Liposuction is where we try to reduce the volume of fat. We do this by physically removing the fat cells. So the procedure, which can be either a local anaesthetic or mainly a general anaesthetic, is where we make an incision in the skin, a very small incision, and we insert a cannula, which is a hollow metal tube, which is attached to a suction device. And then by gently moving back and forwards the tube sucks out the fat cells thereby reducing the volume. And then following the surgery, you’re reliant on the skin shrinking down to reshape and recontour the body. Liposuction is to reduce the volume of fat.
There are two kind of main things, one is to remove a specific area of fat, say a lump sticking out, or asymmetry. And the other is a more generalised reduction in the volume. So for a very small area, or a specific area, liposuction does extremely well to even out and to gain symmetry.
We do use it for a general reduction in volume, but our advice as a medic would be to first of all try and use diet and exercise to reduce your weight naturally. But for some people this proves difficult and liposuction can certainly help with that. The people most suited to liposuction tend to be the people who are younger and also people who have specific areas, or contour problems which they are concerned with, or asymmetry.
The younger patients tend to do better because the surgery is not just the surgery, its reliant on the skin shrinking afterwards once the volume of fat has been removed. So people who are younger do better from that point of view. And from a cosmetic point of view, if there’s like a lump you can very easily remove that lump and the results are very good. From generalised removal of fat, the results are very good also, but you can sometimes get some slight contour abnormalities.
Fairly large volumes of body fat can be removed, but with the increase in volume then patients can potentially run into problems or complications. For me, in my practice, I would probably limit it to about three litres of fat because it is a cosmetic procedure and as well as trying to get a good cosmetic result, one of my, my primary concern is not to give a patient a complication or problems afterwards. So I would have a limit on how much I would do it.
The results are immediate but fairly soon, during and after the surgery there is swelling and bruising and the patient will be put into a compression garment straightaway so they will be covered up. But yes the volume of tissue has been removed, but I would say it takes up to six to eight weeks to get the final result and during that time, the patient wears a garment. And the function of the garment is comfort and also to reduce swelling but also to help the skin shrinking back afterwards.
There are scars, so a cannula is actually inside the body sucking the fat out too, making small incisions, we try to place these into skin creases in order to hide them. But they are permanent. But scars in general, may start off a little red and lumpy but over 12 or 18 months in most people, the scars will settle and they will become softer, flatter and paler.
There are reasons not to have liposuction as with any cosmetic procedure. First of all we would take a history from the patient of their medical potential problems, examine the patient. Our priority is safety for patients so we want to make sure that they don’t run into complications. And so if that is the case, we would maybe not recommend surgery. An example would be patients taking blood thinners, so they made bleed afterwards, potentially having a complication. Patients who do well are patients who have good elastic skin so if it is an elderly patient or someone who has lost a lot of weight, their skin tone may not be as good as in younger patients.
They may not get as good as result because their skin can be droopy afterwards and we might recommend excisional surgery for them.