Liposuction (suction assisted lipectomy or lipoplasty) is a surgical procedure to remove unwanted fat deposits from specific areas of the body. It can be done on the chin, neck, cheeks, the upper arms, above the breasts, the abdomen, buttocks, hips, thighs, the knees, calves and ankles. Liposuction is not a substitute for weight reduction, but a method of removing localized fat that doesn’t respond to dieting and exercise.
The average cost of this procedure in the UK is between £1500 to £2000, for the first area. Additional areas done at the same time are greatly reduced.
The best candidates for liposuction are of relatively normal weight but have pockets of excess fat in particular areas. You should be physically healthy, psychologically stable, and realistic in your expectations. Most important, having firm, elastic skin will result in a better final contour. (Hanging skin won’t reshape to your body’s new contours, and may require an additional procedure to surgically remove the excess skin. See the tummy tuck information page)
There are three types of liposuction currently being done in the UK, these are Tumescent, Ultrasound (or Ultrasonic) and Traditional liposuction.
Liposuction is not recommended if you’ve had recent surgery on the spot to be sculpted, if you have poor blood circulation in that area, or if you have heart or lung disease. You should also understand that liposuction by itself will not improve the dimpled skin known as cellulite, though some plastic surgeons offer other techniques that may improve this condition.
The scars from liposuction are small and strategically placed to be hidden from view, even in a bikini. However, other cosmetic problems may occur, even if your surgeon is very skilled. They may include rippling or bagginess of the skin over the treated area, and pigmentation changes (such as brown spots) that may become permanent if exposed to the sun. Asymmetry (uneven contour or shape) sometimes requires a second procedure.
There is another procedure available called Liposculpture, which should not be confused with liposuction. Liposuction and Liposculpture are different in that with liposuction, the fat is removed via a cannula and the suction process kills the fat cells. With Liposculpture, a thin needle is used to suction small amounts of fat from targeted areas, this process does not kill the fat cells and can, in most cases, be reused to inject in other parts of the body. See our fat injection information page for further details.
Although liposuction is normally safe, you need to keep in mind that liposuction is one of the most serious cosmetic surgeries that you can have done in that it can disturb your body’s organ functions. In rare instances, the procedure may cause severe trauma, particularly when multiple or very extensive areas are suctioned at one time. Other infrequent, but possible, complications include fluid accumulation (which must be drained) and injury to the skin. Although serious complications are infrequent, infection or excessive fluid loss can lead to severe illness. You can reduce your risks by choosing a qualified plastic surgeon who has been granted privileges to perform liposuction at an accredited hospital, and by closely following his or her advice.
BEFORE THE SURGERY
There are many things you can do to have your body in optimum condition before your surgery. Read our Health Booster page to find out.
If you’re having extensive liposuction, discuss the possibility of having blood drawn ahead of time with your doctor. Your own blood can be used to help replace the blood and other fluids you’ll lose during surgery if your doctor feels this is necessary.
Prior to performing this liposuction technique, fluid is instilled into the areas of localized fatty deposits. Plastic surgeons may use varying amounts of fluid, depending on their individual preference.
The sterile fluid used for tumescent liposuction contains a salt solution, low concentrations of lidocaine (a local anesthetic) and adrenaline (a naturally occurring hormone). The adrenaline has the temporary effect of shrinking the blood vessels which subsequently decreases the patient’s blood loss. Injection of this fluid is done a few minutes prior to performing liposuction. Enough fluid is injected into the fatty areas to make the tissues firm and distended.
Tumescent liposuction may sometimes be performed without additional anesthesia, since the fluid that is instilled contains a dilute local anesthetic. Some patients, however, may prefer additional sedation or general anesthesia, particularly if multiple areas of the body are being suctioned or additional surgical procedures are performed at the same time.
Many surgeons feel that the tumescent technique has advantages over other liposuction methods. Advantages may include the capability to remove larger amounts of fatty tissue with less blood loss, diminished postoperative bruising and greater patient comfort. The maximum amount of fat that can be safely removed varies with the weight, body type and medical condition of the patient, the skill and judgment of the surgeon, and the other surgical procedures, if any, being performed at the same time. Removal of large volumes of fat by any liposuction technique may increase the risk of complications.
Ultrasound-assisted lipoplasty, commonly known as “UAL,” is a relatively new liposuction technique that uses sound waves to “liquefy” unwanted fat. Although it is not a substitute for traditional liposuction, UAL can be an effective tool for removing fat from fibrous body areas, such as the male breasts or the back, or for removing larger volumes of fat in a single procedure.
Often, traditional liposuction is performed with UAL to help shape UAL-treated areas or to treat areas of the body not suited for UAL, such as the neck and inner thighs.
As with traditional liposuction, serious medical complications from UAL are infrequent. However, possible complications include clots that block blood flow, infection, excessive fluid loss that can lead to shock, excessive fluid accumulation that must be drained, skin injury, perforation injury to the skin or other organs and adverse reactions to anesthesia.
One potential complication specifically related to the UAL technique is thermal skin injury or burn caused by the heat from the ultrasound device. Also, temporary collections of fluid beneath the skin surface (seromas) are more common with UAL.
