Liposuction

Liposuction is for removing excess fat from areas around the body to give a more aesthetically pleasing body shape.

It is not a treatment for obesity nor does it treat cellulite, but can remove stubborn areas of fat that fail to respond to traditional weight loss methods.

The main areas where liposuction is used are in the tummy, hips, thighs, buttocks, upper arms and the chin region (usually combined with a face or neck lift procedure). Men can develop fatty swellings behind the nipples which look like breasts (gynaecomastia) and this may also be treated by liposuction. When applied to several areas the term liposculpture is frequently used.

The tumescent technique involves infiltrating the fat with a large volume of fluid and this allows you to have more precise results and a quicker recovery time.

You should have realistic expectations about what can be achieved with liposuction, which can improve your appearance and self-confidence, but may not necessarily change your appearance to match your ideal.

The best candidates for liposuction are people close to their ideal weight with firm, elastic skin who have pockets of excess fat in certain areas. Your age is not a major consideration except that older patients tend to have reduced skin elasticity and therefore may not achieve the same result as a younger patient with tighter skin. The amount of fat that can be removed for a localised area is limited and it is not always possible to slim down an area as much as you may wish. Further treatments can be carried out in the same area after about six months.

Pre-operative advice

Smokers have a higher risk of developing complications. It is therefore advised that smokers should stop smoking two weeks prior to surgery and for two weeks after surgery.

Aspirin and similar anti-inflammatories should be avoided for a similar period due to the increased risk of bleeding during surgery.

Patients on oral contraception (not HRT) should stop taking the pill for approximately six weeks prior to surgery. During this period alternative forms of contraception will be required.

People with medical problems such as diabetes or significant heart or lung disease are at greater risk and will need to be carefully assessed before surgery.

It is not appropriate for a detailed discussion about your surgery on the day of your admission to hospital, so you should ensure we have discussed all of your expectations and the potential complications at your pre-surgery consultation.

Admission to Hospital

Most patients are admitted on the day of their operation. I will visit you on the Ward, as will the Anaesthetist who will check that you are fit enough for the operation and discuss any special considerations you may have. Pre-operative photographs, if not already done, will be taken and the areas to be treated will be highlighted with a marker pen.

The Operation

Liposuction can rarely be performed under local or usually general anaesthetic depending on the size of the area to be treated. The operation may take from thirty minutes in simple cases and up to four hours in extensive cases. Very small skin incisions are made around the area to be treated, usually in areas where small scars will be concealed.

The area to be treated is then infiltrated with a large volume of saline solution containing small amounts of adrenaline and local anaesthetic, which may have the effect of reducing blood loss and enabling a more precise, even distribution of fat removal.

As mentioned before, this is known as the tumescent technique. The fat is removed using a variety of liposuction cannulas (tubes) and the amount of fat removed from the various locations is measured. A dose of intravenous antibiotic is given during the operation to reduce the risk of infection.

What to expect after the operation

After liposuction a pressure garment should be worn day and night for the first two weeks, then as much as possible for the next four weeks. This helps reduce the swelling and aids in the recontouring of the treated areas.

The amount of swelling and bruising is variable and depends on the treated areas, the extent of the treatment and the response of the tissues to the trauma of liposuction, which varies considerably between patients. The swelling is usually at its worst 48 hours after surgery and tends to resolve within seven to ten days though in some circumstances it may take several weeks to settle completely.

Fluid may ooze out of the small incisions for the first two to three days following surgery. This may be quite marked and also may be blood-stained. This is entirely normal after tumescent liposuction. Your pressure garment will get messy so it can be removed in order for it to be washed, but it should be replaced as soon as possible.

You will be able to shower the day after surgery, but you should avoid soaking the treated areas for at least five days.

After hospital discharge

You should arrange for someone to drive you home after the procedure and perhaps help at home for a day or two as you may feel stiff and sore. It is not unusual to feel a bit low in the days or weeks following your operation, but these feelings will subside as you begin to look and feel better.

At the initial consultation you will have been given advice about when you can return to work and for how long you should avoid strenuous activities and driving. You are encouraged to mobilise as much as possible following surgery as this helps to reduce the swelling and reduces the risk of a thrombosis (blood clot) in your legs.

What problems may I encounter?

The potential risks and complications will be fully discussed at your initial and pre-surgery consultation. Minor problems may include localised areas of lumpiness (which is due to deep bruising and should be treated by massage if still persistent after several weeks) and some numbness around the treated areas. Most of your bruising and swelling should have settled down within three weeks, but some swelling may remain for six months or more.

We will arrange follow up visits to monitor your progress

Ultimately, you should find that you are more comfortable in a wider variety of clothing and feel more at ease with your body. By eating a healthy diet and taking regular exercise you can help to maintain your new shape.