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FAQ – Liposuction

Who is Liposuction suitable for?

Liposuction is not a procedure suitable for losing weight the ‘quick and easy way’ – there’s no such thing. Instead liposuction is a highly effective method of removing stubborn pockets of fat that cannot be toned up via exercise and a healthy diet. Liposuction will change and improve shape, not weight .

Liposuction permanently removes the areas of fat, giving a balanced more in proportion body shape. Liposuction is not designed to help you lose weight and it does not get rid of cellulite.

Liposuction is most suitable for women and men who are of relatively normal weight, but have isolated pockets of fat that cause certain areas of their body to appear out of proportion.

While Liposuctioncould be preformed at almost any age, it will give the best results if the skin still has enough elasticity to achieve a smooth contour following fat removal. When skin is not elastic, as in some older patients, it may not re-drape well and a skin tightening procedure may be necessary.

Areas where the Liposuction is preformed :

  • Abdomen
  • Hips
  • Outer thighs (saddlebags)
  • Flanks (love handles)
  • Back
  • Inner thighs
  • Inner knees
  • Upper arms
  • Submental (chin),(gullet)
  • Gynecomastia (male breast tissue)

What should I know about liposuction?

Liposuction, also known as lipoplasty or liposculpture suction lipectomy ( suction-assisted fat removal) or simply lipo is a cosmetic surgery operation that removes fat from many different sites on the body. Areas affected can range from the abdomen ,thighs,buttocksto the neck, backs of the arms and elsewhere.

We understand that this is an important decision in your life so, before you decide to go ahead with liposuction fat removal, we will offer you a thorough one-to-one medical consultation with a surgeon who specialises in fat removal procedures.

During your consultation, you will be asked about the results you would like to achieve from Liposuction. This will help your surgeon to understand your expectations and determine whether they can realistically be achieved.

Due to individual physical factors, not everyone will achieve the same results. Your surgeon will take into consideration your unique characteristics in determining the most effective treatment. Following an assessment of the elasticity of your skin, he will be able to estimate the amount of fat to be removed for the best results.

It is important that your decision to have a liopscution surgery procedure is considered carefully. There are many points that should be considered before deciding to have any type of cosmetic treatment or surgery.

There are also some possible risks, as with all surgical operations, which your cosmetic surgeon will talk through and explain to you at your consultation, answering any questions you may have. This is your opportunity to discuss your intended surgery in order that the cosmetic surgeon can ascertain your expectations as to what can realistically be achieved.

Several factors limit the amount of fat that can be safely removed in one session. Ultimately,the surgeon and the patient make the decision. There are negative aspects to removing too much fat. Unusual “lumpiness” and/or “dents” in the skin can be seen in those patients “over-suctioned”. The more fat removed, the higher the surgical risk.

The liposuction procedure may be performed under general, regional, or local anesthesia. The safety of the technique relates not only to the amount of tissue removed, but to the choice of anesthetic and the patient’s overall health. It is ideal for the patient to be as fit as possible before the procedure and not to have smoked for several months.

Removal of very large volumes of fat is a complex and potentially life-threatening procedure. Most often, liposuction is performed on the abdomen and thighs in women, and the abdomen and flanks in men. According to the The British Association of Plastic, Reconstructive and Aesthetic Surgeons (BAPRAS) and to The American Society for Aesthetic Plastic Surgery, liposuction was the most common plastic surgery procedure performed in the last five years.

Areas where the Liposuction is preformed :

  • Abdomen
  • Hips
  • Outer thighs (saddlebags)
  • Flanks (love handles)
  • Back
  • Inner thighs
  • Inner knees
  • Upper arms
  • Submental (chin),(gullet)
  • Gynecomastia (male breast tissue)

The surgical option, from late 19th century

The surgical technique to remove fat has been performed for many years – the most common example being the tummy tuck – and t works in a very simple way.

You cut the skin, remove the fat and then re-drape the skin.

There are some advantages: you can remove a lot of fat, it is good for the surgeon because they can see what they are doing and you can achieve skin tightening at the same time by removing any loose skin.

The downsides though often outweiign the advantages: it is performed under genera anaesthetic, entails a lengthy period of downtime and you are left with a very obvious scar.

Traditional liposuction, early 1980s

Relatively modern techniques for body contouring and removal of fat were first performed by aFrench surgeon, Charles Dujarier. A 1926 case that resulted in gangrenein the leg of a French model in a procedure performed by Dr. Dujarier set back interest in body contouring for decades to follow.

Traditional liposuction was introduced in the early 1980s and became the standard technique for the next twenty years,

It works by making a small incision in the skin and sucking out the fat with the liposuction device, but the problem lies in the fact that we have two different types of fat: deep, loose fat and superficial fat.

