What is liposuction (or liposculpture)?
No matter how much you diet and exercise, fat in certain places sometimes just won’t budge. Liposuction is a surgical procedure for removing pockets of fat in particular areas that are resistant to diet and exercise. Common areas treated by liposuction include the tummy, hips, buttocks, thighs, knees, neck and breasts in males (gynaecomastia).
Liposuction works best for people who are normal or near normal body weight with firm, elastic skin. Whilst age is not a major issue, older patients generally have less skin elasticity. As a result, there is a greater risk that any small dents or wrinkles in the skin would still be there even after the most careful treatment.
The procedure can be performed as a single procedure or in combination with other cosmetic procedures e.g. liposuction may be performed at the same time as a tummy tuck (abdominoplasty) to improve the overall result.
What does the surgery involve?
Suction-assisted liposuction involves the use of a cannula (a thin, hollow tube) to manually loosen and remove fat to create a nicer shape within the body area being treated. The cannula is inserted through tiny incisions in the skin and suction is applied to remove fat from the body.
It takes the surgeon between one to three hours to perform liposuction depending on the size of the treatment area. When the surgeon has finished, the tiny incisions are sewn up and dressings applied.
Liposuction procedures can be carried out under local (you are awake during the procedure) or general anaesthetic (you are fully asleep). The choice depends upon your preference, combined with the size of the areas to be treated and the amount of fat to be removed. If only a small amount of fat is removed, a local anaesthetic may be all that is needed.
The area where the fat is removed is not usually painful. Patients tend to describe it as bruised. You may need to take some simple painkillers for a day or so afterwards for any discomfort.
Often, you only need to be in hospital for a few hours. However, if a large amount of fat is removed (or liposuction is combined with another procedure), an overnight stay maybe necessary.
What are the risks and side effects of surgery?
Having cosmetic surgery can be a very positive experience. Complications are infrequent and usually minor. However, no surgery is without risk and it is important that you are given a clear picture.
There will be some discomfort for a few weeks – the amount depends upon the number of areas treated. All patients get swelling and bruising. Bruising may persist for up to three weeks. Some of the swelling will go down quite quickly but final results take several months to show through.
You may feel numbness for a few weeks to months. This is normal and is a result of disturbing the small nerve fibres below the skin during the procedure.
There is always some scarring where the incisions are made. However, these are usually made in the small skin folds or creases so the scars are extremely discreet.
Irregularities can occur, as remaining fat settles into its final position. Later adjustments are sometimes required.
With all surgery, there is a risk of bleeding, either during the operation or afterwards. However, if this does occur it is unlikely to require any further surgery. There is also a very slight risk of infection - again, this is very uncommon.
There are general risks associated with all operations. Very occasionally a blood clot can form in the leg (deep vein thrombosis or DVT) which would require medical treatment. Part of these clots can also break off and move up to the lungs, causing acute shortness of breath and pain in the chest. This is known as a pulmonary embolus (P.E). Developing a chest infection is uncommon but more likely to happen to people who smoke.
All the risks will be discussed in detail at your consultation. However, if you have further questions or concerns, do not hesitate to discuss these with your surgeon. Decisions about cosmetic surgery should never be rushed.
How do I prepare for surgery?
Following your consultation, if you decide to proceed with surgery, a range of dates will be offered for your operation and you will be asked to choose the one that suits you best. Prior to your admission, you may be invited to attend the hospital for a pre-operative assessment with a nurse. Depending on your age and general health, routine blood tests and a heart tracing (ECG) may be taken. You will be given the opportunity to ask any questions you may have or raise any concerns.
You will be admitted to the hospital on the day of your operation. If you are having a general anaesthetic, you will be asked not to eat anything six hours before surgery. Black tea/coffee or non-fizzy drinks (nothing containing milk) can be taken up to two hours before surgery. Chewing gum should also be avoided six hours before your operation.
It is important to inform your surgeon, anaesthetist and nurse of any medicines (self or GP prescribed) or recreational drugs you take. Medicines containing aspirin should be avoided for two weeks before the operation since they increase the risk of bleeding during surgery. If there are any other medications that may affect surgery then this will be discussed with you at your first appointment.
If you smoke, you should consider giving up six weeks before your operation. The longer you give up beforehand, the better. Smoking reduces the amount of oxygen in the blood. It can increase both the risk of developing a chest infection and healing problems after your operation. If you can’t stop completely, cutting down will help.
Your surgeon may recommend that you wear special compression garments for some time after your operation. These may be provided by the hospital. Otherwise, your surgeon will advise you what to buy and ask you to bring these with you to the hospital.
You will not be able to drive yourself home from hospital and ideally, you should have someone to stay with you for a few days to lend a hand.
What happens after the operation?
At the end of the procedure, tight bandages or a special elastic garment will be applied to the area to help the skin conform to the new shape.
You will be encouraged to get up and move about as soon as the anaesthetic has worn off to minimise the risk of post-operative complications. As long as you are feeling well after the operation, you will be able to go home.
After the operation, you will be advised about how long to wear your elastic garment for. The garment should be removed only for showering or bathing.
Before you leave the hospital, a follow up appointment will be booked at a time convenient for you.
What is the estimated time for recovery, absence from work and return to usual activities?
Recovery times vary from one person to another so the times below are given as a guide only. If you have any concerns during this period, do contact the hospital team for advice.
Removal of large amounts of fat can leave you feeling quite drained for the first few days, so plenty of rest is required. However, it is important to move your legs at least every hour when awake, even if you are resting in bed. This is to reduce the slight chance of developing a blood clot in the leg veins. If the lower part of the body was operated on, walking can be uncomfortable. Nevertheless, it is important to move around on a frequent basis.
Liposuction post surgery timeline
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Days 1 to 3
Apart from bathing, elastic garment to be worn day and night around the operation site (doesn’t apply to the face).
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Day 4 to 7
Walking may be uncomfortable if the operation was on the lower part of the body. Nevertheless, gradually increase your activities.
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Day 7 to 10
Any stitches are removed.
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At 2 weeks
Should be fine to go back to work.
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3 weeks after
Getting closer to your normal activities.
Support garments may be continued.
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2 months after
Should be back to full activities.
May be able to remove your elastic garment.
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6 months after
Takes a good six months for all the swelling to completely go down.
May still feel that some areas are numb.
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12 months after
Final result can be seen as long as your weight has remained stable.