Silhouette cosmetic surgery
Liposuction can permanently remove the localised excess fat (steatomery) which shows little or no fluctuation with weight change.
The principle of liposuction is to reduce the number of fat cells using suction tubes. Since the fat cells do not have the capacity to divide, the result is permanent. The remaining fat cells, however, have the ability to vary their volume in extreme weight change.
Several sites can be treated during the same operation, but the maximum amount of fat removed in one session should not exceed 5-10% of the overall weight of the patient to maintain the well-being of the body’s equilibrium.
Liposuction is not a treatment for obesity and should not lead to an unhealthy lifestyle. Either the procedure is performed under assisted local anesthesia (diazepine-induced analgesia) as an outpatient or, it is performed under general anesthesia with a hospital stay of 10 to 24 hours when the volume of fat removed is very high.
Gentle liposuction refers to a technique performed under local anesthesia using very fine suction tubes. The pressure used to suck the fat is gentle and is performed manually using syringes.
The duration of the procedure varies from 30 minutes to 3 hours depending on the number of areas treated and the amount of fat to be removed. Almost invisible scars (3-5 mm) are often hidden in the natural folds.
The quality of the overlying skin is an essential factor to evaluate. Good quality skin is skin that tightens perfectly in the weeks following liposuction. On the contrary, non-elastic skin with stretch-marks tightens badly and can form ripples. In the case of damaged skin, liposuction should be performed moderately and with caution, or be associated with a lifting.
Many areas can benefit from liposuction :
- the neck to correct a double chin (neck contouring) ;
- the face to improve facial contours ;
- the pectoral region in men
- the breasts : liposuction on the breast has the advantage of not causing scarring but this technique is primarily intended for breasts with little or no excess skin and excellent skin that will tighten around the new smaller volume. In practice , it is used in conjunction with other techniques or to address breast asymmetry of mild volume ;
- abdomen : during the examination the surgeon distinguishes the subcutaneous fat located in front of the abdominal muscles from the peri-visceral fat located behind the abdominal muscles. Only the subcutaneous fat can be sucked through liposuction. If the skin is loose, a tummy tuck can be given in addition to liposuction ;
- the back can be smoothed out and therefore some back folds and can disappear after liposuction ;
- the whole arm can be made thinner or the volume of the whole arm can be reduced. If there is significant excess skin, an additional arm lifting can be performed ;
- whole thighs can be slimmed down. If there is significant excess skin, an additional thigh lifting can be performed ;
- buttocks ;
- calves ;
- hips and love handle reduction : the skin is very tolerant and retracts very well ;
- the trochanter or " saddlebags "
- the insides of the knees ;
- ankles ;
- the pubis.
Once the operation is complete, a compression garment is placed over the dressing. It must be worn for 1 month to reduce swelling and pain, and to facilitate skin retraction.
Mild pain and fatigue can occur and depends on the amount of fat removed. Sometimes a daily anticoagulant therapy may be prescribed for 8 to 10 days to reduce the risk of developing complications.
Normal activity can be resumed 2-10 days after surgery depending on the type of employment. The patient may resume sporting activities after 3 weeks.
The result is generally very satisfactory, and is only visible only after 3 to 4 weeks, after the disappearance of swelling. It only becomes permanent after six months once the skin is retracted.
Risk of complications
As with any surgery, a number of complications can occur. But the likelihood of these complications is reduced in the hands of a qualified plastic surgeon and in the presence of a competent anesthetist. The patient’s compliance to instructions given by the surgeon is also essential and include :
- stopping smoking 1 month before and after the procedure (reduction of all risks) ;
- stopping the pill two months before and after the procedure (reducing the risk of phlebitis and pulmonary embolism) ;
- not taking aspirin for 10 days before and after the procedure (reduced risk of haematoma).
Fortunately, postoperative effects are generally manageable following a liposuction that has been carried out properly, so serious complications are rare.
In spite of the fact that complications are so rare you must be aware of the following problems :
- Haematomas are quite rare but can occur. They can be evacuated.
- Infection : this is extremely rare when the procedure is carried out in sterile environment.
- Seroma : lymph collection under the skin that can be evacuated and that will dry up rapidly without sequelae.
- Thrombo-embolic accidents (blood clots in the veins of the legs, pulmonary embolism) are rare and can be prevented by strict prophylactic measures (standing and walking as soon as possible after surgery, wearing compression stockings, or heparin therapy).
- Numbness of the skin may be observed. It is usually transient and most patients recover normal nipple feeling after 6 to 18 months.
In case of a complications, your surgeon will treat them successfully if necessary.
In practice, the vast majority of cases take place without any problem and the patients are satisfied with the result.
Health insurance coverage
Liposuction is not covered by health insurance, with the exception of specific cases of abdominal liposuction (Launois-Bensaude disease or lipodystrophy after anti-HIV treatment).
Author: Dr. Christophe Laveaux
Specialist in aesthetic surgery - Antibes
Reproductions, even partial, of the texts are allowed on the express condition cite the author (Dr. Christophe Laveaux) with a direct link to the article mentioned.