Liposuction is a very popular procedure with men and women keen to improve the shape and contours of the body by removing excess fat deposits that cannot be addressed through diet or exercise alone.
It removes fat from selected areas in a controlled fashion, by passing a suction cannula underneath the skin and into the fatty layers beneath.
It is possible to perform liposuction on most areas of the body and even the face, but some areas respond better, particularly the tummy, thighs, flanks and hips. Liposuction can be done as a separate operation or combined with cosmetic breast and body procedures.
Liposuction is not a weight loss strategy; it is designed to help smooth and tone areas of the body where stubborn fat is visible and unable to be targeted via other means. It is also important to understand that, while liposuction can enhance the appearance and self-confidence, it won’t necessarily change the looks to match the ideal one. Liposuction won’t get rid of cellulite and is not intended as a treatment of obesity. Patients who have excessive weight are advised to avoid surgery.
Good results also depend on elastic skin that will adapt to a new contour when the underlying fat is removed. Liposuction is most likely to be successful with people who are a healthy weight, with firm, elastic skin and who have pockets of excess fat in certain areas. Although age is not a significant concern, older people may have less skin elasticity and may not achieve the same results as a younger person with tighter skin.
There is no strict limit to the amount of fat which may be removed, but the greater the volume the higher the complication rate and it is necessary to replace fluids in proportion to the amount of fat and fluid removed. High volume removal (more than 2.5-3 litres) may necessitate blood transfusion and therefore the amount removed in any one session is usually kept below this level.
Who is a good candidate for liposuction?
Liposuction is a highly individualised procedure. The common reasons for considering liposuction are:
- Localised deposits of fat in the abdomen, arms, thighs and/or neck, which may be the result of heredity and do not disappear with exercise and diet
- Minimal amount of excess skin and good skin elasticity
- Physically fit, close to the ideal body weight and with stable weight. If somebody is planning to lose a significant amount of weight or even gain weight (for example, due to pregnancy), this is not the time to undergo liposuction
- Liposuction does not remove cellulite and cannot tighten loose skin. Other procedures may be recommended to improve those conditions
What are the different types of liposuction?
There are several liposuction techniques that can be used to improve the ease of the procedure and to enhance outcome.
Tumescent liposuction
A technique in which a medicated solution is injected into fatty areas at the time of surgery. 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 fluid is a mixture of intravenous salt solution, local anaesthetic and adrenaline (a drug that constricts blood vessels). This allows the fat to be removed more easily and reduces pain following the operation. Tumescent fluid injection during surgery also helps to reduce the amount of bruising and minimises blood loss after liposuction. This is routinely used to enhance outcome and reduce pain and bruising.
Super-wet technique
This technique is similar to the tumescent technique, except that lesser amount of fluid is used. Usually the amount of fluid injected is equal to the amount of fat to be removed.
Suction-assisted liposuction (SAL)
The most traditional form of liposuction, draws fat out with a vacuum.
Power-assisted liposuction (PAL)
Traditional SAL with the addition of a tool to increase the motion of the cannula, which speeds up fat removal.
Ultrasound-assisted liposuction (UAL)
Transmits energy through a special hand piece that helps to loosen and melt fat, enabling a greater volume of fat to be removed. This is best for larger areas, dense fat and male patients. In general, UAL takes longer to perform than traditional liposuction and carries a higher risk of complications.
Where will the incisions be?
Generally, the incisions are very small and placed in hidden areas. Sometimes, depending on the area, the incisions cannot be hidden. However, because liposuction incisions are small, the scars are also small.
Most liposuction scars fade and are barely perceptible over time. Visible scars are more likely when large liposuction cannulas are used and in patients who have darkly pigmented skin.
There are two types of marks that can remain on the skin after liposuction. One is a true scar and the other is known as dyschromia, which is a dark (hyperpigmented) or light (hypopigmented) spot on the skin.
Will the fat come back?
The results of liposuction surgery are technically permanent because fat cells have been removed. However, the body shape and contours might be affected by weight gain, ageing, pregnancy, family genes and lifestyle factors.
Fat cells achieve their set number in any given part of the body by puberty, and thereafter only increase in their volume rather than their number. If the fat cells are removed from an area by liposuction, an increased calorie intake should not lead to significantly different volume gains in the treated site compared to non-treated areas. It must be understood that if one takes in excess calories after surgery, then all areas of the body will increase in size, including the treated areas. However, if one is careful with their weight and diet, the change in contour will be permanent.
What are the complications of liposuction?
In general, liposuction is safe and the results are entirely predictable, with an associated high degree of patient satisfaction. Nevertheless, no surgery is without risk.
