What is Liposuction ?
People who undergo liposuction usually have a stable body weight but would like to remove undesirable deposits of body fat in specific parts of the body.
Liposuction is not an overall weight-loss method. It is not a treatment for obesity.
The procedure does not remove cellulite, dimples, or stretch marks. The aim is esthetic. It suits those who wish to change and enhance the contour of their body.
Liposuction permanently removes fat cells, altering the shape of the body. However, if the patient does not lead a healthy lifestyle after the operation, there is a risk that the remaining fat cells will grow bigger.
The amount of fat that can be safely removed is limited.
There are some risks, including infection, numbness, and scarring. If too much fat is removed, there may be lumpiness or dents in the skin. The surgical risks appear to be linked to the amount of fat removed.
Use of Liposuction
Liposuction is normally advised only if lifestyle changes have not achieved the desired results. It can treat areas of fat that are resistant to exercise and diet.
When an individual gains weight, each fat cell increases in size and volume. Liposuction reduces the number of fat cells in isolated areas.
People should discuss the pros and cons of liposuction with their doctor before deciding on whether to proceed. Liposuction should only be carried out after careful consideration.
Results are subtle rather than dramatic.
The following body areas are commonly targeted for liposuction treatment:
Liposuction is cosmetic rather than health-focused.
- inner knees
- flanks (love handles)
- neckline and the area under the chin
- thighs, both “saddlebags,” or outer thighs, and inner thighs
- upper arms
Liposuction works best for people with good skin tone and elasticity, where the skin molds itself into new contours.
People whose skin lacks elasticity may end up with loose-looking skin in areas where the procedure was done.
The person needs to be over 18 years of age and in good health. Those with circulation or blood flow problems, such as coronary artery disease, diabetes, or a weakened immune systems should not undergo liposuction.
Benefits of Liposuction
- Lymphedema: A chronic, or long-term, condition in which excess fluid known as lymph collects in tissues, causing edema, or swelling. The edema commonly occurs in the arms or legs. Liposuction is sometimes used to reduce swelling, discomfort, and pain.
- Gynecomastia: Sometimes fat accumulates under a man’s breasts.
- Lipodystrophy syndrome: Fat accumulates in one part of the body and is lost in another. Liposuction can improve the patient’s appearance by providing a more natural looking body fat distribution.
- Extreme weight loss after obesity: A person with morbid obesity who loses at least 40 percent of their BMI may need treatment to remove excess skin and other abnormalities.
- Lipomas: These are benign, fatty tumors.
Before the operation, patients will need to undergo some health tests to ensure they are fit for surgery.
The following recommendations may be made.
- People who use regular aspirin and anti-inflammatory drugs should stop taking them at least 2 weeks before surgery.
- Women may be asked to stop taking the contraceptive pill.
- Patients with anemia may be asked to take iron supplements.
The individual will need to sign a consent form. This confirms that they are fully aware of the risks, benefits, and possible alternatives to the procedure
During the operation
Patients may receive a general anesthetic before the procedure, which can last for 1 to 4 hours.
An epidural may be used for treatments on the lower body. In this case, the anesthetic is injected into the epidural space surrounding the dura, or fluid-filled sac, around the spine. This partially numbs the abdomen and legs.
A local anesthetic might be used when liposuction is done on very small areas.
If the patient requires only local anesthesia, they might be asked to stand up during the procedure to ensure proper fat removal.
There are a number of liposuction techniques.
Tumescent liposuction: Several liters of a saline solution with a local anesthetic (lidocaine) and a vessel-constrictor (epinephrine) are pumped below the skin in the area that is to be suctioned. The fat is suctioned, or sucked out, through small suction tubes. This is the most popular form of liposuction.
Dry liposuction: No fluid is injected before the fat is removed. This method is seldom used today. There is a higher risk of bruising and bleeding.
Ultrasound-assisted liposuction (UAL): Also known as ultrasonic liposuction, the cannula is energized with ultrasound. This makes the fat melt away on contact. The ultrasound vibrations burst the walls of the fat cells. This emulsifies, or liquified, the fat, making it easier to suction out. This method is suitable for fibrous areas, such as the male breast, back, and in areas where liposuction has been done before.
After ultrasonic liposuction, suction-assisted liposuction is done to remove the liquefied fat.
Power-assisted liposuction (PAS): Also known as powered liposuction, PAS uses a specialized cannula with a mechanized system that rapidly moves back-and-forth, allowing the surgeon to pull out fat more easily.
Laser Assisted Lipolysis (LAL): Also known as laser-guided lipo, this procedure requires the use of tumescent fluid. It is a less invasive and bloody procedure than the traditional liposuction method for removing fat.A small tube is inserted through a small incision to deliver laser energy and heat into the fat that is under the skin.
After the operation, the surgeon may leave the incisions open so that excess fluid and blood can drain from the body.
After the liposuction operation
- Anesthetic: Those who have a general anesthetic usually spend the night in hospital. Those who had a local anesthetic may be able to leave hospital on the same day.
- Support bandages: Either an elasticated support corset or bandages will be fitted for the targeted area.
- Antibiotics: These may be given immediately after the operation.
- Painkillers: Analgesics can help relieve pain and inflammation.
- Stitches: The surgeon will remove the stitches in a follow-up appointment.
- Bruising: Significant bruising may occur in the targeted area.
- Numbness: There may be numbness in the area where fat was removed. This should improve in 6 to 8 weeks.
The results of liposuction will not be clear until the inflammation goes down. In some cases, this may take several months. Most of the swelling settles after about 4 weeks, and the area where fat was removed should appear less bulky.
People who maintain their weight can usually expect permanent results. Those who gain weight after the procedure may find that their fat distribution alters. Those who previously had fat accumulating in their hips might find that their buttocks become the new problem area.
The risk of complications is usually associated with how large the procedure is, as well as the surgeon’s skills and specific training.
The following risks, unpleasant side effects, or complications are possible:
- Severe bruising: This can last for several weeks.
- Inflammation: The swelling may take up to 6 months to settle, and fluid may continue to ooze from the incisions.
- Thrombophlebitis: A blood clot forms in a vein, causing inflammation and further complications.
- Contour irregularities: If there is poor skin elasticity, if the wound heals in an unusual way, or if fat removal has been uneven, the skin may appear withered, wavy, or bumpy.
- Numbness: The affected area may feel numb for a while, but this is usually temporary.
- Infections: Rarely, a skin infection may occur after liposuction surgery. Sometimes this needs to be treated surgically, with the risk of scarring.
- Internal organ punctures: This is very rare.
- Death: Anesthesia involves a small risk of death.
- Kidney or heart problems: As fluids are being injected and or suctioned, the change in the body’s fluid levels may cause kidney or heart problems.
- Pulmonary embolism: Fat gets into the blood vessels and travels to the lungs, blocking the circulation in the lungs. This can be life-threatening.
- Pulmonary edema: Sometimes, when fluid is injected into the body, it accumulates in the lungs.
- Allergic reaction: The patient may be allergic to medications or materials used during surgery.
- Skin burns: The cannula movement may cause friction burns to the skin or nerves.
Those who are most satisfied with the results tend to be the people who consider carefully the pros and cons beforehand, who are informed about what to expect, who choose a qualified and experienced surgeon, and who discuss the details carefully with their surgeon.
Fatih Levent Balcı
General Surgeon .MD
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