Liposuction tackles the deep fat but cant remove the superficial fat because it is very vascular, If you attempt to remove it with liposuction you risk too much bleeding and damage to the skin.

It was obvious; we needed to find a solution to the superficial fat.

Other alternatives, the 1990s

All research at the time was dedicated to finding ways to tackle the superficial fat. The first approach was applying heat to the surface of the skin in an attempt to emulsify the superficial fat underneath – not through an incision – and lots of different forms of energy were experimented with, including laser, radiofrequency and ultrasound.

These techniques were often combined with traditional liposuction. but they didn’t have the desired result because the more energy you apply through the dermis, the more you risk damaging or burning the skin before you even have an impact on the fat underneath.

Smartlipo 2000

Finally, we had a breakthrough; Smartlipo works by making a tiny incision, under local anaesthetic, and then emulsifying the fat by rupturing the membrane of the fat cell using the light, not the heat, of the laser. The contents of the fat cell leak out and the cell itself no longer has a function so is removed by the body.
The first machine had six watt energy and was fantastic in small areas such as under the chin, and for small amounts of tummy or thigh fat but I had many patients wanting much larger areas dealt with. The machine wasn’t producing the results wanted and the length of the procedures meant discomfort for the patients.

Smartlipo MPX, 2008

The company was introducing more and more powerful machines which were producing better results and more comfortable patient experiences, then their sister company in the US, Cynosure, developed Smartlipo MPX.

MPX stands for multiple lasers and the machine employs two lasers. One targets fat membrane and the other targets blood vessels.

The current Smartlipo MPX is also so much more powerful than the original machine from six watts to 46 watts and. that increase in power means you go through tissue easier and tackle larger areas in less time, It also means increased skin tightening which is crucial when you’re tackling larger areas of fat.

Other alternatives:

Bodytite. Introduced into the UK last year, this uses radiofrequency and, at 75 watts, is very powerful. It is suitable for large areas but doesn’t produce the same skin tightening as MPX, nor does it have the flexibility when dealing with rounded areas such as the inner thigh. It doesn’t have the same range of safety features as MPX, which is invaluable even for an experienced surgeon.

Vaser. Reliant on ultrasound, this is good for small areas but doesn’t give the skin. tightening of Smartlipo. It works by vibrating the fat cells and damaging them but it can also damage the tissue around it causing pain and bruising. It can also cause irregularities. It has its place but has pros and cons as all systems do.

Other lasers. Targeting the fat cells not the membrane, they can produce unwanted dead tissue under the skin.

Procedure steps of Liposuction

There are different methods of Liposuctions, though the procedure overall is commonly referred to as liposuction. Liposuction surgery actually refers to a procedure using a small tube inserted into the affected area whereby the fat is broken up and then sucked out.

Liposculpture refers to a technique that uses a syringe to remove fat. The incision required is smaller, and is therefore less invasive.

In all liposuction methods, there are certain things that should be done when having the procedure:

  • The patient and the surgeon will discuss which area(s) will be treated and what outcome to expected
  • Written consent is given on the day of surgery from the patient
  • The patient is prescribed an antibiotic.
  • The areas to be treated are marked and photos are taken.
  • A sterilizing solution such as Betadine, is applied to the areas
  • The procedure is performed under Local anesthetic, IV or light general anaesthetic.
  • Small Incisions are made.
  • All vital signs including blood pressure, heart rate, and blood oxygen level are monitored throughout.
  • If the procedure is performed under local anaesthetic the patient may feel a scraping or rasping sensation from the cannula movement.
  • The procedure is a day case, the patient would need an escort home.

Liposuction is usually performed using a general anaesthetic. You may be treated as a day case patient or be required to stay in the hospital for one night. This will depend on the technique chosen by your surgeon and the amount of fat to be removed.

Liposuction can be performed on several areas of the body at the same time, and can be used in conjunction with other cosmetic surgery procedures.

  • Fat is removed by first inserting a small, hollow tube (called a Cannula) through one or more tiny incisions. Incisions are usually less than one-quarter inch in length and are placed as inconspicuously as possible.
  • The cannula is connected to a vacuum pressure unit (Liposuction) or syringe (Liposculpture).
  • Guided by the surgeon, unwanted fat is sucked away

Liposuction requires general anaesthetic, so a day is required in the comfortable surroundings at the hospital/clinic . Liposculpture normally (but not always) requires genral anaesthetic but you can normally go home the same day. Your surgeon can discuss these requirements with you at your consultation.

The basic surgical challenge of any liposuction procedure is:

  • To abstract the right amount of fat
  • To cause the least disturbance of neighboring tissue, such as blood vessels and connective tissue
  • To leave the person’s fluid balance undisturbed
  • To cause the least discomfort to the patient

As techniques have been refined, many ideas have emerged that have brought liposuction closer to being safe, easy, less uncomfortable, and effective. The marketing that goes on makes it hard for the consumer to determine truth from exaggeration however.

