Plastic Surgery

Liposuction

What is the Liposuction?

Liposuction, also known as lipoplasty is a cosmetic surgery that removes fat from many different sites on the human body. The most popular treatment areas include buttocks, neck, chin (submental), face, arms, abdomen, thighs, hips, love handles (flanks).

The basic surgical challenges of any liposuction procedure are to remove the right amount of fat, to cause the least disturbance of neighboring tissue, such as blood vessels and connective tissue, to leave the person’s fluid balance undisturbed and to cause the least discomfort to the patient.

Liposuction permanently removes fat cells and can alter body shape. However, the remaining fat cells can grow, so weight loss is not necessarily permanent, especially if you eat an unhealthy diet and don’t exercise after the surgery.

Liposuction is not a treatment for obesity, and it will not remove cellulite or stretch marks. There is a limit to the amount of fat that can safely be removed.

What is the procedure?

The procedure generally last between 30 and 90 minutes depending on the area(s) covered. Liposuction is usually carried out under general anesthetic. If it is only a small area being treated then local anesthesia may be used.

In general, fat is removed via a cannula (a hollow tube) and aspirator (a suction device). Liposuction techniques can be categorized by the amount of fluid injection and by the mechanism in which the cannula works:

1) Suction-assisted liposuction (SAL)

Suction-assisted liposuction is the standard method of liposuction. In this approach, a small cannula (like a straw) is inserted through a small incision. It is attached to a vacuum device. The surgeon pushes and pulls it in a forwards and backwards motion, carefully through the fat layer, breaking up the fat cells and drawing them out of the body by suction.

2) Ultrasound-assisted liposuction (UAL)

In ultrasound-assisted or ultrasonic liposuction, a specialized cannula is used which transmits ultrasound vibrations within the body. This vibration bursts the walls of the fat cells, emulsifying the fat (i.e. liquefying it) and making it easier to suction out. UAL is a good choice for working on more fibrous areas, like the upper back or male breast area. It takes longer than traditional liposuction, but not longer than tumescent liposuction. There is slightly less blood loss. There appears to be slightly more risk of seromas forming (pockets of fluid) which may have to be drained with a needle.

After ultrasonic liposuction, it is necessary to perform suction-assisted liposuction to remove the liquefied fat.

3) Power-assisted liposuction (PAL)

PAL uses a specialized cannula with mechanized movement, so that the surgeon does not need to make as many manual movements. Otherwise it is similar to traditional SAL.

4) External ultrasound-assisted liposuction (XUAL or EUAL)

XUAL is a type of UAL where the ultrasonic energy is applied from outside the body, through the skin, making the specialized cannula of the UAL procedure unnecessary.

XUAL is a possible way to avoid such complications by having the ultrasound applied externally. It can also potentially cause less discomfort for the patient, both during the procedure and afterwards; decrease blood loss; allow better access through scar tissue; and treat larger areas.

5) Water-assisted liposuction (WAL)

WAL uses a thin fan-shaped water beam, which loosens the structure of the fat tissue, so that it can be removed by a special cannula. During the liposuction the water is continually added and almost immediately aspirated via the same cannula. WAL requires less infiltration solution and produces less immediate edema from the tumescent fluid.

6) Laser-assisted liposuction

Laser Lipo involves using thermal energy to dissolve specifically targeted fatty deposits (Lipolysis). Once these cells have been broken down subsequently removed naturally using the body's lymphatic system or extracted with a gentle suction via a fine cannula which is inserted in the same incision.

What kind of result can you expect?

After liposuction, the new body’s shape is more or less permanent. If a patient does gain a moderate amount of weight after liposuction, then the figure will simply be a larger version of the new body shape. Fat cells that are removed by liposuction do not grow back. If the patient does not gain excessive amounts of weight, then the new more pleasing silhouette is permanent.

Patients should not expect to lose a dramatic amount of weight with liposuction. However, because fat is removed from cosmetically important areas, liposuction should produce significant improvements in aesthetic appearance.

Recovery period and recommendations

After the surgery, the treated area will be bandaged or stitched, and you may need to wear some elastic compression clothing to reduce swelling. If general anesthetic is used you may be asked to stay overnight in hospital. You may have to take antibiotics straight after the procedure to reduce the risk of infection. Most people also take mild painkillers (analgesics) to ease the pain and swelling afterwards.

There will be considerable bruising to the area treated. The bruising will be worse when a larger area has been treated. Deep bruising and swelling may last for up to six months.

There may also be some numbness in the area, which should go away in six to eight weeks.

It usually takes about two weeks to make a full recovery, but it can take up to six months to see noticeable results, as the treated area may take time to settle down.

Possible side effects and complications

Side effects of liposuction can include bad bruising, especially in patients who have a tendency to bleed or who have been taking aspirin or anti-inflammatory drugs; swelling, which may not settle for up to six months; inflammation of the treated areas; fluid coming from the cuts (incisions); scars from the cuts (incisions); thrombophlebitis (an inflammation of the veins), which is common inside the knee and on the inside of the upper thigh when these areas are treated; swollen ankles.

Any major operation runs the risk of infection and excessive bleeding. Antibiotics may be needed to help prevent infection.

Other complications specific to liposuction include:

- thrombosis - the clotting of blood within a blood vessel, which can obstruct or stop the flow of blood;

- lumpy and uneven results after the fat has been removed;

- bleeding under the skin - known as hematoma;

- pulmonary embolism - a potentially fatal blockage in the lungs caused by a blood clot;

- numbness in the treated area that may last for months;

- damage to the internal organs from the procedure;

- a build-up of fluid in the lungs - known as pulmonary edema, which can occur as a result of the fluid injected into the body;

- changes in skin color and a loss of normal feeling in the area treated if the ultrasound method is used.






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