The best candidates for liposuction are people of relatively normal weight and with elastic skin, who have pockets of excess fat in certain areas. The patient should be physically healthy, and have realistic expectations. They are at or just slightly over their ideal weight, and feel that they can maintain this weight following surgery. Individuals who have lots of loose skin (for instance, after significant weight loss) may be better candidates for ‘body contouring’ surgeries, such as tummy tucks or body lifts, that remove loose skin as well as excess fat.
Liposuction is beneficial in overweight diabetic patients also wherein excessive weight gain poses a greater demand for insulin and thus deteriorating the physical condition of the patient.
Liposuction is a popular surgical procedure to remove unwanted excess fat. It is one of the commonest cosmetic surgery procedures performed nowadays. Liposuction is not a substitute for dieting and exercise, but it can remove stubborn areas of fat that do not respond to traditional weight loss methods. Liposuction is particularly well-suited for men and women who are of relatively normal weight or a little overweight but have isolated pockets of fat that cause certain areas of their body to appear disproportionate. The best results from liposuction are achieved when you have healthy elastic skin with the capacity to shrink. When skin is inelastic as in some older patients or after massive weight loss an additional skin tightening procedure such as tummy tuck, thigh lift, buttock lift, or arm lift may be required. Generally, eight to ten liters of fat can be reduced by liposuction. The procedure is done under local or general anesthesia and you may need to be hospitalized for a day.
Anesthesia for liposuction
Your surgeon will select the type of anesthesia that is most suitable and safe for your surgery. If only a small amount of fat and a limited number of body sites are involved, liposuction may be performed under local anesthesia. General anesthesia is a good choice for more extensive procedures. In such cases, the anesthetist makes sure you are completely asleep and pain-free during the procedure.
Dr. Goyal will evaluate your health, determine where your fat deposits lie, and assess the condition of your skin and he will explain the body-contouring methods that may be most appropriate for you. For example, if you believe you want liposuction in the abdominal area, you may learn that an abdominoplasty or “tummy tuck” may more effectively meet your goals; or that a combination of traditional liposuction and UAL would be the best choice for you.
Be frank in discussing your expectations with Dr. Goyal.
The time required to perform liposuction varies considerably, depending on the size of the area treated, the amount of fat being removed, the type of anesthesia used, and the liposuction techniques which are selected. A small area, such as the chin/neck, may be treated in less than 30 minutes, while a more extensive procedure might take several hours. Liposuction is performed through small, inconspicuous incisions using a negative pressure of nearly minus one atmosphere. During the procedure, a medicated fluid (termed ‘Tumescent solution or wetting solution’) is first injected into the treatment areas. This fluid is a mixture of intravenous salt solution, lidocaine (a local anesthetic), and epinephrine (a drug that constricts blood vessels). This fluid allows for easy removal of fat, reduces blood loss, and assists in pain relief both during and after surgery. Next, a small incision (3-4 mm) is made, and a hollow tube is inserted under the skin. This tube or ‘cannula’ is moved to and fro through the fat layer, breaking up the fat cells and suctioning them out. Once the desired contour is obtained, a compressive garment is placed; this helps to minimize bruising and assists in patient comfort.
Techniques used in liposuction
While the basic technique of liposuction, as described above, is used in all patients undergoing this procedure, there are a variety of other techniques like Power assisted (PAL), VASER, LASER, or Water Jet. PAL is the number one surgical procedure worldwide owing to its various advantages namely that it can be performed even under local anesthesia.
Power-assisted Liposuction (PAL)
This technique uses an electric motor to rapidly vibrate the hollow cannula used for suctioning. This vibration breaks up fatty tissue, allowing for a more effective removal of fat in a shorter time. This technique is particularly well-suited for the treatment of body areas where the fat is ‘fibrous’ (tough to suction); these include the upper back and breasts in males. PAL is also useful for the treatment of fatty areas where there is scarring from prior liposuction, and for more extensive liposuction surgeries, as it diminishes operating time and surgeon fatigue.
You can walk and have normal dinner on the same evening and can be discharged the very next day. You may need some assistance initially. Compression garments are typically worn for 6-8 weeks after surgery, to control swelling and to assist in shaping the body. While pain is usually mild, the patient will experience some discomfort and temporary numbness. These subside with time. Sutures, if used, are removed or dissolved on their own within the first week. It is better to take leave from work for 2-3 days and avoid exertion and heavy work for a week at least.
There is no inch loss in the first 2-3 weeks. The results of liposuction are usually seen after 2-4 months and improvement continuous even later. You should wait for at least 3 months to buy new outfits. The small incisions used for access to the instrument will fade over several months usually becoming barely visible. The results of liposuction surgery are technically permanent because the fat cells have been removed. However, your body shape and contours might be affected by weight gain, aging, pregnancy, family genetics, and lifestyle factors. It is crucial to maintain healthy habits and a stable weight to prolong the results of liposuction.
As judged by current worldwide experience, liposuction is a safe surgery. Bleeding, infections, and reaction to anesthesia are some risks common to all surgeries. Uncommonly there can be skin ulcerations, asymmetry, depression, waviness, and prolonged numbness after surgery. The safety of the procedure depends on the amount of fat removed, the person’s general health, the surgeon’s training, and experience.
The most frequently treated areas are the abdomen and waist, hips, thighs, upper arms, breast and chest areas, knees, calves, ankles, cheeks, jowls, and neck. Two or three areas can be safely combined provided it does not exceed the safe limits.
ASAPS (American Society of Aesthetic Plastic Surgeons) and several other world authorities recommend fat removal equivalent to 5-8 percent of body weight as the upper limit. That means 5 kgs can be safely removed from a 60 kilos person and 8 kilos from a 100 kilos person.
Liposuction of 500 ml or more fat is a major surgical procedure and is safe when done by a qualified person in a hospital with good anesthetic and ICU facilities. In absence of the above-mentioned, even smaller liposuction can be risky.
Yes, this procedure is called fat grafting or fat transfer. Fat Transfer takes your unwanted body fat via liposuction and transfers it to areas of the body where volume is needed. It is the procedure where excess fat is removed from areas such as the abdomen, flanks, hips, or thighs and, after special preparation, injected into areas of the body that need filling. The usual indications of fat grafting are: Sunken & hollow appearance around the eye, filling of sunken cheek, augmented smaller breasts, augmenting any depressed area of the body due to trauma, injections, or abscess.