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Liposuction

Suction assisted lipectomy is an aesthetic body contouring procedure designed to remove localised fat deposits, such as that which occurs on the thighs, buttocks and abdomen as well as the arms, neck and under the chin. With the liposuction method, localised fat deposits are removed through tubes and cannulas which are passed through small incisions. A vacuum apparatus applies a negative pressure and the fat is literally sucked out from the area of involvement.

Suction lipectomy is ideal for patients who have bulges which persist after diet and exercise. It is not a substitute for weight loss. Your surgeon at the Aesthetic Day Surgery will discuss the results that you can personally expect from liposuction at your initial consultation.

What is Liposuction?
Suction assisted lipectomy is an aesthetic body contouring procedure designed to remove localised fat deposits, such as that which occurs on the thighs, buttocks, abdomen and hips, as well as the arms, neck and under the chin.

Liposuction is not a substitute for a good diet and a healthy exercise program. It is however, an excellent way of getting rid of unwanted fat deposits and bulges and permanently changing the undesired contours. It is an operation that, in experienced and properly trained hands, produces excellent results routinely with a minimum of potential risks or complications. Thus, liposuction has a very high satisfaction rate.

How is Liposuction performed?
With the liposuction method, localised fat deposits are removed through suction cannulae which are passed into small incisions. A vacuum apparatus applies a negative pressure and the fat is literally sucked out from the area of involvement. A pressure garment is usually worn for 3-6 weeks post-operatively in order to decrease bruising and swelling and to encourage the skin to contract to the new shape.

What results can I expect?
Liposuction works on the principle that people are born with a defined number of fat cells. If you get fatter, your individual fat cells get fatter rather than multiplying (not totally true with extreme obesity). Thus, if you have an undesired deposit of fat producing an undesired contour (most commonly ‘pot belly’ or ‘saddle bag thighs’ in females or ‘love handles’ in males) then these can be permanently changed or eliminated by liposuction removal of the fat cells producing that undesired contour because fat cells generally don’t multiply and that contour is permanently changed.

Suction lipectomy is ideal for patients who have bulges which persist after diet and exercise. It is not a substitute for weight loss. Usually the overlying skin will contract following suction lipectomy however in some circumstances a procedure designed to remove excess skin may also be required. With liposuction alone the skin is not surgically tightened. Therefore it is best suited for people who are in good physical shape and have ‘youthful’ skin qualities. However, sometimes quite good results can be obtained in older patients where the aim is just to remove some bulging fatty areas.

Who is the best candidate for Liposuction?
Paradoxically the best candidates for liposuction are usually people who are not that overweight or even at ideal body weight but have an area of fat that just won’t shift despite how much exercise or dieting they do. The classic story is “I lose weight and all that happens is my breasts disappear and my thighs and tummy stay the same”. “I look just the same as my brother or sister”. The story is similar for males and “lovehandles” on the hips.

Any age can be appropriate for liposuction but the younger the patient, usually the more capacity for skin uptake.

Is Liposuction suitable for me?
The decision to go ahead with an aesthetic procedure is a very personal one. The first step is a consultation with one of the qualified plastic surgeons at the Aesthetic Day Surgery. Whatever your reasons you should frankly discuss your personal goals and expectations with respect to the outcome of the procedure (both physical and emotional) with your surgeon. As with any aesthetic surgery you should always keep in mind that the desired result is improvement, not perfection.

Note: it is important to stress that suction lipectomy is in no way a substitute for weight loss or exercise.

What limits how much Liposuction I can have?
The first determining factor is the quality of the skin over the area to be liposuctioned. After the fat is removed, liposuction relies on the skin contracting down to prevent any looseness or sagging. So if the skin is of poor quality due to say stretch marks or already sagging then the amount of liposuction that is appropriate or safe will be limited or even contraindicated. Younger skins tends to have more tone and allow more aggressive fat removal. Different body areas have different quality skin and allow more or less aggressive fat removal.

Any number of specific areas can be done at the one surgical procedure. However, liposuction is certainly most appropriate as a means to change contour in a specific area rather than a means of weight reduction. Large volume liposuction means greater blood loss and fluid electrolyte blood changes making it a more significant procedure. All the major common areas are able to be treated at once in the good candidate.

What areas are good for Liposuction?
Basically any area that contains fat can be liposuctioned The classic areas treated include the outer thighs (saddlebags), abdomen, flanks, hips, inner thighs, knees, ankles, breasts (in appropriate patients), the neck and chin region.

