Liposuction

Liposuction

Liposuction

Price from 1273 GBP

Liposuction is a procedure involving the removal of excess fat from under the skin from given regions of the body.

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Liposuction

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During liposuction, fat is removed from places where it exists in excessive amounts, which allows the modelling of the body through removing fatty tissue from under the skin. It is usually performed on the hips, thighs and stomach area.

Liposuction

Characteristics of the liposuction procedure

The first liposuction procedure was reported by a French doctor, Dujarrier, in 1920 and was performed with the use of a curette for scraping the lining of the uterus and ended badly due to damage to the femoral artery. In the 1970s, Yves-Gerard Illouz performed this procedure with the use of a blunt tube and vacuum. He published an account of his achievements in 1982. In 1987 before removing fatty tissue, Klein injected it with physiological saline, adrenaline, lidocaine and sodium bicarbonate. In the nineties, liposuction became a safe and popular procedure. In 2006 liposuction was the most commonly performed procedure in plastic surgery according to the American Society for Aesthetic Plastic Surgery.

Liposuction - benefits

  • Shapes the body
  • Limits, in the place of its performance, the circumference of the body
  • Reduces the amount of fat around the stomach
  • Corrects unevenness of skin caused by accumulated fat (to a limited extent).

Liposuction–indications for treatment

The best candidates for liposuction are patients with the right weight or who are moderately overweight with fatty tissue accumulated in some places. It is possible to achieve the most spectacular results with such patients. It is common opinion that liposuction should not be used as a method of weight reduction . However, for many people liposuction is a very good motivation for losing weight before the procedure and staying in shape afterwards.

In women, liposuction is usually performed around the hips, buttocks and thighs. It is caused by the fact that women’s body shape is usually gynoid (pear shape) with fatty tissue accumulated around the above-mentioned areas.

In men, liposuction is most often performed around the stomach. This is caused by an android body type with fatty tissue accumulated around the stomach.
This procedure is also performed in many other places, for example: to slim down the waistline, slim down the inside part of the knee, reduce fat around the arms, neck/chin (to reduce the so- called double chin). Liposuction is also used to reduce the size of breasts in men (gynecomastia).

One should remember that liposuction does not replace healthy eating and regular physical activity. Moreover, healthy eating habits and physical activity are necessary for maintaining the right body shape.

Most researchers agree that liposuction does not improve physical fitness and stamina, does not reduce the risk of heart and cardiovascular disease connected with obesity and does not lower sugar and cholesterol levels in the blood.

Contraindications for the treatment

Liposuction does not improve health and does not save lives, so it should not be performed for just any means. If a patient has many other diseases and is not particularly fit, the risk of the operation is too high.

Liposuction should not be performed on patients with herpes or a respiratory tract infection, or shortly afterwards.

Liposuction should not be performed on patients who are aiming to lose weight.

It should also not be performed in the case of a local bacterial or fungal infection.

Patients with chronic diseases which increase the risk of the treatment may be disqualified or consulted by a specialist of a given branch of medicine.

Caution should be exercised in the case of patients with scars in the area where the liposuction is to be performed.

In patients with hernias, correction of the hernia should be performed before the liposuction due to the risk of damage to the contents of the hernia sack.

Liposuction should not replace plastic surgery of a given area. In some cases, plastic surgery of the abdomen or arms provides better results than liposuction, however, both techniques can be combined.

Liposuction– before the procedure

Before the procedure, a patient should be consulted by the doctor performing the procedure. It is recommended to be prepared for such a consultation through, for example, writing down:

  • other conditions – current or past
  • past operations
  • cosmetic and aesthetic medical procedures performed in the given area of the body
  • list of medicines taken (including OTCs), as well as the dose taken, for example: Piramil 2.5 mg 1-0-1 (one tablet in the morning and in the evening). Packaging of medicines may also be taken to the consultation.

During the consultation, the patient is examined and approved for the procedure. A plan and the scope of liposuction is presented to the patient. If necessary, additional tests or consultations will be recommended. This is a very good time for asking questions and raising any doubts.

Consultation with the doctor performing the procedure should take place a few days or a few weeks before the procedure. It is good if there is some time before the consultation and the procedure, as the patient has time to think things over, talk to family or friends.

