Fatty Tissue Removal (Liposuction)
Who would benefit from this procedure?
Liposuction is a technique used to remove fatty tissue under the skin. It is most effective when people are at a stable weight and have stubborn areas that do not change with weight loss or exercise. Some areas are more effectively treated than others and a full assessment will help decide if liposuction will be effective in the area that concerns you. However liposuction can be used throughout the body.
If you have loose skin or stretch marks then liposuction may not be the best approach as there is a higher risk of ending up with more loose skin.
Liposuction is a technique that can be used in conjunction with other procedures. You should be clear on the benefits of this joint approach and the extra recovery time that may be associated with it.
How is it done?
There are many techniques used for liposuction but generally suction assisted liposuction (the most common form of liposuction) is effective and reliable. There are variations on the technique which involve varying amounts of fluid being injected into the area to be treated to help reduce blood loss and pain. Mr Dheansa most commonly uses the 'wet' or 'superwet' technique of suction assisted liposuction.
Other techniques include ultrasound assisted liposuction, radio-frequency assisted liposuction and LASER assisted liposuction. These techniques do not appear to have any significant advantages over more traditional techniques at the moment.
All techniques require a compression garment to be used afterward to help reduce swelling and stretching of the skin. This is useful to help prevent loose skin developing after liposuction. The garment is often worn for a month.
For most cases a general anaesthetic (you are asleep) is used but in selected cases a local anaesthetic (only the treatment area is made
numb) could be effective. This is something that Mr Dheansa will discuss with you before committing to surgery.
You will normally be admitted to the hospital on the day of surgery. You will be seen by your anaesthetist and you will have an opportunity to discuss your anaesthetic with him/her. Mr Dheansa will review you before your operation and go over the procedure again. He will mark the areas to be treated and go over with you the aims of the surgery. If you have any last minute questions please make sure that you ask them at this stage.
What happens before surgery?
You should have had a full discussion about the procedure, its suitability, outcomes, complications and long-term effects with Mr Dheansa. You should be clear about the incisions to be used, the area(s) to be treated, length of stay and the costs of the procedure. Knowledge of your general health will allow assessment of fitness for an anaesthetic. If you are unclear about any aspect of your care or the procedure itself you must contact Mr Dheansa (contact details below) to clarify the situation before committing to surgery.
The operation
Once fully anaesthetised the treatment area is injected with a weak adrenaline solution containing local anaesthetic. This helps reduce bleeding and pain during liposuction. Mr Dheansa will then make small incisions through which to perform the liposuction. The amount of fatty tissue removed depends on several factors including the size of the area, the amount of change desired, skin quality, previous scarring and response of the tissues during liposuction. Once adequate tissue has been removed the incisions are closed with dissolving sutures underneath the skin and a shower resistant dressing applied.
After the operation you will be looked after in the recovery area until you are awake enough to go back to the ward. You will have a compression garment on the treated area and small dressings over the incisions used for the liposuction. You may be sore at this point and the nursing staff will ensure you get enough painkillers to make you comfortable.
After the Surgery
What happens after the surgery?
If you have your surgery performed as a day case you will be reviewed by Mr Dheansa after your operation to check all is well before being discharged. If the surgery requires an overnight stay you will have regular checks by the nursing staff and be reviewed by Mr Dheansa the following morning before discharge.
You will be given appropriate painkillers which you should take regularly according to the directions given. Arrangements will be made for a review in the outpatient clinic before you go home – usually for about 2 weeks after the operation. Please ensure that there is someone to look after you at home for the first few days. You may find it harder to do many things and may feel quite tired and sore.
What should I expect post-op?
Liposuction is technique that is especially useful for changing the profile of an area to improve its appearance. Its effects may be more noticeable in clothing rather than without. It may not significantly alter a person’s clothing size but clothes may fit better after treatment.
Everybody is different and individual patients vary in their recovery time. You should expect to feel bruised, sore and swollen for the first week or so. This will gradually improve. The treated area will go through many changes before you arrive at your final result. This process may take between 3 – 6 months and is a gradual process.
What can I do and not do at home?
You should avoid driving for approximately 1-2 weeks according to the areas treated. Equally you should avoid strenuous activity/sport/fitness for a similar period. Mr Dheansa will advise you on the specifics relating to your case before you go home. Taking adequate rest at this stage is essential.
You must wear your compression garment all the time (except when showering!) to help reduce the swelling and keep the skin firmly compressed.
Although you may shower it's best to avoid getting your wounds too wet for the first 48 hours. After this time they may get wet but it is best not to let the wounds soak in water for too long. You should avoid baths or swimming until you see Mr Dheansa in the outpatient clinic.
