commonly used by plastic surgeons today. The fluid - a mixture of intravenous salt solution, Lignocaine (a local anaesthetic) and adrenaline (a drug that contracts blood vessels) - allows the fat to be removed more easily, reduces blood loss and provides anaesthesia during and after surgery. Fluid injection also helps to reduce the amount of bruising after surgery.
Large volumes of fluid - sometimes as much as three times the amount of fat to be removed - are injected in the tumescent technique. Tumescent liposuction, typically performed on patients who need only a local anaesthetic, usually takes significantly longer than traditional liposuction (sometimes as long as four to five hours). However, because the injected fluid contains an adequate amount of anaesthetic, additional anaesthesia may not be necessary. The name of this technique refers to the swollen and firm or 'tumescent' state of the fatty tissues when they are filled with solution.
The super-wet technique is similar to the tumescent technique, except that lesser amounts of fluid are used. Usually the amount of fluid injected is equal to the amount of fat to be removed.
Ultrasound-Assisted Lipoplasty (UAL)
This technique requires the use of a special cannula that produces ultrasonic energy. As it passes through the areas of fat, the energy explodes the walls of the fat cells, liquefying the fat. The fat is then removed with the traditional liposuction technique.
UAL has been shown to improve the ease and effectiveness of liposuction in fibrous areas of the body, such as the upper back or the enlarged male breast. It is also commonly used in secondary procedures, when enhanced precision is needed. In general, UAL takes longer to perform than traditional liposuction.
How long will the surgery take?
The time required to perform liposuction varies considerably, depending on the size of the area, the amount of fat being removed, the type of anaesthetic and technique used.
What can I expect after my surgery?
After surgery, you will probably experience some fluid drainage from the incisions. Occasionally, a small drainage tube may be inserted beneath the skin for a couple of days to prevent fluid build-up. You will probably be fitted with a snug elastic garment to wear over the treated area for a few weeks, this is to control swelling and help your skin conform to its new contours. Your doctor may also prescribe antibiotics to prevent infection.
Don't expect to look or feel great immediately after surgery. Although the newer techniques are believed to reduce some post-operative discomforts, you may still experience some pain, burning, swelling, bleeding and temporary numbness. Pain can be controlled with medications prescribed by your doctor, though you may still feel stiff and sore for a few days.
How long will it take for life to return to normal?
Healing is a gradual process. You will probably be advised to start walking around as soon as possible to reduce swelling and prevent blood clots from forming in your legs. You will begin to feel better after about a week or two and you should be back at work within a few days following your surgery. The stitches are removed or dissolve on their own within the first week to ten days.
Activity that is more strenuous should be avoided for about a month as your body continues to heal. Although most of the bruising and swelling usually disappears within three weeks, some swelling may remain for six months or more.
Your surgeon will schedule follow-up visits to monitor your progress and to see if any additional procedures are needed. If you have any unusual symptoms between visits - for example, heavy bleeding or a sudden increase in pain - or any questions about what you can and can't do, call your doctor.
How will I feel about my new look?
You will see a noticeable difference in the shape of your body quite soon after surgery. However, improvement will become even more apparent after about four to six weeks, when most of the swelling has subsided. After about three months, any persistent mild swelling usually disappears and the final contour will be visible.
If your expectations are realistic, you will probably be very pleased with the results of your surgery. You may find that you are more comfortable in a wide variety of clothes and more at ease with your body. And, by eating a healthy diet and getting regular exercise, you can help to maintain your new shape.
Does liposuction carry any risk?
Liposuction is normally safe, particularly at LPSA where patients are carefully selected, the operating facility is properly equipped and physicians are adequately trained.
However, it is important to keep in mind that even though a well-trained surgeon and a state-of-the art facility can improve your chance of having a good result, there are no guarantees.
Though they are rare, complications can and do occur. Risks increase if a greater number of areas are treated at the same time, or if the operative sites are larger in size. Removal of a large amount of fat and fluid may require longer operating times than may be required for smaller operations.
The combination of these factors can create greater hazards for infection; delays in healing; the formation of fat clots or blood clots, which may migrate to the lungs and cause death; excessive fluid loss, which can lead to shock or fluid accumulation that must be drained; friction burns or other damage to the skin or nerves or perforation injury to the vital organs; and unfavourable drug reactions.
There are also points to consider with the newer techniques. For example, in UAL, the heat from the ultrasound device used to liquefy the fat cells may cause injury to the skin or deeper tissues. Also, you should be aware that even though UAL has been performed successfully on several thousand people worldwide, the long-term effects of ultrasound energy on the body are not yet known.
In the tumescent and super-wet techniques, the anaesthetic fluid that is injected may cause Lignocaine toxicity (if the solution's Lignocaine content is too high), or the collection of fluid in the lungs (if too much fluid is administered).
The scars from liposuction are small and strategically placed to be hidden from view. However, imperfections in the final appearance are not uncommon after lipoplasty. The skin surface may be irregular, asymmetric or even "baggy," especially in the older patient. Numbness and pigmentation changes may occur. Sometimes, additional surgery may be recommended.