Maintaining a healthy diet plan and integrating exercise into your daily lifestyle may not remove unwanted fat. Not the excessive and overweight body fat – obesity, but the undesirable layers of fat located at specific areas of the body. These excess fat deposits are usually stubborn to burn off and may be present due to some health conditions, pregnancies, age, or genetics. However, they can be removed through a process known as “Liposuction” resulting in an improved body shape and proportion.
What is liposuction?
Liposuction, also referred to as liposculpture suction, lipoplasty, suction-assisted lipectomy, or simply lipo is a plastic surgery procedure. The aim is to improve body contours and proportion by removing excess fat deposits, to refine and reshape specific body areas.
Target areas for fat removal include the
Although you may lose some weight during the procedure, liposuction may not be considered a weight loss surgery. Specifically, the amount of fat removed during a liposuction section ranges from 3 to 4 liters. Further attempts to reduce larger amounts of fats may increase risk factors and complications during and after the surgery.
The Liposuction procedure is carried out by a certified plastic surgeon, cosmetic surgeon, or dermatologist. It involves the use of a narrow, hollow tube – cannula, and a suction device – aspirator to suction fat deposits under the skin. The technique contours targeted areas of the body and performed under local, regional, or general anesthesia.
Who is the ideal patient for liposuction?
Liposuction is most beneficial and ideal for you if
- You are at, or near your ideal body weight
- Have good skin elasticity and muscle tone (3)
- Have struggled with losing fat deposits at specific body areas, despite diet plans and exercise
- Healthy, without health conditions that could lead to surgery complications. Such as coronary artery diseases, diabetes, weak immune systems, restricted blood flow (4).
Why carry out liposuction?
The liposuction procedure is carried out for two purposes,
- Cosmetic purposes – which is to change body shape, solely for aesthetics.
- Reconstructive purposes – to treat certain health conditions, usually the removal of lipomas – fatty lumps between the skin and muscle layers. This procedure is used in medical conditions such as; Lymphedema, and Lipoedema. Lymphedema is the swelling of the arms and legs as a result of an excessive fluid collection within the tissues over a long term period (5). Lipoedema is a condition of abnormal fat deposits under the skin in the buttocks, thighs, and legs (6).
Different types of liposuction
There are various types of liposuction, categorized according to the technique used for the process. These techniques can be differentiated by the mechanism of action of the cannula, as well as the amount of fluid injected. Sometimes, surgeons use two or more techniques for a session.
This technique is specific for the diameter of the cannula used – a stainless steel tube with an outside diameter ranging from 1mm to 3mm. It is inserted through an incision or small opening into the subcutaneous fat.
Suction-assisted Liposuction (SAL)
This technique is also referred to as “suction-assisted lipectomy”.
This technique is the most common type of liposuction. The word “tumescent” means swollen and firm, and involves the use of anesthesia in the surgery process (7).
A large amount of sterile solution – usually up to three times the amount of fat intended for removal is injected into the targeted areas of excessive fat deposits. The sterile solution is a mixture of lidocaine, epinephrine, and IV salt solution. Lidocaine is a local anesthetic, which helps to relieve pain during and after surgery. Epinephrine is a drug that contracts blood capillaries and helps to reduce the loss of blood, bruising, and swelling. The IV – intravenous salt solution helps remove the fat easily. The targeted tissue on injection with the fluid mixture becomes swollen and firm. The surgeon then makes incisions into the skin and inserts the cannula connected to a vacuum that suctions the fats and fluids out from the body.
Water-Jet Assisted Liposuction
This technique is used for lipedema patients who require lymph-sparing liposuction. It involves the removal of fat by the use of a fan-shaped jet of water that contains the anesthetic solution.
This technique is used in the removal of lipedema fat. It is not performed alone, rather alongside tumescent liposuction or Water-jet assisted suction technique.
Otherwise known as the vibrating cannula, this technique involves the rapid movement of the cannula in a back and forth motion. It allows the surgeon to pull tough fat at a rapid rate and with more precision. Usually, this technique is used for the removal of large volumes of fat, scarred areas, or in a scenario where liposuction has been carried out previously (8).
This technique is used for the reconstructive liposuction processes. Extra care is given to the lymphatic vessels which are already abnormal in this scenario. Hence, only small, blunt cannulas are used, and specifically, only the longitudinal orientation of cannulas are used at critical junctures. This surgery is more time consuming, and intended to relieve symptoms such as ameliorate disability, pains, halt disease progression, and improve life quality.
As the name implies, this technique uses ultrasound vibrations to rupture the fat cell walls into a liquid form for easier removal. It can be done in two ways, internal – below the skin surface with a small, heated cannula, or external – above the skin surface with an emitter. It may help remove fat from dense, fiber-filled areas of the body (9).
Also known as lipolysis, it uses laser energy to liquefy/emulsify fat deposits. A small cannula is used, hence, this technique is adopted for use in small, confined areas such as the face, and chin. An advantage of this procedure is that energy from the laser stimulates collagen production, which may prevent skin sag after surgery. Collagen is the fiber-like protein that helps maintain skin structure.
In the tumescent technique, the fluid injected is up to three times the amount of fat to be removed. However, in this technique, the fluid injected is equal to the amount of fat to be removed. This liposuction procedure takes less time but requires the use of sedatives – medicine that makes you drowsy.
What to expect – The Processes involved
Your surgeon will select the appropriate liposuction technique to achieve your desired goal. Sometimes, a variety of techniques is combined for a procedure.
- The surgical team will prepare you, mark targeted areas on your body and take photos – so that before and after photos can be compared.
