Liposuction/Liposculpture/Fat injection (Coleman)

LIPOSUCTION is a surgical procedure used to remove or reduce localised fatty deposits that will not respond to diet or exercise. Contrary to popular belief, liposuction is not a treatment for obesity, a method for losing weight or an alternative to a healthy lifestyle.

Liposuction is one of the most successful plastic surgery procedures, as the incisions are tiny and inconspicuous, the recovery is relatively quick, the complication rate low and the results mostly predictable and satisfactory. Liposuction is the same as liposculpture and is also know as suction-assisted lipectomy. It is performed largely under general anaesthetic, although sedation and local anaesthesia may be used for smaller areas.

Who is suitable for liposuction?

Liposuction is best suited to healthy individuals who are around their ideal weight for height, and who have good-quality, elastic skin. Although liposuction can tighten skin to a degree, it will not correct gross skin excesses. As a result, young patients tend to do better than older patients. Patients with more skin than fat excess usually require an excisional procedure (dermolipectomy), such as a thigh lift or tummy tuck to remove the excess skin.

In women, the most common areas treated with liposuction include the thighs, hips, buttocks and tummy, with the ‘saddlebag area’, ‘love handles’ and tummy all responding particularly well. Other areas that can be treated include the knees, calves, ankles, breasts, arms and neck. Liposuction may also be used at the same time as breast reduction surgery, or to reduce a fatty neck at the time of facial rejuvenation. Although the inner thighs do not respond as well to liposuction, some improvement can still be achieved here.

In men, the most common areas to betreated with liposuction are the chest, tummy, ‘love handles’ and neck.

No specific diet or exercise programme is required prior to surgery, although the closer you are to your ideal weight, the more satisfactory the outcome is likely to be.

What to expect at the initial consultation

At a first consultation, I will ask you to tell me in your own words what it is you wish to change about your appearance. It is important to be honest and forthright as surgery is always tailored to your specific needs and expectations. Do bear in mind, however, that it is not possible to achieve unrealistic expectations.

In addition, I will take a full medical history, including details of any previous surgery – cosmetic or non-cosmetic – previous hospitalisation, chronic medical problems, medication and allergies, whether you smoke or not, the reasons for wanting the procedure and your goals and aspirations.

The examination will concentrate on the areas you are concerned about, but also assess your general fitness and suitability for surgery. Routine photographs will be taken.

Following the assessment, I will discuss all the available options and formulate an operative plan, including what type of surgery and anaesthesia will be used, the venue for surgery and costs. Any risks and possible complications will also be discussed.

It is important that you are clear about what your surgery will entail. Well-informed patients cope better with surgery and you have the right to ask any question you want and to expect your surgeon to answer with honesty and without jargon. Consent for surgery will also be taken.

Where does the treatment take place?

  • Parkside Hospital, Wimbledon, SW19
  • St Anthony’s Hospital, Cheam, Surrey
  • The New Victoria Hospital, Kingston, Surrey

A consultant anaesthetist will meet you prior to surgery. Liposuction usually takes one to two hours to perform and, depending on your time of admission, you may require an overnight stay in hospital.

What can go wrong?

If performed by a fully qualified and accredited plastic surgeon in a proper operating theatre under sterile conditions on a relatively fit and healthy patient, liposuction is a safe procedure. In general, complications are rare. Liposuction is one of the safest procedures performed on a daily basis by plastic surgeons. However, as with any surgical procedure, there are certain risks and complications, and these will be explained to you at your consultation. Possible risks include:

  • Bleeding and haematoma
  • Infection
  • Wound healing problems
  • Poor sensation of the overlying skin
  • Poor scars, including hypertrophic and keloid scars
  • Asymmetry and irregularities
  • Fat necrosis (benign fat lumps)

How long does it take to recover?

You should be almost pain-free immediately after the operation, but you will be given painkillers to control any pain over the next few days if required.

You should drink plenty of fluids and pass lots of urine for the first 24-48 hours following surgery and, although you should rest, you should try to stay mobile – sit in a chair or walk around a little. This not only helps to mobilise fluid and reduce pain in the areas treated, it prevents the possible development of blood clots in the legs.

A pressure garment is applied at the end of the operation. It is advisable to wear the pressure garments continuously for 3-6 weeks, then just in the daytime for a further 3 weeks, to help you conform to your new shape and keep swelling and bruising to a minimum. Taking Arnica – starting on day two after surgery – will also help to reduce bruising and swelling.

Do not expect to look or feel good immediately after surgery. Because of the fluid injected and fluid retention, you will actually be heavier following liposuction. The areas treated will be swollen and sore – as if you have worked out too hard at the gym. It is not unusual to feel depressed in the days or weeks following surgery. Try to keep in mind that this is normal and will subside as you begin to look and feel better.

The tiny wounds take about 5-7 days to heal and will gradually fade over the following year. The stitches will generally dissolve in a week. Bruising develops quickly from day two or three following surgery, but is usually mostly gone 10-14 days after your operation, although some degree can persist for up to three weeks after surgery.

Swelling follows a similar but slower course and can persist for a few months. Remember that healing is a gradual process, which varies from individual to individual.

Depending on the degree of liposuction you have and the job you do, you should be able to return to work after one week.  People do respond differently, though, and some patients take longer than this, even up to two weeks. Plan to keep things quiet during this time.

Stretching and bending exercises can be started at the end of the first week following surgery, but more strenuous activity should be avoided for up to four weeks after surgery. Again, people are different and when you resume activity will depend on the extent of your procedure and how you feel.

How satisfied can you expect to be with the procedure?

Liposuction is a highly effective technique for giving you a new body contour with very little scarring. The fat that has been removed from your body at the time of surgery is permanently removed. If you maintain a healthy lifestyle following surgery and your weight remains constant, your shape should stay the same, the bulges should not reappear and you should be satisfied with the procedure.

Most patients are satisfied with the results of their liposuction – they feel more at ease with their bodies and more comfortable in a wider variety of clothes. As long as your expectations are realistic, you should be happy with your new shape.

I will discuss the exact nature of your treatment, including procedure details, recovery times and any possible side effects at a consultation. This will reflect your exact circumstances and needs. The information included here is provided for general guidance only.

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