Body weight before liposuction should be stable. The patient should not be, or have recently been, on a diet to lose weight.

Smoking should be stopped or limited.

On reporting for the procedure:

  • patient should provide results for tests recommended during the consultation. In some clinics, tests are performed before the procedure; however, these extend the time before being admitted to the clinic and the procedure.
  • A patient should not eat 6 or more hours before the surgery. Usually a light meal may be eaten before leaving the house. This refers in particular to general anesthetic.
  • Medicines taken regularly should be taken in the morning (unless recommended otherwise by the doctor during the consultation).
  • The area which is to be subjected to liposuction should be free of any cosmetics or they should be removed after reporting to the clinic.
  • Two weeks before the surgery, sunbathing and using sunbeds should be avoided.
  • It is recommended to remove hair in the given area (however it is not recommended to use a razor as it may damage the epidermis, so it is better to use cream for hair removal, classic depilation should be performed well in advance so as to avoid irritation).

Upon arrival at the clinic, it is recommended to:

  • take a shower,
  • remove jewelry,
  • use the toilet before the procedure.

On the date of arrival at the clinic for the procedure, another consultation with a doctor takes place. During this consultation the patient is examined and the procedure is discussed in detail. The areas where the liposuction will be performed are marked with a pen on the patient’s body. The patient should tell the doctor which areas they want modelled the most. Documentation in the form of pictures will be made. This is a very good time for asking questions. During this consultation the patient should sign their consent to the liposuction.

Type of anaesthetic

After arriving at the clinic for liposuction of stomach areas, apart from a consultation with the plastic surgeon, a consultation with an anesthetist (a physician trained in anesthesia) should take place. During this consultation the patient will be examined. The anesthesia and time afterwards will be discussed. This is a very good time for asking questions related to the anesthetic. The patient should sign their consent to being anesthetized. If the procedure is performed under local anesthetic, a consultation with an anesthetist might not be necessary.

The procedure may be performed under general anesthetic with tracheal intubation, perineural anesthesia (spinal anesthesia – an injection to the spine), analgosedation combined with local anesthetic, or under local anesthetic only. The type of anesthetic depends mostly on the scope of the procedure and experience of the clinic staff. The most common type of anesthetics are general anesthetic and perineural anesthesia.

Under general anesthetic with tracheal intubation, the patient will sleep during the procedure and will not be aware of what is happening around them. A pipe will be inserted through the mouth into the trachea (intubation), through which air will be provided (a mixture of breathing gas and anesthetic gases)). The tube will be connected to a machine (respirator) which will provide the appropriate amount of gases for breathing. During general anesthetic, the patient is under the care of an anesthetists and an anesthetic nurse.

The procedure performed under perineural anesthesia – an injection to the spine - means that before the operation, the anesthetist will ask the patient to sit on the operating table with their head bent to the front, or lie down with their knees bent towards their chest. A needle with a drug will be inserted into the spine. This kind of anesthetic covers body parts below the belly button, however, it is also possible for this anesthetic to cover the upper abdomen. During the procedure the patient is conscious, breathes on his/her own and remembers the procedure (it is possible to ask the anesthetist for additional medication which will allow the patient to sleep and not remember the course of the procedure).

Liposuction of the abdomen performed under analgosedation with local anesthetic: for this kind of anesthetic, a patient does not need to be intubated and is able to breathe on their own. Usually, the patient feels sleepy, is confused and usually does not remember the course of the procedure. During the procedure, the fatty tissue is injected with liquid which helps the removal of fat and reduces bleeding. Local anesthetic may be added to this liquid.

How is the procedure performed?

After the anesthetizing of the patient (in the form of general anesthetic, perineural anesthesia or analgosedation) by the anesthetist, the skin of the patient is disinfected. A surgeon cleans the skin with an anesthetic swab in the area where the procedure will be performed (operating field). This procedure is usually performed three times. Following that, sterile surgical drapes are placed around the operating field.

The surgeon makes small incisions in the skin (about 4-5 mm). These incisions are placed on the edges of the area which will be subjected to liposuction. The location of incisions may very among clinics; however, they should definitely be in less visible places, but with good access to the fatty tissue subjected to liposuction. There are 2-3 incisions made for one area. Scars after the incisions are not usually visible.

