Liposuction is a surgical procedure in which fatty tissue is sucked out of certain typical areas with accumulated fat. This surgery is not a weight loss method. It is a form of body contouring. We can focus exactly on the area where fat is accumulated and have a positive impact on the patient’s body shape.
Liposuction is used to remove accumulated fat and to form especially the abdomen, buttocks, hips, upper arms, thighs, knees, jowls, and neck.
The basic principle of liposuction is the breakdown and subsequent suction of fat via a cannula connected to an aspirator (vacuum device) which enables the suctioning of subcutaneous fat. The cannula is inserted into the body through tiny incisions, which are carefully pushed through the natural fat layers by a surgeon.
Liposuction can be categorized by the types of devices used, i.e. classic (tumescent), vibration, ultrasound-assisted and laser-assisted. Classic wet liposuction is used most commonly. In this method, fluid is injected into subcutaneous layer and this type of technique is further categorized by the amount of fluid injection.
In classic liposuction, the fluid volume injected into the body is less than or equal to the fat expected to be removed. The fluid contains saline, adrenaline and sometimes a smaller amount of anaesthetic.
In tumescent liposuction, the amount of the solution injected is higher, containing an anaesthetic. The solution is injected slowly by a pump and under a surgeon’s control. The procedure can be performed without general anaesthesia, since local anaesthesia through a lidocaine solution is sufficient, but then it takes longer than under general anaesthesia. The amount of the solution is 3 times higher than the amount of fat to be removed. The injected solution creates tumescence and the fat can be drawn by suctioning. This method allows co-operation with the patient.
The diameter of the cannulas used is the most important with all liposuction types. In our clinic, cannulas of small diameter, 3-4mm are used. They are less harmful to the patients.
Using high calibre cannulas represents a high risk of post op complications, resulting in irregular areas of intervention.
The cannula’s tip – mouth – is connected to a silicone tube which is attached to a high powered vacuum device.
A plastic surgeon should never be forced to meet an overweight female patient’s wish if he/she is unconformable with the purpose of the liposuction. She should reduce her excess fatty tissue naturally, either by exercising or undertaking a weight loss diet.
The amount of fat removed should not be more than 2,000 to 2,5000 ml to maintain safety and avoid risks. Removing too much fatty tissue does not correspond to an aesthetic procedure and represents a great risk to the patient’s health.
Before the procedure:
See the pre-surgery instructions
Particular caution should be used in lower limb diseases, lymphatic and venous system disorders – varices, oedemas.
Smaller areas – jowl, medial knee ligaments - can be removed under local anaesthesia, or in combination with analgosedation, if appropriate. Total or epidural anaesthesia is most suitable.
The surgeon injects a solution directly into marked areas designed for fat removal. The solution amount and content might vary depending on the method used. The duration of the surgery also varies, from 1 to 4 hours, naturally depending on the number of treated areas.
Fat is removed via a suction cannula which is introduced into the body through tiny incisions made by a scalpel. The surgeon pushes the cannula carefully from the surface into the deeper fat layers. To maintain the symmetry of individual areas, control of the fat amount removed and of the appearance is recommended. Cannulas can be exchanged, if necessary. The surgery is over after the wound has been sutured. Immediately after surgery, the patient is given a compression garment, which is an essential part of post op care. The compression garment is worn for approximately 4 - 6 weeks.
To achieve the best possible results of the liposuction, the patients are recommended to perform rolling, which levels the areas and removes small amounts of unabsorbed secretion.
The range of post-op swelling and bruising are individual, they can be mitigated as advised by the physician. Feelings of burning, pain, and numbness belong to the current post-op symptoms that will fade and the swelling will subside within 3 weeks. The desirable effect will be evident after 2 - 3 months.