Also, you should be aware that at present, the tube-like instruments or cannulas used to perform UAL are slightly larger than the cannulas used for traditional liposuction. The longer incisions that are needed for UAL require that they be placed carefully in hidden areas. For this reason, some surgeons prefer to use the traditional liposuction technique in areas where an obvious scar may result.
If you are having only a small amount of fat removed, UAL may be performed under local anesthesia combined with a sedative to make you drowsy. You will be awake but relaxed and feel only minimal discomfort. Some surgeons may prefer to use an epidural block, similar to the anesthesia commonly used in childbirth.
General anesthesia may be used if you prefer it, or if your doctor so advises. In that case, you will sleep through the procedure.
The time required to perform UAL may vary considerably, depending on the amount of work you are having done. However, UAL generally takes longer than traditional liposuction because of the extra “fat-liquefying” step involved.
To begin the procedure, salt water containing local anesthesia and adrenaline is injected into the area to be treated. Then, a metal cannula connected to an ultrasound generator is inserted beneath the skin through a small incision. The ultrasonic energy causes the walls of the fat cells to break down, allowing the fat to flow out of each cell. The “liquified” fat combines with the injected fluid to create an emulsion, which is removed from the body by vacuum pressure.
If you are awake, you may feel some warmth and vibration during the procedure. You will probably be given some fluid through an IV (intravenous) tube to keep your fluid level balanced. Typically, only a small amount of blood is lost during UAL. However, if your surgeon determines that a blood transfusion may be needed, you can donate your own blood in advance of the procedure.
After surgery, you will likely experience some fluid drainage from the incisions. A drainage tube may be inserted beneath the skin to prevent fluid build-up. To help control swelling, you may be fitted with a snug elastic bandage or compression garment to wear over the treated area. The bandage or garment is typically worn for up to four weeks, to help your skin shrink to fit its new contour.
The side-effects of traditional liposuction surgery — pain, burning, swelling, bleeding and temporary numbness — can be expected from UAL as well. The pain can be controlled with medications prescribed by your surgeon, though you may still feel stiff and sore for a few days.
Traditional liposuction may be performed in a surgeon’s office-based facility, an outpatient surgery centre, or a hospital. It’s usually done on an outpatient basis, for cost containment and convenience. Extensive procedures may require a hospital stay of two or three days.
Liposuction can be performed under local anaesthesia, which numbs the area, combined with a sedative to make you drowsy. You’ll be awake but relaxed, and will feel minimal discomfort. Some surgeons may instead use an epidural block, similar to the anaesthesia used in childbirth.
If your doctor plans to suction a large area, or to treat several sites, you’ll probably have general anaesthesia. In that case, you’ll sleep through the operation.
Suction-assisted lipectomy usually takes an hour or two, but the time required may vary considerably, from thirty minutes to several hours, depending on the area and amount being suctioned.
To begin the procedure, the surgeon makes a small incision, just large enough to allow the insertion of a hollow tube called a cannula. The opposite end of the cannula is attached to a machine that creates a strong vacuum.
The surgeon manipulates the cannula deep within the fat layers under the skin, breaking up the fat and suctioning it out. Sometimes
additional incisions are needed to remove all areas of fat.
The surgeon inserts a cannula through small incisions in the skin. At the other end of the tube is a vacuum-pressure unit that suctions off the fat.
If you’ve had local anaesthesia, you’ll feel some vibration and friction during the procedure. You may also feel a stinging sensation as the cannula moves closer to the muscle.
You’ll lose fluid along with the fat during liposuction, and it’s crucial that this fluid be replaced to keep your body from going into shock. You’ll be given fluids intravenously, and if needed you may also receive a blood transfusions (this can be the blood you’ve donated in advance).
AFTER THE SURGERY
After surgery, a drainage tube may be inserted beneath your skin for one to three days to remove any fluid build-up that occurs. A snug elastic dressing, girdle, or body stocking must be worn over the treated area to control swelling and bleeding, and to help your skin shrink to fit your new contour.
You may need to wear this garment continuously for two to three weeks, then just in the daytime for a few weeks more, depending on your surgeon’s instructions. Your doctor may also prescribe antibiotics to prevent infection.
Don’t expect to look or feel great right after surgery. You’ll even be heavier for a while, because of the extra fluids you’ve been given. The suctioned areas will be swollen and bruised, and you may feel a burning sensation.
The pain can be controlled with medications prescribed by your surgeon, though you may still feel stiff and sore for a few days. You may temporarily lose all feeling in the suctioned area; don’t worry, it will return.
Healing is a gradual process. Your surgeon will probably tell you to start walking around as soon as possible (to help prevent blood clots from forming in your legs), but to avoid more strenuous activity for two to four weeks.
Any stitches will be removed in five to ten days or dissolve, and you should be back at work in 2 – 3 days, or as much as two weeks after your surgery. When you resume activity depends on the extent of your procedure, how you feel and what your doctor recommends.
While most of the swelling and discoloration will be gone a month or two after surgery, some swelling can remain for six months or more. Your surgeon will schedule follow-up visits to monitor your progress and to see if any additional procedures are needed.
If you have any unusual symptoms between visits (e.g. heavy bleeding or a sudden increase in pain) call your surgeon.