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Base-line information
you need to know about liposuction in order
to make the informed choices if you are
considering liposuction
- You are born with
a finite number of fat cells distributed
around your internal organs and under
your skin.
- If you gain weight,
you are not making more fat cells, you
are filling the cells you already have
to a greater capacity.
- If you remove fat
cells, they are gone for good and your
body won't make more ' although it can
try and fill those that remain to a greater
degree.
- Liposuction removes
the fat cells under the skin, but not
those distributed around your organs,
and therefore, it is only suitable for
targeting localised deposits of fat that
have proved resistant to diet and exercise.
It is not a means of losing weight.
Liposuction
Several different
liposuction methods exist and they have
been developed, in part, to enable practitioners
to treat patients without the need for using
in-patient hospital facilities and general
anaesthesia.
The original method is often called suction-assisted
lipectomy. In essence it involves using
a sterile metal tube attached to a vacuum
pump, which a surgeon passes through subcutaneous
fat deposits, sucking up the fat and depositing
it in the vacuum pump’s storage bottle.
It is very similar, in principle, to your
domestic vacuum cleaner and used expertly,
in the correct tissue planes, it is very
effective.
This basic method has been improved by first
infiltrating the areas to be sucked with
a solution of saline, adrenaline (to decrease
bleeding) and local anaesthetic solution
' this allows larger volumes to be sucked
away safely in one go. Broadly-speaking,
there are two variants to methods using
infiltrating solution before liposuction,
based entirely on how much solution is added.
The two variants are called 'super-wet'
and 'tumescent' liposuction. More fluid
is used in tumescent liposuction (about
2 ' 3 times the estimated volume of fat
to be removed) allowing it to be used without
general anaesthesia. I always perform liposuction
under general anaesthesia, so I infiltrate
volumes in the 'super-wet' range.
When surgeons talk about liposculpture,
they are simply saying that they use their
liposuction equipment to sculpt the subcutaneous
tissues by targeting different areas of
fat at different levels and to different
degrees to try and achieve the aesthetic
result you desire ' no more, no less.
Commonly asked questions
about liposuction
Am I
a good candidate for liposuction?
This is best decided
during a consultation, but generally speaking,
the best candidates for liposuction are
physically and mentally healthy adults who
despite exercise and a healthy life style
have localised deposits of superficial fat
that resist all efforts to shift them.
You are likely, therefore, to be within
10Kg (20 lbs) of your ideal weight.
If you are hoping this will represent a
quick way to lose weight, this is not the
operation for you. Likewise, if you have
loose folds of skin after weight loss, or
your skin is relatively inelastic, I am
likely to suggest an alternative treatment
to achieve your goals realistically.
Also, if you are a smoker, you will be asked
to stop smoking for six weeks before surgery
and to avoid inhaling other peoples’
smoke secondarily. Smoking significantly
increases the risk of postoperative complications
and often ruins the results of this operation,
so I do not perform this operation on smokers.
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How
is liposuction performed?
As outlined above,
I perform a 'super-wet' variant of suction
assisted lipectomy when treating the abdomen
and the legs. This requires general anaesthesia.
Before surgery I will make guidance marks
on your skin, then these regions are injected
with wetting solution (saline, adrenaline
and local anaesthetic) after which inconspicuous
incisions used to introduce the suction
canulae through which fat is sucked away
in several planes to achieve an even, sculpted
and aesthetic result.
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What
should I expect from my consultation?
During your consultation,
I will take a full medical history. I will
ask you specifically about any medical conditions
you may have, as well as any previous surgery
you may have undergone. I may need to write
to surgeons who have operated on you in
the past to discover what you have had done,
so the more detailed information you can
bring with you, the better.
I will examine you completely, then focus
on the areas you wish to have treated with
liposuction to assess whether you have muscle
or soft tissue herniae there, and to assess
the size, symmetry and shape of your excess
subcutaneous fat. I will also look at the
quality and elastic tone of your abdominal
skin.
Finally I will then take standardised-view
photographs in order to help plan and discuss
your operation. During this discussion I
will explain about the advantages and disadvantages,
side effects and possible complications
of liposuction
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What
does my operation involve?
Before surgery, you
will meet and be assessed by your anaesthetist
who will prescribe medications for your
comfort and to lessen anxiety if need be.
On the evening before, or the morning of
your operation I will review what we have
discussed and planned previously and we
will both sign your operative consent forms.
Then I will draw the guidance lines on your
skin to indicate the areas to be treated
with liposuction.
The operation is performed under General
Anaesthesia ' you will be asleep. The procedure
takes a variable amount of time depending
on how much is being removed from how many
areas! As an illustration, extensive liposuction
to the abdomen and both legs may take 1
- 2 hours
After surgery you will be monitored in a
recovery area. You will have some discomfort
following surgery for which you will receive
pain relief. You will able, and encouraged
to walk with help within 8 - 12 hours of
surgery to maximize your recovery.
Typically you will leave hospital the next
day.
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What
about my recovery and return to normal activities?
Following surgery,
you will wear a compression garment for
three weeks, 24 hours a day; 7 days a week
(except when washing it or you!) and then
during the night for the next two weeks
' this helps resolve the bruising and swelling
that will form in the areas treated. Most
of it will resolve over 2 ' 3 weeks and
even before that, you will see an improvement
in contour and shape of the treated areas,
but your final result will mature over 3
' 6 months. When you are discharged from
hospital, someone must drive you home and
someone must stay with you to assist you
the first few days whilst at home.
You will feel tired and sore for about a
week after liposuction ' but maybe more
or less depending on your tolerance and
the extent of liposuction. Again, depending
on your occupation, your tolerance and the
extent of the liposuction you have had,
you will be able to return to work in 1
' 2 weeks.
The scars from this procedure are multiple,
short ones, designed to heal inconspicuously.
That said scar healing is dependent on multiple
competing factors which include: my surgical
technique; wound tension and position; any
post-operative trauma and infection; but
mostly on your genetic makeup. I lend my
expertise to provide you with the least
noticeable scar possible, but because each
individual's result is unique, wound healing
and your abdominal scar appearance are only
partly under my control. All new scars benefit
from friction-free massage (using vaseline,
for instance, to lubricate the massaging
process). Beginning to massage scars two
to three weeks after surgery, will help
them mature, soften and flatten faster than
if left to their own devices. New scars
should be protected from sunlight for 2
years to avoid them pigmenting differently
to the surrounding skin and becoming a different
colour permanently. Factor 15 sun block
should be applied whenever they are exposed
- even to a British winter sun.
Finally, you must realise that you can still
gain weight and deposit fat in the areas
that have been treated ' not all fat has
been removed from these regions, so if you
gain over 10 Kg in body weight, the chances
are these regions will fill out again although
usually with a better contour.
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