Liposuction

You should be in good physical shape with good skin tone and elasticity. You should be at your target weight that is stable before embarking on liposuction, it is not a substitute for weight loss. Both men and women who have concentrated pockets of fat resistant to weight loss but who have achieved the maximum possible results with regular exercise and healthy balanced diet are ideal candidates. If you intend to loose more weight or have future pregnancies it is best to post-pone surgery for optimal results.

Those with significant medical problems and smokers are not suitable. If you have not yet achieved your target weight you should delay surgery to achieve the best long-term effects. If you are planning to have more children you should consider waiting until you have completed your family. Those with unrealistic expectations or those who have been encouraged by others to change their appearance are not good candidates.

In all liposuction tiny incisions are placed in natural body creases such as the groin, belly button, armpit or buttock crease. The first step is to infiltrate a special fluid mixture into the fat. The solution contains normal saline, adrenaline that acts decreases bruising and prevents bleeding, and a local anesthetic that makes the area numb for many hours after surgery. A blunt-ended cannula is then placed through the incisions to suck out fat using a vacuum. The treated areas are feathered out at the edges to blend naturally with the surrounding areas.

Standard Liposuction

Most cases are done using standard liposuction (suction-assisted liposuction). In this technique, concentrated areas of fat to be removed are marked on the skin preoperatively. Once you are anaethetised, tumescent solution is injected. The tumescent technique is the safest way to remove fat while decreasing bruising and promoting postoperative comfort. Liposuction is done via small incisions using a cannula attached to suction to remove the unwanted fat. It is performed under general anesthesia as a day case procedure. Most routine cases remove a few liters of fat. Large volume liposuction removes more than 5 liters of fat and in these cases an overnight stay may be recommended.

Ultrasonic Liposuction (UAL)

Ultrasonic liposuction is a procedure that uses a special cannula to deliver ultrasound energy to the fat inside the body to help break it down and aid removal. The fat is then removed in the same way as standard liposuction in the same operation. It is also sometimes called ultrasound-assisted lipectomy (UAL) or Vaser (which is the brand name of a machine). It is often recommended for stubborn fat deposits and other difficult-to-treat areas such male breast tissue (gynecomastia) or lipodystrophy.

At your initial consultation, I spend a great deal of time getting to know you personally and taking a full medical history. The success of any cosmetic procedure relies on you being open with me at this stage. It is important for me to explore your reasons for seeking liposuction, what you dislike and your expectations of surgery. I also need to know about your general health, lifestyle and medications, prescribed or otherwise. I specifically need to know about previous operations.

I will examine your areas of concern and your overall body shape and skin quality. I will assess what areas are problematic and what can be done to address your concerns. At the end of that consultation I will describe the surgical options to address your problems and devise your personal surgical plan. I will also explain the risks and limitations of surgery to you at this stage. It may be that I recommend an alternative to liposuction to achieve your desired outcome. I always have a second consultation to answer any questions before we book surgery.

As a female Plastic Surgeon I have an intimate understanding of how a ladies’ feelings about her body can affect self-image and femininity. I understand how it can be difficult to get rid of those final stubborn areas with diet and exercise. I work with you to achieve the desired outcome whether that is being able to fit back into your clothes, to improve your self-confidence or to simply have your pre-pregnancy body back. For men I offer a woman’s perspective on your concerns and aim to help you re-create the physique you desire.

You should be physically fit and at or close to your ideal weight which should be stable prior to embarking on liposuction. Your health will be assessed pre-operatively and you may need some tests that will be arranged if required. You should stop aspirin, anti-inflammatory medications and any non-prescribed medication at least a week before surgery. If there is any change in your health prior to your surgery date you should let me know. Your health and general well being are my primary concern when I am treating you therefore if you are unwell for any reason it may be necessary to postpone surgery.

You will need to come to hospital starved and ready for a general anaesthetic. Surgery generally takes one and a half to two hours, and an overnight stay may be required for high volume liposuction.

You will return to the ward around an hour after surgery and be encouraged to mobilise and eat and drink. You will feel swollen and bruised and you will be given appropriate painkillers. You will be given a compressive dressing that should be worn continuously for a few weeks following surgery.

You will go home with some compressive dressings that you should wear continuously for the first week. You should keep the wounds clean and dry for the first week. You will need someone to collect you and support you at home for the first few days. Some moderate discomfort is expected for a few days and you will be given oral pain medication for a week or two postoperatively. Short walks and deep breathing exercises are encouraged immediately after surgery to promote circulation in the legs and lungs. You will be reviewed in clinic at one-week post op and the dressings are changed. Numbness and bruising is common for a few weeks after surgery.

You can return to light exercise at a week but should not do anything strenuous for 2-3 weeks. You should arrange to take a few days to a week off work depending on your job. You should continue to wear your compression garment for six weeks.

Once the scars have healed you can start to massage with a simple moisturiser. Bruising and swelling will start to settle over the first few weeks and you may find that one area settles more quickly than the others leaving you asymmetric (lopsided) whilst the other sites catch up. This is perfectly normal and we will not start to see the final results for at least six weeks, sometimes longer. The scars will be red/pink initially and slowly fade over many months or years. It can take several months for all surgical swelling to subside and for the very final results to be evident.

Liposuction is often part of a Mummy Makeover. The common stubborn areas seen after pregnancy are the abdomen, flanks, pubic region, hips, inner and outer thighs, buttocks and arms.

When you are considering any type of surgery, you should be fully educated about potential risks and complications. Most patients are delighted with outcome of their procedure. Sensation usually changes following liposuction. Although permanent numbness is uncommon, sensation can take a number of months to return. In addition to numbness, bruising and swelling are common. Uncommon complications include infection, haematoma, skin necrosis and seroma (a collection of tissue fluid). The scars will be red or pink for a number of months before they fade to a pale white line however they are short and well hidden in natural body creases. Some patients develop abnormally thickened scars that may require additional treatment in the clinic. It is very unusual to have scars that require additional surgery. Complications of any general anaesthetic include potential cardiac or respiratory problems and blood clots in the leg (DVT or in the lung (PE).

In the long term the fat cells do not grow back but if you gain weight the remaining cell will increase in size and fat can re-accumulate therefore the result of your procedure can change with fluctuations in weight or further pregnancies.