Following that, a probe is inserted to inject the fatty tissue. A probe is a thin metal pipe (2-3 cm in diameter) approximately 20 cm in length. On the sides of the probe there are openings through which liquid is injected into the fatty tissue.

The composition of the liquid varies among clinics but usually contains 0.9% physiological saline and adrenaline. It may also contain substances such as lignocaine and sodium bicarbonate. The amount of liquid given is 0.5-3 ml per 1 ml of fatty tissue aspirated depending on the technique used. The purpose of using physiological saline is to irrigate the fatty tissue, which helps its further aspiration. The purpose of using adrenaline is to shrink blood vessels, which reduces bleeding. Lignocaine is supposed to limit pain after the operation. Lignocaine works for 1-4 hours, so if the procedure is performed under a general anesthetic or spinal anesthesia it is not needed as the anesthetic will be enough.

After injecting the fatty tissue, it is necessary to wait a couple of minutes for the adrenaline to start working. During this time, another area may be injected.

Following that, the surgeon will insert the probe through incisions in the skin. The surgeon will then move the probe vigorously backward and forward to get to every place in the area marked. The purpose of this is to fragment the fatty tissue, which will help to aspirate it later. The probe is connected to a suction pump, which creates a vacuum through a rubber pipe. The vacuum allows the fatty tissue to be sucked out.

There are many types of probes for liposuction, which results in there being many types of liposuction. It is difficult to say which one is best, but it is important that a surgeon has experience with using a certain type of probe.

Suction assisted liposuction (SAL) – the probe itself does not create energy and the fatty tissue is broken down with the surgeon’s movements.

Power assisted liposuction (PAL) – the probe moves slightly within a few millimeters’ range. The movements may be circular, sideways, or backward and forward. They help to break down fatty tissue.

Laser Assisted Liposuction (LAL) – The energy of the laser helps to break down fatty tissue.

Ultrasonic Assisted Liposuction (UAL) – The energy from ultrasonic waves helps to break down fatty tissue.

There are many other techniques of liposuction, however, other liposuction techniques are less common. The choice of technique should depend on the experience of the surgeon.
Liposuction is performed as long as is necessary to reduce the thickness and tension of tissue in a given area. The amount of fat sucked out should be symmetrical in certain body areas (e.g. on both hips). If before the procedure, the patient’s body was asymmetrical (that is, there was more fatty tissue on one side than on the other), it should be taken into account during the liposuction and more should be sucked out from a given side.

Different clinics deal differently with the incisions after liposuction. They may be stitched up with a thin thread or secured with a special plaster (Steri-Strip). They may also be left for 24 hours and dressed afterwards with a small dressing.

Once the procedure is finished, the patient is dressed in a compression garment. This is similar to cycling leggings. It covers the area from the thighs to the abdomen and lower part of back and it has straps to go over the shoulders. The compression garment reduces the risk of bleeding and deep-vein thrombosis, it smoothens unevenness and models the body. If the procedure was performed around the arms or chin, an elastic bandage may be applied.

The procedure takes from one to a few hours.

Once the procedure is finished, the patient is moved to a recovery room (especially if the procedure was performed under general anesthetic).

Course and duration of recovery

Straight after liposuction (in a recovery room) the patient is supervised and given pain medication. Postoperative supervision may vary in different clinics; it is more scrupulous though after a general anesthetic than after spinal anesthesia or analgosedation. Typical treatment in the recovery room is described below.

Vital signs are usually displayed on a cardiac monitor. There are electrodes places on the chest so heart rhythm may be displayed on the monitor. A cuff on the arm fills up with air regularly to measure blood pressure. A pulse oximeter placed on a finger measures oxygen saturation in the blood. The patient is given a remote control with which they can call staff. There is a nurse present in the recovery room.

The patient stays in the recovery room from a few, up to several, hours.

If the scope of the procedure was not big, the patient may be discharged on the same day.

Usually, on the following day in the morning the patient is moved to another (normal) room where he or she stays till being discharged. On the first day a patient may move freely around the clinic and have light meals. The patient is given pain medication and dressings will be changed. A patient may see himself or herself in the mirror. The body is swollen and small bruises or hemorrhages may be visible. These bruises and small hemorrhages are normal, though.

