Liposuction, also known as liposculpture, or lipectomy, slims and reshapes specific areas of the body by removing excess fat deposits, improving body contours and proportion, and ultimately, enhancing the patient’s self-concept.
Liposuction can radically and definitively diminish localized areas of protruding fat, which cannot be eliminated even with strict diet and exercise.
However, liposuction is not a method for losing or controlling weight, neither a treatment for obesity. Thus, a properly performed liposuction will not replace an improvement in lifestyle. The principle of liposuction, as presented by Illouz (1977) is to remove fat through very small skin incisions, with atraumatic and blunt-tipped cannulas. These cannulas are attached to a closed negative pressure system, which permits safe and sterile aspiration of excessive fat cells.
Practically, liposuction can be applied to numerous body areas: hips, outer thighs, abdomen, knees, calves, ankles, upper arms, or even the face and neck (i.e, to treat double chin).
Meanwhile, it must be kept in mind that liposuction, however common a procedure it may be, remains a genuine surgical intervention that ought to be performed by a skilled Plastic Surgeon, specially trained for this technique, in a truly surgical environment.
Before the operation
A preoperative check-up is made following the surgeon’s recommendations. The anesthesiologist will be seen in consultation at latest, 48 hours prior to surgery.
No medication containing aspirin will be taken for 10 days before surgery.
According to the type of anesthesia chosen, you may be asked not eat or drink for 8 hours before surgery.
Hospital stay and type of anesthesia
Type of anesthesia: Liposuction can be performed, depending on the amount of areas to be treated, either local anesthesia associated with intravenous sedation or general anesthesia. In some cases, regional anesthetics, such as an epidural can be used. The type of anesthesia will be selected after a discussion with the surgeon and the anesthesiologist.
Hospital stay: The duration of hospitalization depends on the amount of fat removed. It can be short (a few hours) for small liposuctions under local anesthesia, or longer (1 or 2 days) for larger liposuctions under general anesthesia.
Techniques are adapted to each individual case, in order to obtain the best possible results. However, there are common principles:
Skin incisions are small (3 to 4 millimeters) and discrete, usually hidden in a natural fold. Fat cells from deep and superficial fat layers are aspirated through smooth cannulas tunneled though subcutaneous tissue layers, taking care to avoid nerves and blood vessels.
The amount of fat removed is adapted to the amount of the overlying skin, which represents a fundamental factor for the quality of the final result.
The duration of the procedure depends on the amount of fat removed and on the number of body areas to treat. It can vary from 30 minutes to 3-4 hours.
After the operation
The necessary time needed to recover from surgery is proportional to the amount of excess fat removed. After surgery, you will observe swelling and bruising in the treated areas. Pain can vary from one patient to another, but it is usually mild, due to the use of very thin cannulas. Fatigue is common in the first few post-operative days, especially after large liposuctions.
You can go back to your usual activity 4 to 7 days after surgery, again depending on the extent of your liposuction and the type of professional activity. Bruising usually disappears 10 to 20 days after surgery. It is strongly recommended to wear a compressive garment for 4 to 6 weeks.
It is possible to start sports again at least 4-5 weeks after surgery.
There is no dramatic improvement of body contour in the first 2 to 3 weeks, because of the tissue swelling (edema) in the operated areas.
It is only after 3 weeks and with the absorption of the edema that results will begin to appear. The skin will retract completely in 3 to 6 months over the new contours and readapt to the new silhouette.
The final result can be best appreciated 6 months after the procedure. It is most satisfactory when the patient selection and technique are properly done, permitting removal of localized fat deposits and producing skin retraction.
In some cases, localized imperfections can be observed, which must be distinguished from genuine complications: insufficient corrections, residual asymmetry, surface irregularities. These can be corrected secondarily under local anesthesia after 6 months.
Liposuction, even if performed for aesthetic reasons, is a genuine surgical procedure, with the consequent risks related to all medical acts. There are surgical and aesthetic complications. Concerning anesthesia, the anesthesiologist will inform you about all the anesthetic risks. You must be aware that anesthesia can sometimes cause unpredictable body reactions that can be difficult to control. The presence of an experienced anesthesiologist, in a surgical environment, means that the risks are practically statistically negligible.
In fact, techniques, products and monitoring methods have progressed considerably over the last decade, offering optimal safety, especially when the operation is elective and the patient is in good general health. Some complications that can occur after combined Liposuction with abdominoplasty,(abdominoplasty, actually constitutes one of the most extensive and involved procedures in Plastic and Aesthetic Surgery), are the following:
- Thrombo-embolic accidents (blood clot in the veins of the legs, pulmonary embolism) are rare, but can be life-threatening. They can be prevented by strict prophylactic measures, such as standing and walking as soon as possible after surgery, wearing compression stockings, or heparin therapy (low doses of heparin injected under the skin)
- Blood clots (hematomas) are quiet rare but can occur. They can be evacuated to prevent an impairment of the final aesthetic result.
- Infection, though common, can be treated with drainage and antibiotics.
- It is common to notice 8 days after surgery a lymph collection accumulating under the skin. Such a collection can be drained and will dry up rapidly without sequela.
- Localized skin necrosis. Large areas of necrosis rarely occur. They can be prevented by a proper surgical examination and a cautious and well-executed operation, with moderate tension on sutures.
- Numbness of abdominal skin may be observed, frequently in the lower abdomen. It is usually transient and most patients recover normal skin sensation after 3 to 12 months.
- In some patients with highly damaged skin or skin with poor circulation, the healing process may be delayed resulting in conspicuous scars, which may necessitate a second operation.
My Way …. “Metron Ariston”
I use the Waterjet-assisted Liposuction (WAL) for optimal aesthetic results and autologous lipotransfer.
Precisely, Waterjet-Assisted Liposuction and Fat Transfer Device is transforming the way liposuction is performed. It is a 2nd generation device, updated with advanced technology. With the help of a fan-shaped, pulsating water beam, the fat is gently separated away from the tissue and evacuated simultaneously. The process leaves the surrounding connective tissue, nerves and vascular structures almost undamaged, keeping the patient safer, with limited bruising and quicker recovery time.
I have used WAL in several patients and in all body areas – chin, abdomen, thighs, knees hips, arms – and have combined it with autologous fat transfer for buttocks and breast augmentation, as well as for the volume and rejuvenation of the face and hands.
It is the ultimate device for lipo-sculpting, presenting multiple advantages: it respects the integrity of fat cells, the patient heals faster with less pain & bruising, the process is faster, and recovery is quicker. The final result is also better and more long-lasting, which is what makes this procedure a breakthrough in Lipo-sculpting.
This webpage aims to provide some information about the subject. Individual patient circumstances may differ, which might alter both the advice and course of therapy given to you by your doctor.
American Society of Plastic Surgeons, British Association of Plastic, Reconstructive and Aesthetic Surgeons, French Society of Plastic, Reconstructive and Aesthetic Surgery