At your clinic appointment Mr Dheansa will advise you on further management and what to expect over the ensuing weeks.
Will my scars change?
All scars go through a maturing process and go through a series of changes before settling down. This process varies from person to person as well as from site to site on the same person. Generally once a wound has healed the scar will be a thin pale line. Over the ensuing 6-12 weeks the scar may become raised, pink and wider. It often becomes itchy too. It then stabilises before slowly becoming flatter, paler and less itchy. This can take up to a further 12 months. Even after this time scars continue to improve but at a much slower rate.
Avoid sunlight on the scar for the first year to avoid it getting burnt and then subsequently dark. It is very hard to make it pale again. Mr Dheansa will advise you of any further precautions or actions if required.
Things to Consider
It is important to be prepared before and after your surgery. Here are a few things to consider about this operation.
Abnormal Scars
Sometimes even if all heals well a patient may develop abnormal scars (pink, wide, raised and itchy). Patients may already have noticed such a tendency from previous scars. Such scars take a very long time to settle (up to 18 months) and may be difficult to treat.
Asymmetry
It is rare for any individual to be exactly the same on both sides and although surgery is intended to achieve symmetry it is impossible to guarantee. The final result from liposuction may be different on one side when compared to the other.
Over Correction/Under Correction
All patients have expectations of how the final result will look and the amount of liposuction to be performed will be discussed before any surgery. However sometimes the final result may appear too hollow (overcorrection) or still have some residual fullness (under correction). Liposuction is not an exact science and individual patient variation can have an effect on the final outcome.
Numbness
The treated area will lose sensation (feeling) after the operation and it will take several weeks for it to return. Some areas may remain numb.
Bruising and Swelling
Some patients may experience some bruising. This often results in increased swelling and some tenderness. The skin may become discoloured and take a few weeks to settle down.
Pain
This is usually easily controlled with painkillers and again often resolves within a week or so.
Skin Irregularity
Liposuction can sometimes result in an irregular surface to the skin which patients may be able to feel or to see. There may be some lumpiness in the treated area which may be permanent.
Change in Contour
Liposuction is sometimes unpredictable. It means the area may not end up smooth. There may be dips or irregularities which may be permanent.
DVT/PE/Chest Infection
Clots in the leg (DVT), lungs (PE) or chest infection are uncommon with this operation.
Weight Gain
If a patient gains weight after liposuction the distribution of fat may differ from their pre-operative pattern. This is because it is less likely for the treated area to lay down fat. This may mean that areas previously unlikely to change after weight gain may do so post – treatment. To avoid this situation it is important to maintain weight at a steady level.
Changes in weight may also have an adverse effect on the skin. This may gradually lose its elasticity and become lax resulting in loose skin.
Are there any potential risks?
There are potential risks and complications with any operation and it is important to be aware of them before committing to any surgery. You may also have particular circumstances that affect the final outcome and these will be discussed with you at your consultation.
Anaesthetic
You will be assessed for fitness for anaesthetic and providing this is appropriate the risks from general anaesthetic are low. Anaesthetic can sometimes cause a reaction though this is very rare.
Bleeding
Rarely there may be significant bleeding under the skin that does not settle. Should this occur you may have to return to theatre to control the bleeding. This should not have any long term effect should it occur.
Wound Infection
Wounds can very occasionally get infected. If you notice increasing redness, pain or an offensive odour from the wound, contact Mr Dheansa as soon as possible. If this should occur you will need to have antibiotics and frequent dressings. The wound may take longer to heal and the resulting scar may be less than perfect.
Skin Laxity
The skin over the treated area often takes weeks or months to gain its new shape. This is helped by the compression garment but in some cases it does not fully retract resulting in skin laxity. This is dependent on a patient’s skin quality and the amount of liposuction performed. Skin laxity is difficult to treat and one option may be to consider surgical excision of the excess skin. However this results in a long scar that may not be cosmetically acceptable. In some cases it may be appropriate to limit the amount of liposuction performed to reduce the risk of skin laxity.
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Frequently Asked Questions
How long is the operation?
Check with Mr. Dheansa
When can I shower?
SEE 'What can I do and not do at home?' section above.
How long should I keep taking pain killers?
For at least 1 week and then as required.
When can I go to the gym?
You should avoid the gym until about 4 weeks after the operation but check with Mr Dheansa first.
How long until the final result?
It takes about 3 months for you to settle.
When can I fly?
Generally it is ok to fly 2-3 weeks after the surgery but this depends of length of flight and your recovery. Check with Mr Dheansa before flying.