If liposuction was performed in many areas of the body, the patient will stay in the clinic for 1-2 days. The dose of painkillers will be also decreased gradually. The patient will be able to move more and more. Dressings will be changed on a daily basis. Maximum swelling occurs on the 3rd-5th day after the procedure.

On discharge, the patient will be given recommendations, instructions as to further proceedings and dates for check-ups.

In the second week after the procedure, bruises will disappear.

Swelling will disappear around the 4-6th week after the procedure.

Liposuction– results

The results of liposuction are not visible straight away. The first results may be seen after 3-4 weeks and they constitute around 25 % of the final result. After 6-7 weeks around 50% of the final effect will be visible. 95% of the final result will be visible after 3 months and the final result after 6 months.

The results of liposuction are shaping, slimming and reduction of circumference of a given body part.

To achieve desirable effects, it is recommended to have a healthy lifestyle and stabilize body weight.

Recommendations after treatment

Recommendations given by surgeons vary and depend on the scope of the procedure, course of the procedure, situation after treatment and the surgeon’s experience. Recommendations should be followed and should not be modified without consulting the clinic.

Example recommendations:

  • a compression garment should be worn 24h for 3-4 weeks after the procedure
  • the compression garment may be taken off for a quick shower
  • after a shower, the skin should be treated with cream or body balm
  • the compression garment should be washed regularly, which is why it is good to have two sets of them
  • after 3-4 weeks, the compression garment should be worn 12 hours a day (for example, at night)
  • painkillers may be necessary for a few days after the procedure
  • stitches should be removed in 7 days after the treatment at a checkup
  • lymphatic massages should be performed by a recommended physiotherapist every day, or every second day, for 2-4 weeks (they reduce swelling and help shape the body).
  • work may be taken up after a few days. Non-vigorous physical activity is recommended.
  • sports may be taken up after 4-6 weeks
  • sunbeds and saunas should be avoided for 6 weeks
  • if in doubt, contact the clinic.

Liposuction– how long do the effects last?

The result of liposuction are permanent if a patient maintains a healthy lifestyle (correct diet and physical activity) and the results last a lifetime. In the case of an increase in body weight, more liposuction procedures may be necessary.

In places subjected to liposuction, an invisible subcutaneous bruise forms. Some fat cells are also removed so in the case of a significant increase in body weight, fatty tissue may accumulate first in places which were not subjected to liposuction.

How to avoid complications?

It is not possible to avoid all complications (in all cases). However, it is important that in the case of complications, a patient is taken particular care of by the doctor.
From the patient’s perspective, to avoid complications one should follow the following rules:

  • Tell the doctor everything about one’s health before the operation.
  • Follow the recommendations after the procedure.
  • Stop smoking.
  • Go to check-ups as scheduled.
  • Maintain a stable body weight.
  • Exercise regularly.
  • Do not use liposuction instead of weight loss.
  • Do not have liposuction instead of plastic surgery in a given area
  • Do not modify the recommendations without consulting the clinic.

Liposuction– possible complications

Complications are possible in the case of every surgery. They are not common and it is worth asking your doctor which complications are more, and which are less, likely in your case.
Potential complications connected with the surgery are fat embolism, hemorrhages, hematomas, infections of the area subjected to the procedure, delayed wound healing, heavy scarring, keloids, local skin necrosis, skin discoloration, unevenness of the area subjected to liposuction, sagging skin and the necessity of performing another liposuction.

Noticeably, it is not possible to foresee and list all possible complications.

Liposuction– recommended additional treatment

Liposuction and plastic surgery in a given area are often recommended. This refers in particular to gynecomastia of glandular or fatty tissue, or abdominoplasty.
Lymphatic massages are recommended after liposuction.

Author: Norbert Czapla, Doctor of Medicine

Literature:

  • Aesthetic Plastic Surgery; 2009; Sherrell J. Aston, Douglas S. Steinbrech, Jennifer L. Walden
  • Essentials of Plastic Surgery, 2014, Jeffrey E. Janis,
  • http://pl.wikipedia.org/wiki/Liposukcja

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Price list of the treatment

We encourage you to familiarize yourself with the prices of the procedure Liposuction in the city chosen by you. The price depends on the scope, method of the procedure, type of anesthesia as well as the location and reputation of the clinic.

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