- The liposuction machinery to be used for the surgery will be set up.
- IV fluid lines will be situated to help regulate fluid levels during the surgery.
- You will receive anesthesia – which induces a temporary state of unconsciousness, for your comfort during the procedure.
- During the surgery, small incisions or skin punctures will be made on your skin, in well-hidden natural body creases.
- The surgical team will monitor your blood pressure, heart rate, and blood oxygen level all through the procedure.
- The procedure may last for hours, depending on the extent of fat removal.
- At the end of the procedure, incisions are closed up with sutures, sometimes, small tubes are also placed at incision sites to drain body fluids.
- You may lose a lot of fluid and may need fluid replacement – this will be done intravenously.
- After the surgery, you will wake up in a recovery room, covered with a compression garment fitted for the targeted areas.
- Expect some numbness, pain, swelling, and bruising from the procedure, this typically subsides within a few weeks (10).
- You may return to non-strenuous work after 2 to 3 days, but this will vary depending on the techniques used and your health conditions.
- It may take up to 6 months for the treated area to settle completely and take up a leaner appearance.
How you prepare for surgery
- Discuss extensively with your surgeon on expectations during and after the surgery – including risks, and possible complications.
- Be honest about every underlying health condition, medical history, medications, and supplements – including full health history and also detailed weight history.
- You may be required to run lab tests before the procedure.
- You may be required to stop taking certain medications at least three weeks before surgery.
- You may be required to stop smoking at least two weeks before the surgery – smoking hinders wound healing.
- You may be required to avoid shaving and all forms of hair removal ahead of the surgery to prevent ingrown hairs.
- As a woman, you may be required to stop taking contraceptive pills.
- You may be required to stop all forms of consumption after midnight the night before surgery.
- You may be required to sign a consent form, confirming your knowledge of the benefits and risks of the procedure (11).
- Have someone drive you to the hospital on the day of surgery and make arrangements for a possible overnight stay.
- Arrange for someone to drive you home afterward, and possibly stay with you for at least 24 hours.
Side effects and risks
Like every surgical procedure, liposuction has its underlying risks and possible complications. The following are possible unpleasant side effects
- Severe bruising – This may last for weeks.
- Paresthesias – The nerve compression at the site of the liposuction, resulting in intense sensitivity, could be pain or numbness and may be chronic or temporary.
- Inflammation – Fluids may keep oozing from the incision and swelling may stay up to 6 months.
- Thrombophlebitis – A blood clot in the vein. This is life-threatening and represents more than 23% of liposuction surgery deaths.
- Withered, wavy, or bumpy skin – This appearance of contour irregularities is usually a result of poor skin elasticity.
- Internal organ puncture – visceral perforations, a very rare occurrence
- Death – Occurs in about one per ten thousand cases, and may be associated with anesthesia.
- Kidney, lungs, or heart problems – The change in body fluid levels during injection and suction may cause these problems.
- Pulmonary embolism – a life-threatening complication involving blockage of blood circulation in the lungs, as a result of fat getting into the blood vessels.
- Pulmonary edema – an accumulation of injected fluids in the lungs.
- Allergic reaction – allergy to materials or medications used in the surgery.
- Skin burns resulting from friction movement of the cannula.
- Seroma – The accumulation of serum, in areas where fat tissues have been removed (12). The serum is the straw-colored liquid from blood.
- Skin necrosis – Tissue death, the skin above the liposuction site changes color and falls off, this area may also become infected with bacteria.
- Skin deformities; at the site of the liposuction after the procedure.
- Lidocaine toxicity; in rare circumstances, this anesthetic administered with fluids during liposuction may have a toxicity occurrence causing serious heart and central nervous system problems.
If you experience shortness of breath, chest pain, excessive bleeding, or unusual heartbeat after the surgery, call your surgeon immediately.
Liposuction is a plastic surgery procedure. It aims to improve body contours and proportion by removing excess fat deposits to refine and reshape specific body areas. Although you may lose some weight during the process, liposuction may not be considered a treatment for obesity, removal of stretch marks or cellulite. The liposuction procedure is carried out for either cosmetic or reconstructive purposes. And is ideal for patients who have struggled with losing fat deposits at specific body areas, despite diet plans and exercise. There are various liposuction techniques, categorized by the mechanism of action of the cannula, as well as the amount of fluid injected. As with surgical sessions, there are risks and possible complications, discuss extensively with your surgeon on expectations during and after the surgery.
Frequently Asked Questions (FAQ’s)
Can liposuction remove fat permanently?
Yes, the fat cells removed during liposuction are gone permanently. Maintaining a “post-lipo weight” will ensure the non-accumulation of fat in the near future.
How long before the results of your liposuction becomes visible?
After the surgery, the treated areas will get a leaner appearance. Visible changes can take as long as 6 months to become visible.
Can you lose weight via liposuction?
Although you may lose some weight during the session, liposuction is not classified as a weight loss technique.
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- “Liposuction” – plasticsurgery.org
- “Surgery: Basic Science and Clinical Evidence” – books.google.com
- “Liposuction” -mayoclinic.org
- “What is lymphedema?” – medicalnewstoday.com
- “Liposuction” – nhs.uk
- “Does tumescent liposuction damage the lymph vessels in lipoedema patients?” – journals.sagepub.com
- “Advances in Liposuction” -journals.lww.com
- “Innovation in Plastic and Aesthetic Surgery Lipoplasty” -springer.com
- “Tumescent Liposuction” – ucsfhealth.org
- “What is liposuction?” – medicalnewstoday.com
- “Updates and Advances in Liposuction” -academic.oup.com