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Summary

Liposuction or lipoplasty is a surgery to remove excess fat from various areas of the body such as the thighs, buttocks, neck, and abdomen. Your surgeon will recommend this procedure to you if you are physically fit, have realistic expectations from the surgery, and have fat that cannot be managed by diet or exercise. Liposuction is not suitable for smokers as smoking interferes with healing. Those who cannot take anaesthetics are also advised against this surgery. The procedure involves making an incision and placing a small tube in the area to remove the excess fat, usually through vacuum suction. Some complications of liposuction surgery are infection, fluid accumulation, delayed healing, irregular body contours, or the need for a second surgery.

  1. What is liposuction?
  2. Why is liposuction recommended?
  3. Who can and cannot get liposuction?
  4. What preparations are needed before liposuction?
  5. How is liposuction done?
  6. How to care for yourself after liposuction?
  7. What are the possible complications/risks of liposuction?
  8. When to follow up with your doctor after liposuction?

Liposuction (lipoplasty or lipectomy) is a surgery that involves the removal of extra fat from particular areas of the body. The procedure is commonly done on the abdomen, buttocks, thighs, neck, arms, and the area below the chin. It helps to reshape these areas and alter the body proportion and contours. Liposuction is not a method for weight loss; however, people opt for this surgery to improve their appearance. In a single session, a maximum of five litres of fat can be removed. Sometimes, liposuction may be performed along with other surgeries such as a breast reduction, tummy tuck surgery, or facelift. You may also require repeated procedures based on how many areas are to be surgically treated.

You may be eligible for the surgery if you:

  • Wish to eliminate excess fat from parts of your body that is not manageable by exercise or diet.
  • Are of optimal weight, but just have a few particular areas with fat pockets.
  • Are healthy enough for the procedure.
  • Have realistic expectations from the surgery with specific goals for body shaping.
  • Have a healthy diet and exercise regimen.

The areas of the body on which liposuction can be done include:

  • Waist and abdomen
  • Thighs
  • Hips
  • Buttocks
  • Upper arms
  • Chin and neck
  • Cheeks
  • Inner knee
  • Back
  • Ankle and calf

Liposuction may not be an ideal procedure if you:

  • Are a regular smoker
  • Are unable to take an anaesthetic injection due to a medical condition
  • Are at a high risk of surgical complications due to your medical history
  • Tend to bleed heavily
  • Your wound healing ability is compromised

Some other considerations before you opt for this surgery include:

  • If you are older, the procedure may not give you the same results as younger people. This is due to reduced skin elasticity with age.
  • Liposuction is not used to treat obesity.
  • This surgery does not fix dimpled (cellulite) or sagging skin.

Before undergoing surgery, inform your surgeon about:

  • Your medical history
  • Any allergies you may have
  • Any medicines you are taking

To prepare for liposuction, your surgeon may ask you to:

  • Get a full medical check-up
  • Undergo an X-ray or electrocardiograph to assess your health
  • Stop taking some medicines such as aspirin and non-steroidal anti-inflammatory drugs that increase the risk of bleeding
  • Discontinue the use of herbal supplements, herbs like ginkgo, garlic, and other natural substances that affect the clotting mechanism of blood
  • Take antibiotics
  • Stop smoking, if you are a smoker
  • Maintain an optimal weight

You will be asked to arrange someone, a friend or relative, who can bring you to the hospital and also take you back home.

You will need to rest for a few days following the surgery. Therefore, your doctor  may suggest you to take an off from work.

You will have to sign a consent form, and the medical team may take some photographs for documentation and to show you the results after surgery.

Before the procedure, anaesthesia will be administered to you. This can be local or general anaesthesia, which numbs a part of the body or makes you fall asleep during the procedure, respectively. The surgeon may choose the type of anaesthesia based on how much volume of fat is to be removed and the type of surgery.

