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Liposuction or Lipoplasty

Liposuction, lipoplasty or liposculpture is commonly known as “suction-assisted fat removal” and has been developed to help remove fat from various parts of the body to improve body shape and size. It is more beneficial as a body sculpting procedure than as a weight loss tool. The aim of liposculpture is not necessarily to remove all the fatty tissue but rather enough to make an area significantly slimmer in shape and appearance.

Liposculpture can be used to help give patients a “kick-start” to a further exercise programme and weight loss. Many people who have liposuction surgery and have a significant amount of fat removed from the abdomen, go on to lose further amounts of weight. Treatment of the abdomen and some areas of the thighs make exercise easier which may also help with weight loss. It is important to stress that liposculpture complements the beneficial effect of exercise and eating a sensible diet and both of these things are necessary if further weight loss is possible. If diet and exercise are not implemented, then weight gain will occur.

Liposculpture is an elective cosmetic procedure and candidates should be in good health and have no major medical problems. A person considering liposuction would ideally be at a relatively normal weight but may have extra fatty tissue in localised areas such as the neck, arms, breasts, abdomen, flanks, thighs and knees.

Importantly, liposculpture cannot eliminate cellulite or treat loose hanging skin. Skin does retract but does not completely tighten skin in all areas, or in all patients. It is best suited for people who are in good physical shape with firm, non-flaccid skin. This is more so in people under 50 years of age, although many people much older will have excellent results with minimal or no looseness of skin. If the skin is not elastic enough then additional skin tightening procedures may be required for the best looking results to be achieved. Such procedures as a “tummy tuck” or a “thigh lift” may be required to tighten the skin over the liposuctioned area.

Liposculpture is commonly performed under local anaesthesia but may be performed under full general anaesthesia.

Guest Contributor: Meaghan Heckenburg, Liposculptor at Be Sculpted

In the middle of the 1980’s significant improvements were made in local anaesthesia by the work of Dr Jeffrey Klein, a dermatologist in California. Very low concentrations of local anaesthesia can be used to numb large areas of fatty tissue without the need for general anaesthesia. The fatty tissue is put under slight pressure by large volumes of saline mixed with the local anaesthetic drug called lignocaine. The fluid forces the local anaesthesia throughout the areas to be treated and allows it to be distributed evenly. Small amounts of adrenaline are added to the solution to allow constrictions of fat blood vessels. Blood loss is virtually negligible and this reduces bruising considerably. This is called “tumescent technique”. Small access points are used to introduce the small tubes necessary for the procedure, both to put the fluid in and to remove the fatty tissue. The incision points heal on their own and do not require suturing. Sometimes they may leave a little scar, become lighter or darker in colour but most of the time they become undetectable with time. This procedure can be performed as a day-only procedure as an out-patient. With the tumescent technique, it is very safe and the incidence of side effects are low. If general anaesthesia is chosen, then the procedure will need to be performed in a hospital and may require a stay of a few days. Complications are considerably reduced with the use of the tumescent technique compared to general anaesthesia, particularly things like blood loss, infection, deep venous thrombosis (clots in the legs), pulmonary embolism (clots in the lungs), skin breakdown, injury to other body organs. All of these things are very rare when the procedure is performed under local anaesthesia.

After surgery, there is usually some discomfort (soreness and stiffness) for a few days and will usually settle with paracetamol alone. Leaking of the anaesthetic fluid lasts about 24-36 hours. Numbness can take a few weeks to a few months to resolve. Bruising (if it occurs) may last for 2-3 weeks. Texture irregularities or lumpy areas may sometimes occur and may take a few months to settle. Because of potentially slow resolution of postoperative swelling, the final results may take 3-6 months to achieve. It is necessary to wear compression garments for 2-4 weeks after the procedure, particularly the first 2 weeks when swelling is maximal. One may return to work after a couple of days, depending on the level of physicality required.

Risks and Complications

Any surgery involves the risk of infection, bleeding, scarring or serious injury, however tumescent liposuction has an amazingly good safety record.

There is a maximum dose of the local anaesthetic drug (lignocaine) that may be used during the procedure. This is calculated using a person’s body weight. Therefore multiple areas may not be able to be treated at the same time. It is also advisable to keep the volume of fat removed under 5 litres per procedure, otherwise recovery is prolonged and there may be alteration of important body fluid electrolytes. However the greatest risks of liposuction are those associated with general anaesthesia.

Q. Can I have liposuction if I am extremely overweight?

A. Liposuction is not an appropriate treatment for obesity. It is also not a substitute for a prudent diet, good nutrition and regular exercise. Obese patients may be good candidates for limited liposuction if their goal is simply to improve the shape of certain areas of the body. Obesity is associated with an increased risk of surgical complications.

Q. Is liposuction permanent?

A. The fat cells that are removed by liposculpture do not grow back. If the patient later gains or loses weight the change tends to be distributed proportionately over the entire body. For the best results, the patient’s postoperative weight should be lower than the preoperative weight but the exact value of that is impossible to predict. Although one can expect some changes with age, provided the patient does not gain large amounts of weight, the patient’s new silhouette is relatively permanent.

Q. Can liposuction treat Cellulite?

A. Cellulite results from the pulling of fibrous tissue that connects the skin to underlying muscle. This is genetically determined and more common in female fatty tissue compared to male fatty tissue. While tumescent liposculpture may reduce the degree of cellulite, it is unlikely to eliminate it. Reducing the size of a fatty area with overlying cellulite will however improve one’s overall appearance.

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