How long will the procedure take?
Depending on the extent of the procedure, suction lipectomy surgery may last anywhere from 1 to 3 hours. However, please keep in mind that this is only actual surgical time. To ensure the highest standard of personalised patient care, attention to details and results, the Aesthetic Day Surgery requires you to spend appropriate time both immediately before and after the procedure within the surgery. In general, you would need to allocate up to a full day of your time to allow for pre-operative procedures, the surgery itself and appropriate post operative care. (Note: this time would be in addition to your initial and follow up consultations with an ADS surgeon). If your procedure is more extensive and is to carried out in a hospital then you can expect to remain in hospital for between 2-3 days.

How long will it take to recover from Liposuction?
Although each patient is different, in general, you will need complete bed rest for the first 24 hours following the procedure. As with any operation the first 48 hours are the most uncomfortable. A snug dressing will be in place for at least 7 to 14 days. When possible, a commercially made support garment, such as long-legged panty girdle, support tights, abdominal binder or surgical bra will be used. Normally some form of support dressing will be utilised for between four to six weeks. Most activities may be resumed within 2-3 weeks however strenuous exercise should be avoided for up to 6 weeks. Bruising associated with the liposuction may take 2-3 weeks to disappear and although a lot of swelling is gone after several weeks, it may take several more weeks to see the final result.

Many patients choose to return to work after one week and some even sooner depending on the extent of the procedure.

Will the procedure leave any scars?
The advanced surgical techniques applied by the surgeons at the Aesthetic Day Surgery are designed to minimise (and where possible eliminate) all visible scarring. Because of the small size of the incisions (less than 1cm), scars are not usually significant after liposuction. Any scarring that does occur will fade over time, albeit there is some variation from patient to patient.

What are the side effects and potential complications of this procedure?
Although side effects vary from from one patient to the next, in general significant bruising and swelling are common. The bruising usually subsides in 3-6 weeks and the swelling in 8 weeks. Most patients experience discomfort and at times pain which may last from several days to one week after the surgery – this depends greatly on the patient and the extent of the procedure. Numbness may also occur but usually disappears after some months. Slight irregularities such as minor grooving (or dimpling) under the skin may occur. Other complications such as infection and prominent scars are unusual. Your surgeon at the Aesthetic Day Surgery will discuss the side effects and any potential complications directly with you at your initial consultation.

What if I put on 20kg?
If you put on weight after liposuction you will get fatter, but globally. You won’t selectively re develop the contour that has been corrected by the liposuction. So if, say, you had saddle thighs corrected and put on a lot of weight, your legs will get fatter but usually the saddle area will get fatter pretty much in proportion to the rest of your leg and you won’t redevelop the saddle.

Can all Liposuction procedures be carried out at the Aesthetic Day Surgery?
Most suction lipectomy procedures may be performed as Day Cases at the Aesthetic Day Surgery. However, this will depend on the extent of the procedure, your general health and your surgeon’s advice. In appropriate instances, some suction lipectomy operations are performed by an Aesthetic Day Surgery surgeon at St. George Private Hospital.

Is a general anaesthetic necessary for this operation?
Depending on the extent of the procedure either a local, twilight or anaesthesia may be advised by your surgeon.

Note: liposuction is a surgical procedure that should be performed by an appropriately trained and experienced Plastic Surgeon in a fully accredited surgical operating theatre with a fully qualified anaesthetist, no matter what type of anaesthetic is used. This provides the safest environment possible for the procedure.

* Local anaesthesia can be used for very minor areas, usually ‘touch ups’ but should still be done in the sterile environment of an operating suite.

* Sedation and local anaesthetic can be used for more extensive areas but is really only appropriate if the sedation is administered and supervised by a specialist anaesthetist and the procedure performed in an operating suite.

* The typical patient is best managed with general anaesthetic due to the area that has to be infiltrated. Most patients find it a relief that they will wake up and it is all over. The general anaesthetic is usually very light and the patient breathes for themselves usually with a ‘laryngeal mask’ to keep their airway open. It is really a very heavy sedation. With a tumescent technique, a large volume of fluid and local anesthetic are infused which allow the anaesthetic to run light and this provides good pain relief after the operation.

Is there an advantage to me having it done under twilight sedation or local anaesthesia?
Twilight sedation and local anaesthetic have been pushed by some non Plastic Surgeons as almost a marketing tool, claiming it offers some intrinsic benefit to the patient. Many of those doctors have no recognised surgical qualifications and as such can not gain accreditation to a hospital or operating suite – they can only offer very limited facilities and anaesthetic. If your surgeon can’t do the procedure for you in a hospital or licensed accredited day surgery facility under a general anaesthetic then he most likely does not have specialist surgeon qualifications recognised in Australia.

What parts of the body are best suited to Liposuction?
Areas of contour defect that can be improved by liposuction include: the face (chin and neck), abdomen, waist, hips, thighs, buttocks, knees, ankles, arms and breasts, lateral breast/chest wall and breast enlargement in men. Better results are able to be obtained when fat deposits are localised.