WHAT CAN LIPOSUCTION BE USED FOR?

Liposuction is a treatment for the removal of excess fat.  It is ideally suited for the removal of localised fat deposits especially on the thighs, buttocks, hips, loins, abdomen, arms, neck, inner knees and ankles.  It can lead to permanent change in body shape and contour and is very useful to treat stubborn areas that are resistant to diet and exercise.  It is not a suitable treatment for generalised obesity and will not improve cellulite or stretch marks.

Liposuction permanently removes fat cells which are never replaced and hence the change in body shape can be permanent. However, the remaining fat cells can increase in size as weight is gained and so weight loss may not be permanent unless a healthy lifestyle is adopted.

Liposuction may also be used for the treatment of lipomas (benign (non-cancerous) tumours of fat), gynaecomastia (fatty breast development in men), and for adjusting the shape of breasts after reconstructive surgery.

WHAT DOES THE TREATMENT INVOLVE?

Liposuction is usually performed under a general anaesthetic (the patient is asleep).  In some cases, for treatment on the lower body, it can be performed with an epidural like that used for women in labour.  This involves a needle in the back which numbs the lower half of the body but leaves the patient conscious.  Local anaesthetic is only suitable for liposuction on very small areas of the body and is not often used.  In most cases the surgery can be performed as a day case and therefore does not usually require an overnight stay in hospital.

After the anaesthetic, the surgeon will make small cuts in the skin between 1 and 2 cms long in the areas to be treated.  A rigid tube can then be passed under the skin into the fat.  The tube is attached to a strong suction device.  The tube is passed back and forth to break up the fat which is then sucked out by the vacuum.  For very small areas a simple syringe may be all that is needed to create the vacuum.

There are a few different techniques that can be used.  “Wet” liposuction involves injecting fluid into the fat before removal. The fluid may contain local anaesthetic and adrenaline to help reduce bleeding.  Ultrasound liposuction can be used for stubborn fat deposits and involves the use of ultrasound before the surgery to break up the fat.

There are limits on the amount of fat that can be safely removed in one go and so multiple operations may be required at intervals of a few months.

If you decide on surgery you will undergo some simple health checks and be required to sign a consent form giving permission for the operation. This requires that you are aware of the risks and complications involved with the procedure.

WHAT ARE THE RISKS AND COMPLICATIONS?

There are general risks associated with a general anaesthetic including chest infection especially in smokers.  Deep Vein Thrombosis (also known as DVTs or clots in the veins of the legs) can also occur which can break off and travel to the lungs.  This is known as a pulmonary embolus and can, although very rare, be life threatening.

Complications specific to liposuction include:

• Bleeding under the skin, known as a haematoma.  This can be very uncomfortable and in a few cases it may be necessary to go back to the operating theatre to stop the bleeding and remove the clot.
  
• Infection may require antibiotic treatment.
  
• Scars: The scars will be very small but some people have a tendency to form lumpy red scars which can be unsightly.
  
• IIf ultrasound is used, there may be some permanent changes to the colour of the overlying skin and some loss of normal feeling in that area.
  
• With wet liposuction there atre a couple of additional specific complications.  Pulmonary oedema, which is a fluid build up in the lungs, can occur as a result of the fluid that is injected.  This causes problems with breathing and needs immediate treatment.  The fluid used can also cause allergic reactions.

It is also important to be aware that it is impossible to guarantee that the skin will be perfectly smooth, even after treatment. Some numbness can occur and there may be significant bruising and swelling which may take several months to settle completely. In some cases there may be significant loose skin after the liposuction which may require further surgery to have this removed.

WHAT HAPPENS AFTER THE OPERATION?

In most cases you will be allowed to go home the same day but, following a general anaesthetic, you will not be able to drive and will need someone to help out at home for the first 24 hours.

You will probably need simple painkillers to help with any discomfort.  You will be required to wear a supportive corset or pressure bandages around the treated areas.  You will be advised to wear these for a few weeks following the treatment although it is permissible to remove them for washing.  You will be given instructions about looking after the wounds and having stitches removed.

Most patients will need between 7 and 10 days off work depending on the job and strenuous exercise is not advised for the first month.