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Dr Jagdish M jyoti - Cosmetic Surgeon,Apollo Hospitals, Hyderabad, India.

Liposuction


Q. What is Liposuction?

Ans : Liposuction also known as lipoplasty or liposculpture is the surgical removal of adipose tissue by the use of small metal cannulas.

Q. What are the indications for liposuction?

Ans : Liposuction works best for treating localised fat deposits that do not respond to traditional diet and exercise. The treated areas will retain the new contours . Large volume of fat removal will also help reduce weight of the person.

Q. If the fat is removed, will it return?

Ans : The body produces fat cells during three different periods: in utero, early childhood and early adolescence. In general, after reaching maturity the total number of fat cells in the body will not increase. Fat cells that are removed through liposuction or other techniques will not be replaced by other fat cells. So the resultant loss of fat & weight loss cells will be permanent.

Q. What are the most common outcome of liposuction?

Ans : The most common sequelae include contour irregularities, paraesthesias, oedema, ecchymosis & discoloration, which occur routinely in almost all patients who undergo liposuction. However, they resolve spontaneously or with minimal treatment such as massage & Pressure garment.

Q. How much fat can be removed?

Ans : Whatever extra subcutaneous fat is there can be removed in a single sitting from different parts of body (5-8% of the body weight).

Q. What is the postoperative care required?

Ans : No special care is required but one has to wear pressure garments for at least 3-6 months.

Q. What is "tumescent solution"? Why do we use it?

Ans : Tumescent Solution (Wetting solution) is infiltrated into the subcutaneous fat before Liposuction. It has two advantages: an anaesthetic effect secondary to the use of lidocaine and a haemostatic effect due to use of epinephrine.

Q. Does the excessive skin need to be resected after removal of fat by liposuction?

Ans : In general, despite large amounts of fat being removed, skin has good elasticity and will reconfirm to the new underlying volume. However, in patients with inelastic skin or in older patients the skin may not redrape and skin resection may be needed.

Q. What is the difference between ultrasound assisted liposuction and traditional liposuction?

Ans : Traditional liposuction removes fat cells through the mechanical avulsion of fat. Ultrasound assisted liposuction (UAL) uses an ultrasound generator and hand piece to produce USG energy to destroy fat cells in vivo through a process known as cavitation. The emulsified fat is then removed through a hollow channel in the cannula using standard suction.

Q. When will the results be apparent?

Ans : The results of liposuction are usually seen after 3 weeks to 3 months and improvement continues even later.

Q. What parts of body can be treated by Liposuction?

Ans : Commonly treated areas are

  1. Cheeks, jowls and neck
  2. Upper arms
  3. Breast or chest areas
  4. Back
  5. Abdomen and waist
  6. Hips and buttocks
  7. Inner and outer thighs
  8. Inner knee
  9. Calves and ankles

Q. How many areas of body can be treated simultaneously?

Ans : Two or three areas can be combined safely provided the overall fat to be removed does not exceed the safe limits. Combining more areas proportionately increases the surgery time and overall recovery time. If the person is more than 8 kilos overweight it makes sense to concentrate on one or two areas like abdomen and thighs for example, rather than removing little from many areas.

Q. What is the safe upper limit for fat removal by liposuction in one sitting?

Ans : ASAPS (American Society of Aesthetic Plastic Surgeons) and several other world authorities recommend fat removal equivalent to 5-8 percent of body weight as 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 qualified person in a hospital with good anesthetic and ICU facilities. In absence of the abovementioned, even smaller liposuction can be risky.

Q. Any scars after liposuction surgery?

Ans : The small 3-4 mm cuts used for liposuction are made in hidden areas. Therefore scars are not a big concern. Spot like marks lighten with time.

Q. What are the risks involved in liposuction surgery?

Ans : Fat is superficial and liposuction is relatively safe surgery. Bleeding, infection and reactions to anaesthesia are some risks common to all surgeries. Uncommonly there can be asymmetry, depressions, waviness, pigmentation prolonged numbness after surgery. You can help to lessen certain risks by following the advice and instructions of your plastic surgeon, both before and after surgery.

Q. what is safe liposuction?

Ans :

Amount of fat Removed Fat removed less than 10% of body weight in a single sitting is considered safe.
Person’s Health In people with diabetes/hypertension and other risk factors more precautions are required.
Training of Surgeon Qualified plastic surgeon trained in liposuction is recommended.
Hospital Facilities Complete monitoring is recommended. Larger the liposuction more the facilities needed, including ICU facility in the hospital.

Q. How do I look after liposuction?

Ans : If you had any bulges showing through your clothes they flatten and your body looks streamlined. You can get a flat abdomen if your abdominal muscles are strong. You will loose inches at the liposuctioned part, and the rest of the body will remain the same. You also loose weight equivalent to or less than the amount of fat liposuctioned.

Q. What is ultrasonic liposuction?

Ans : Ultrasonic liposuction cannula emits ultrasound waves. Which helps in breaking down the fat. Currently this equipment is out of vogue because of increased complications reported with its use.

Q. What are the chances of fat reaccumalation after liposuction?

Ans : Liposuction breaks the fatty tissue mechanically, which is taken out of the body and discarded. It will not come back if you maintain a healthy lifestyle.