Areas where the Liposuction is preformed :

  • Abdomen
  • Hips
  • Outer thighs (saddlebags)
  • Flanks (love handles)
  • Back
  • Inner thighs
  • Inner knees
  • Upper arms
  • Submental (chin),(gullet)
  • Gynecomastia (male breast tissue)

Recovery after Liposuction Surgery

After yourLiposuction fat removal procedure you will need to wear a support garment for between four and five weeks.

It is normal to experience soreness in the operative area after surgery for 2-3 weeks.
Some swelling and bruising is to be expected. Swelling usually begins to subside a week or so following surgery, while bruising can last three weeks or longer. There may also be numbness in certain areas and it may take several weeks before feeling returns.

Aside from normal, post-surgery discomfort, you should not experience side effects from liposuction. If anything abnormal is happening, you must contact the clinic as soon as possible so we can see if there is any problem is and, if so, put it right straight away.

At London Medical & Aesthetic Clinic, we take a special pride in our excellent levels of post-operative support and aftercare. To monitor your progress, we will invite you back to the clinic at prescribed intervals for follow-up examinations with your surgeon. You can expect a slimmer; more toned facial or bodily area that you can feel more confident about.

These lifestyle changes can help make the operation a success:

  • Giving up smoking
  • Eating healthily. If overweight, you have a greater chance of developing complications
  • Exercising regularly. Your GP can recommend exercises

Liposuction is a very straightforward procedure. You may be able to return to work in just a few days. We would recommend not undergoing any strenuous activity for 3-4 weeks after your surgery.

Many patients are able to resume most of their normal activities within one or two weeks and begin some form of exercise soon after. Often you will also be prescribed support bandages for a few days to aid recovery and promote shrinkage of the tissue.

The timing of your recovery depends largely on the extent of your treatment.

Liposuction will reduce those areas of fatty deposits that previously created unflattering bulges and perhaps made it difficult for you to feel comfortable in your clothing. The healing process is gradual, so you should expect to wait a while before fully enjoying the results of your procedure.

As long as you maintain your post-operative weight, the results of Liposuction will be permanent. Even if you gain a few extra pounds, you may find that the weight is distributed more evenly instead of accumulating in the areas that were problematic for you in the past.

Possible risks or complications with liposuction

As with all operations, there are some risks,side effects and possible complications associated with liposuction.

Fortunately, significant complications from Liposuction are infrequent. Every year many people undergo successful Liposuction, experience no problems and are delighted with the results.

Anyone considering surgery, however, should be aware of both the benefits and the risks. Your surgeon will discuss these in detail with you during the consultation.

A side effect, as opposed to a complication, is medically minor, although it can be uncomfortable, annoying, and even painful.

  • Bruising
  • Swelling
  • Scars
  • Scarring is an individual thing, partly dependent on heredity. For some, scar healing may take as long as a year.
  • Pain can be controlled by either over-the-counter medication, or by a prescription.
  • Numbness
  • Post-operative weight gain
  • Limited mobility

There are a number of factors that can limit movement following the procedure:

  • The patient is required to wear a post operative compression garment
  • Temporary swelling or pain

During your follow up appointments the surgeon will advise the patinet when they can resume exercise and normal activity.

As with any surgery, there are certain risks involved. During your consultation your surgeon will discuss all the possible side effects of the chosen procedure.

Careful patient selection minimizes the occurrence of side effects.

Can I combine liposuction with other treatments?

Many people who undergo liposuction or liposculpture like to combine it with other complimentary procedures.

If you are interested in body sculpting procedures, you might like to explore tummy tuck surgery, buttock implants, calf implants, arm or thigh lift surgery.

If you would like to lose weight, rather than body sculpt, explore our obesity surgery. If you are considering liposuction because of an impending wedding, you may be interested in multiple surgeries which comprises liposuction and breast enlargement.

Different Types of Liposuction

There are different Types of Liposuction dending on the method and mechanism used for fat removal :

Suction-assisted liposuction (SAL)

Suction-assisted liposuction is the standard method of liposuction. In this approach, a small cannula is inserted through a small incision. It is attached to a vacuum device. The surgeon pushes and pulls it in a forwards and backwards motion, carefully through the fat layer, breaking up the fat cells and drawing them out of the body by suction.

Power-assisted liposuction (PAL)

PAL uses a specialized cannula with mechanized movement, so that the surgeon does not need to make as many manual movements. Otherwise it is similar to traditional SAL.

