Liposuction, also referred to as liposculpture or suction assisted lipectomy, is a technique to remove unwanted fat deposits. The unsightly distribution of body fat is usually due to an inborn tendency to deposit fat in one particular area of the body, most commonly around the hips. Other areas for fat deposits include; the neck, arms, tummy, loins, thighs, inner side of the knees and the ankles.
Fat cells are believed not to be regenerated in adult life: their removal by liposuction will give a permanent change in contour and be independent of any changes in your body weight.
It is advisable that you first discuss this procedure with your General Practitioner (GP), who may then refer you to the Consultant Plastic Surgeon of your choice. Sharing your expectations with your GP and surgeon is the best way to increase the possibility of achieving your desired outcomes.
It is important to understand that liposuction is not a treatment for obesity. The amount of fat that can be removed from a localised area of the body is limited by what is considered safe (maximum of 3 litres) and a natural limitation when no further fat can be removed. Therefore it may not be possible to slim down an area as much as you might wish. Further treatments may be carried out in the same area after six months. Where the skin is inelastic and loose, Liposuction will tend to leave the skin more lax and it may be recommended that a skin excision be carried out to correct this, either at the same time as the liposuction, or as a second procedure. This is most likely in the abdomen, after pregnancy or weight loss, the buttocks or the neck. Please also note that dimples and wrinkles of the skin, sometimes calledcellulite will not be improved by liposuction.
You should avoid aspirin and anti-inflammatory drugs for 2 weeks before the operation. You should take iron if you are anaemic. Occasionally your surgeon will advise you to stop taking the contraceptive pill if the liposuction is going to be extensive, perhaps involving skin excision. Similarly if you are a smoker you should refrain from smoking for a minimum 4-6 weeks prior to the operation.
Although liposuction is one of the most commonly performed cosmetic plastic surgery procedures in the world, and the majority of these operations are successful, as with any surgery there are risks and potential complications. The Consultant Plastic Surgeon will details these potential complications and risks during your consultation.
The procedure is normally carried out under general anaesthesia as a day case although some cases of multiple site liposuction may require overnight stays. An epidural is an alternative for the lower part of the body, but a local anaesthetic alone is only suitable for small areas.
The liposuction technique involves inserting a cannula (narrow metal tube) through a small incision in the adjacent skin. The cannula is attached to a strong vacuum pump which is drawn back and forth within the area of excess fat. The process removes tunnels of fat leaving the small blood vessels and nerves intact. The skin will then retract.
There are some minor variants in the techniques. Some surgeons prefer to inject the area to be treated with solutions (wet or tumescent technique). Suction is usually applied with a powerful vacuum machine, but it is sometimes perfectly adequate to use a simple syringe for small areas. Ultrasound assisted lipectomy is another variant.
You are likely to need simple pain killers for a day or so after the operation and you will probably be asked to return approximately 7 – 10 days after surgery to have the sutures removed. The surgeon will usually recommend that you wear a snug pressure garment or corset around the treated area for 2 -3 weeks after the operation. This is used to reduce bruising and swelling but can be taken off while you wash, etc. or indeed when the garment itself needs to be cleaned.
You can expect considerable bruising which will be uncomfortable and at times painful: the larger the area treated the greater the bruising will be. Some people bruise more easily than others. The discoloration of this bruising will usually last for about a month, but the lumpiness and swelling of deep bruising can take up to six months to disappear, particularly when the abdomen or ankles have been treated.
As swelling can take a long time to settle you may not see the full benefit of the liposuction operation for up to six months. A greyish stripe can discolour the skin for several months and may be seen when the ankles have been treated although this happens very rarely. If you have a tendency to be anaemic, or if you were to have a large area treated, you may need to take iron tablets for a month. You can expect some numbness in the treated skin which lasts for several months.
You will have small scars, 1.0 to 2.0 centimetres long, at the site of insertion of the suction cannula. There is a small risk in some people that these scars may stay red for a while but they are usually located in less obvious areas.
You will only need to take a few days off work if a small area is treated, but larger areas may necessitate 7 to 10 days off work. Your Consultant Plastic Surgeon will advise you of the required time off work and what activities are permitted during the recovery period.
As with all surgical operations there are inherent risks and potential complications.
After surgery, some patients may experience dimpling, lumpiness, numbness, scarring, discoloration, or sagging skin in the treated area. Follow-up surgery may be needed to correct these problems.
In order to minimize associated risks of liposuction surgery, it is important that you follow all of your surgeon’s advice.
More serious complications include blood clots, infection, excessive fluid loss leading to shock, pulmonary embolism due to dislodged fat or blood clot, fluid build-up in the lungs, and drug overdose. A combination of the following factors is associated with an increased risk of serious complications:
- The removal of large amounts of fat
- More than one procedure being performed at the same time
- The use of general anaesthesia
Please note: that with all procedures there is a possibility of patient dissatisfaction with the outcome.
Allergic reaction to anaesthetic
In very rare cases anaesthetics can cause allergic reactions. The best current estimate is that a life-threatening allergic reaction (also known as anaphylaxis) happens during one in 10,000 to one in 20,000 anaesthetics. Your anaesthetist will choose the drugs for your anaesthetic by taking into account many different factors, in particular, the type of operation, your physical condition, and whether you are allergic to anything.
Most people make a full recovery from anaphylaxis. It isn’t known how many anaphylactic reactions during anaesthesia lead to death or permanent disability. One review article suggests that one in 20 serious reactions can lead to death. This in effect implies that the chance of dying as a result of an anaphylactic reaction during anaesthesia is between one in 200,000 and one in 400,000 anaesthetic procedures.
For additional information regarding this operation please contact your Consultant Plastic Surgeon.