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Liposuction

This is one of the most requested and popular plastic surgery procedures in the world. Liposuction is a minimally invasive surgical procedure that disperses and suctions excess fat and re-contours the body through multiple small incisions

Liposuction can only be used to spot-remove excess, irregular or unwanted fat from the abdomen, flanks, hips, thighs, backfat and other areas; it is not a global fat removal procedure or a weight reduction substitute.

Liposuction is performed by inserting a long, thin, blunt tube known as a cannula through small 3-5mm incisions near the site of excess fat. The fat is prepared by infiltrating excess fluid that includes some local anaesthetic and pain relief. This is what is commonly referred to as wet or tumescent techniques. The cannula and various energies generated by the suction kit (Vaser, vibrational, microaire, ultra-sound) act to disrupt and destroy the fat. The fat is then suctioned out of the area along with the previously infiltrated fluid. The liposuction aspirate therefore includes fluid, fat, disrupted broken fat and oil, and only minimal blood.

The procedure takes one to four hours depending on the number of areas to be aspirated and most patients see significant results after the first session. No excess skin is removed therefore it is very important to wear compression garments over the areas treated by liposuction to help the skin reattach to underlying tissues. Skin that doesn’t have good elasticity can sag after the underlying fat is removed and may require further procedures to remove or tighten excess skin.

Liposuction therefore works well combined with other cosmetic procedures that deal with excess skin such as a tummy tuck or breast lift.

Liposuction is a helpful adjuvant to gym bunnies/weight trainers wo are unable to shift stubborn fat in areas that are not amenable to exercise and to new mums with massive hormonal shifts as part of a “mommy make-over”

Liposuction techniques, equipment and outcomes have improved considerably in recent times. The American Society for Aesthetic Plastic Surgery reports liposuction procedures in the U.S.A rising 32% between 2014 and 2018.

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At a glance

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Frequently asked questions

Healthy nonsmokers with a BMI (body mass index) of 30 or below are good candidates for liposuction. Good skin tone and elasticity are essential to a good outcome, since the skin needs to snap back into the body’s new contours once the fat is removed. 

If you’re seeking  weight-loss solution or cellulite treatment, liposuction is not suitable.

Liposuction is an inpatient daycase or overnight procedure procedure that’s usually performed under general anesthesia.

For tumescent liposuction, the most traditional liposuction technique, a mixture of saline (salt water), lidocaine (local anaesthetic), adrenaline to constrict blood vessels and Hyalase to help the fluid move through tissue layers is injected into the fat to be treated. The fluid mix treats the fat so that it becomes swollen, firm, and easier to remove. It also constricts your blood vessels, which reduces bruising, blood loss, and recovery time.

The blunt cannula, woth various perforations or holes through which to suction fat is then passed through small incisions and passed back and forth under the skin in multiple planes, from multiple directions to break up the fat before suctioning it out. 

For a small area, the preparation and procedure may take as little as 30 minutes but stil requires an equipped theatre facility. A 360 liposuction—which includes the abdomen, flanks (love handles) back fat, and all around the torso—involves re-positioning an anaesthetised patient can take 4+ hours. Large volume liposuction can lead to a significant shift of fluid from cells to the vascular space and requires awareness and close monitoring for the first 24 hours.

Variations on traditional liposuction are all aimed at reducing tissue damage and shortening recovery time. Most also claim to contribute to a skin tightening effect.

Power-assisted liposuction (PAL) incorporates a vibrating cannula to break down fat cells eg MicroAire liposuction.

Vibration-assisted liposuction (VAL), uses vibration to break up the fat cells, and also shelp even out the remaining fat and smooth lumps.

Laser-assisted liposuction (LAL), including SmartLipo, uses low-energy waves to liquefy fat, and is commonly referred to as “laser lipo.” Be advised, that liquified fat can’t be used for fat transfer (liposculpting) 

Ultrasound-assisted liposuction (UAL) uses ultrasound waves to rupture cell walls and liquefy the fat. It can cause significant heating of the tissues surrounding the insertion site.

VASER liposuction, an advancement or  variation of UAL, more evenly disperses the ultrasonic energy with a grooved cannula and probe. 

What is the post-op recovery like?

The procedure itself should not hurt, since you’ll either be fully asleep (with general anesthesia) or very relaxed and sleepy (with local plus sedation). 

Recovery can be painful. You’ll feel very sore, especially during the first few days after liposuction. You’ll be swollen and bruised, and you’ll need at least a week to rest before you head back to work.

Generally it’s not too uncomfortable and over-the-counter pain reliever is sufficient, however, you will also receive prescribed pain medication.

You’ll have swelling, bruising, and inflammation as well as some numbness and nerve pain. The treated area might also feel firm from the infiltration of fluids and subsequent swelling. All of this should resolve within 6-12 weeks. 

Some people see lumpy areas after the swelling goes down. This should improve after a few weeks, but wearing a compression garment as you recover can help prevent lumps. 

Rozina is convinced a good compression garment is essential to the post-op recovery and a good outcome . They are graduated compressive dressings designed  to minimize swelling and bruising, help the skin smoothly adhere to the underlying tissue, and speed up healing as well as ease discomfort.

Rozina recommends wearing the compression garment 24/7 (remove to shower, but not to sleep) for the first 3 weeks then continue to wear or downgrade to something less compressive for the next 3-6 months or as long as you can tolerate. Rozina is also a keen proponent of manual lymphatic massage (MLD) that can  gently encourage lymphatic drainage to help drain fluid and bring down swelling. 

Most people can return to their regular activities in three to four weeks whils still wearing the compression support.

You will probably notice an improved body contour immediately eg inner thighs or saddlebags treated, , but your results will be obscured by swelling in the initial period. The swelling should be dramatically reduced within six weeks and continue to go down over the next six months. 

You will continue healing and seeing better results for up to a year. these include decreased swelling, smoothing of any lumps and greater skin tightening

The fat that is removed is permanently discarded and those fat cells are gone.

Your  remaining fat cells however can expand or new ones can form if you gain weight. So the results of liposuction depend on you maintaining your post-lipo weight.

Significant weight-gain  will increase the size of the remaining fat cells, new fat cells can develop, though the area will still look better than if you never had liposuction.

2011 study in the journal Obesity found that without lifestyle changes, fat reaccumulated in other areas of the body one year after liposuction. Despite fat returning, the cosmetic shape benefit was retained and most people remain very happy with their surgery results.”

Many use liposuction as a kick start to a healthier, more active life and are ultimately very happy with their self-image and their surgical choice.

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