Twin-cannula (assisted) liposuction (TCAL or TCL)

Twin cannula (assisted) liposuction uses a tube-within-a-tube specialized cannula pair, so that the cannula which aspirates fat, the mechanically reciprocated inner cannula, does not impact the patient’s tissue or the surgeon’s joints with each and every forward stroke. The aspirating inner cannula reciprocates within the slotted outer cannula to simulate a surgeon’s stroke of up to 5 cm rather than merely vibrating 1–2 mm as other power assisted devices, removing most of the labor from the procedure. Superficial or subdermal liposuction is facilitated by the spacing effect of the outer cannula and the fact that the cannulas do not get hot, eliminating the potential for friction burns

Ultrasound-assisted liposuction (UAL)

In ultrasound-assisted or ultrasonic liposuction, a specialized cannula is used which transmits ultrasound vibrations within the fat tissue. This vibration bursts the walls of the fat cells, emulsifying the fat ( liquefying it) and making it easier to suction out. UAL is a good choice for working on more fibrous areas, like the upper back or male breast area. It takes longer than traditional liposuction, but not longer than tumescent liposuction. There is slightly less blood loss. There appears to be slightly more risk of seromasforming (pockets of fluid) which may have to be drained with a needle.

After ultrasonic liposuction, it is necessary to perform suction-assisted liposuction to remove the liquified fat. Ultrasound-assisted liposuction techniques used in the 1980s and 1990s were associated with cases of tissue damage, usually from excessive exposure to ultrasound energy. Third-generation UAL devices address this problem by using pulsed energy delivery and a specialized probe that allows physicians to safely remove excess fat.

External ultrasound-assisted liposuction (XUAL or EUAL)

XUAL is a type of UAL where the ultrasonic energy is applied from outside, through the skin, making the specialized cannula of the UAL procedure unnecessary. It was developed because surgeons found that in some cases, the UAL method caused skin necrosis (death) and seromas, which are pockets of a pale yellowish fluid from the body, analogous to hematomas (pockets of red blood cells).

XUAL is a possible way to avoid such complications by having the ultrasound applied externally. It can also potentially cause less discomfort for the patient, both during the procedure and afterwards; decrease blood loss; allow better access through scar tissue; and treat larger areas. At this time however, it is not widely used and studies are not conclusive as to its effectiveness .

Water-assisted liposuction (WAL)

WAL uses a thin fan-shaped water beam, which loosens the structure of the fat tissue, so that it can be removed by a special cannula. During the liposuction the water is continually added and almost immediately aspirated via the same cannula. WAL requires less infiltration solution and produces less immediate edema from the tumescent fluid.

Laser Assisted Liposuction (LAL)

The concept of laser assisted liposuction technique – LAL was invented and developed by Dr Ayham Al-Ayoubi in 2007, which is based on lasering the fat tissue using Smartlipo laser energy, followed by skin tightening by taking advantage of the thermal effect of the laser energy, after which he uses the suction machine or the bodyjet liposuction technique to suck out the liquefied fat.

Dr Al-Ayoubi has revolutionized the Smartlipo treatment being the first surgeon to combine the gentle liposuction with Smartlipo for more rapid results without relying on the traditional laser liposis alone.This technique has been adapted by numerous numbers of plastic surgeons and cosmetic doctors from all around the world.

A laser is used to melt the fat in the target area, making it easier to remove. This laser is administered through a fibre threaded through a microcannula. The premise is similar to UAL. It is believed that this technique can also reduce bruising and bleeding.

Usning (Smartlipo , SmartlipoMPX or Smartlipo Triplex)pulsating laser beam has a photo-mechanical effect rupturing the fat cells’ membrane. Also it has thermal effect which melts the fractured fat cells and coagulates small blood vessels which reduce the bleeding to minimum. Both effects together (Photo-dynamic and Thermal) will give the skin tightening results.

The areas to be treated are marked with a special pencil and each is divided into segments of 5x5cm. A small incision 1-2mm is made with a micro-scalpel in which the local anaesthetic is injected. The local anaesthesia is carried out via longitudinal infiltration of the subcutaneous fatty tissue in anything from ten to twenty directions in order to form a network.

The optical fibre of the laser is inserted into the same incision created for the infiltration of the anaesthetic solution. Its transit through the skin is monitored by means of the guiding light on the laser device itself. The actual treatment begins by slowly moving forwards lengthwise following the lines traced on the skin and trying to constantly maintain the same speed of movement.

The deep fat is lasered first followed by the superficial fat and finally the fat is suctioned out. There are no stitches, just a very small incision that heals very well and quickly.

Alternatives to Liposuction

Non- Surgical alternatives to Liposuction

Liposuction should only be carried out after you’ve discussed the suitability of the procedure thoroughly with your surgeon, and where exercise and diet have failed to improve your body shape.

  • Smart lipo
  • Laser Assissted Liposuction
  • BodyTite
  • Tummy Tuck with skin tightening
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