The surgery includes the following steps:

  • The surgeon will make small cuts (incisions) in the area and insert a thin tube called a cannula through the cuts. moving it in and out to loosen the extra fat.
  • Once the fat is loosened, he/she will remove the fat from your body using a syringe or suction device connected to the cannula.
  • The liposuction process can be carried out using various techniques such as:
    • Suction-assisted lipoplasty: In this method, fat is removed with the help of vacuum suction.
    • Mechanical-assisted lipoplasty: Here, the fat is shaved by a motor-driven shaver, and then vacuumed out.
    • Ultrasonic-assisted lipoplasty: It is performed by liquefying fat cells through ultrasonic energy, and then using suction to remove fat.
    • Laser-assisted lipoplasty: Although it is a relatively new technique with research still ongoing, lasers are considered efficient in dissolving fat.
  • Once the fat is removed, the surgeon will cover the incisions with bandages or dressings.

The time required for the surgery depends on the amount of fat removed and the number of areas at which liposuction is performed. After you wake up from the effect of the anaesthesia, you may notice a tube attached to the surgical site temporarily. The tube is used to drain any excess fluid or blood.

You will be discharged on the same day as the procedure. However, some people may require a hospital stay of a few days.

Once you reach home, you will need to take the following care:

  • As a part of your recovery process, you may need to wear bandages or a compression garment around the area of surgery. This helps in compressing the skin to adapt to the new form and reducing the swelling.
  • Your doctor may prescribe some medicines (to be taken orally or to be applied on the skin) that prevent infection and help in healing. You may also be given some medicines to relieve pain.
  • Avoid intense physical activity, lifting heavy objects, swimming, or indulging in strenuous sports during the recovery process.
  • You must protect the surgical site from any excessive force or abrasion during the recovery period.
  • The scars from the surgery may disappear over time.

Once the swelling reduces, you will be able to appreciate the improvement in your body contour. These changes can take up to six months to be noticeable. Although the change in your body form after surgery is mostly permanent, the firmness may reduce with age.

Liposuction helps to remove disproportionate fat deposits, thus improving the overall shape and contour of your body.

When to see the doctor?

Visit or call your doctor right away if you:

  • Experience heavy bleeding from the incision site
  • Develop fever or chills
  • Feel pain, tenderness, or any other issues that worsen with time
  • Notice redness around the surgical site

The potential complications and risks of liposuction include:

  • Hyperpigmentation of the skin near the surgical site
  • Damage to the underlying organs, blood vessels, and nerves
  • Irregular contours
  • Shock, which can be caused by fluid loss in large quantities
  • Impaired wound healing
  • Risks associated with anaesthesia, such as toxicity or fluid collection in lungs
  • Thermal burn from the ultrasound machine (in ultrasound-assisted liposuction)
  • Infection
  • Numbness or feeling an altered sensation on your skin
  • Continuous pain
  • Swelling in the legs
  • Cardiac and lung-related complications
  • Accumulation of fluid in the treated surgical area, causing a cavity
  • Loosening of the skin
  • Need for revised surgery or secondary procedures

You will need a follow-up appointment after the surgery where your surgeon will assess the healing process.

Disclaimer: The above information is provided purely from an educational point of view and is in no way a substitute for medical advice by a qualified doctor.

References

  1. American Society of Plastic Surgeons [Internet]. Illinois. US; Liposuction
  2. Health direct [internet]. Department of Health: Australian government; Liposuction
  3. Chia CT, Neinstein RM, Theodorou SJ. Evidence-based medicine: liposuction. Plast Reconstr Surg. 2017 Jan;139(1):267e–274e. PMID: 28027260.
  4. MedlinePlus Medical Encyclopedia [Internet]. US National Library of Medicine. Bethesda. Maryland. USA; Liposuction
  5. Better health channel. Department of Health and Human Services [internet]. State government of Victoria. Australia; Liposuction
  6. University of Rochester Medical Center [Internet]. University of Rochester. New York. US; Liposuction
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