AM I A GOOD CANDIDATE FOR LIPOSUCTION?
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 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. In
most cases you will be allowed to go home the same day or
the fullowingbut, 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 and wear a supportive corset or pressure
bandages around the treated areas. It is advisable to wear
these for a few weeks following the treatment although it
is permissible to remove them for washing. You will also be
given instructions about looking after the wounds and having
stitches removed.
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.
- If 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 are 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?
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. Patients would usually be fit to fly after one week.
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