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Liposuction is the process where fat is removed from beneath the skin in order to improve body contour and appearance. It is not designed to offer weight loss. The term "liposculpture" means exactly the same as liposuction, and has only been coined as a marketing tool by some companies!

Liposuction is performed under general anaesthetic, and is a straight forward operation, the length of which is determined by how much fat is to be removed and how many sites of the body are being dealt with. The commonest sites treated are the abdomen, hips and flanks, and inner thighs. Other sites include buttocks, arms and knees. The area under the chin is also an area which often responds well to liposuction.

Liposuction simply removes the fat between the skin and the underlying structures. Patients with young tight skin tend to get the best results as their skin is able to take up the slack and tighten itself over a number of weeks. More mature skin, with loss of its elasticity, gives more modest results, although older patients can do very well with liposuction.

Many patients ask whether the liposuction is permanent or whether the removed fat will return. The process of liposuction removes the fat cells and these do not return. However, it is impossible and in fact undesirable to remove all of the fat cells and the remaining ones can accumulate further fat in the normal process of weight gain if exercise and optimum nutritional habits are not maintained.

Before the operation

There is nothing special or complicated to be done by the patient. If you are on the oral contraceptive pill you should continue to keep taking it, and inform the surgeon or anaesthetist in the hospital. If you smoke it would be a good idea to try to stop for a month before and two weeks after as this will improve wound healing and your post-operative recovery. It would be advisable to stop any herbal medicines and avoid aspirin or ibuprofen-like drugs for 2 weeks before the operation.

The surgery

You will come into the hospital on the morning of surgery. The operation is performed under general anaesthetic and takes between one and four hours depending on how much liposuction is being performed. When you wake up you will have a tight dressing over the treated area or be wearing a custom fitted garment.

Post-operative follow-up and after care.

You are advised to stay in hospital overnight. All being well, you will be discharged the following day with antibiotics and painkillers. It is import to leave the dressing alone and wear the pressure garment 24 hours a day. You may notice that the area treated is swollen and bruised. This is normal and usually improves by 48hours and is gone by 10 days. It is important to remember that the final result of the liposuction is best viewed at 3 months after the surgery. At between 5 and 7 days you will be seen in the clinic and the dressings removed and the wounds checked.

It is important to rest and take it very easy for at least 2 weeks after the operation. Depending on how much liposuction has been performed, you will be advised to take 5 days to 2 weeks off work and it is essential to avoid all strenuous activity during this period. The pressure garment needs to be worn day and night for a month to give the best result possible, and failure to wear it without doubt diminishes the final appearance. Vigorous sport such as jogging or the gym should be avoided for 6 weeks. A check up clinic appointment at 3 months after the surgery will be arranged for you.

Possible complications

All operations carry a risk of complications, although in liposuction these are fortunately low. There will be small scars made where the liposuction cannula is inserted under the skin, however they often become completely unnoticeable with time. Occasionally, scars may be red and lumpy for a few months but they usually settle down by themselves without any treatment.

The risk of infection and significant bleeding are between 1 and 2 % and precautions are taken to avoid this with antibiotics and careful operative technique. Many patients will notice that there is bruising and swelling of the affected area, the amount of which varies between individuals. Most bruising resolves spontaneously at 2 weeks.

There is a very small risk of damaging structures under the skin with the liposuction cannula, for example, if you have a small abdominal hernia the bowel can be injured during abdominal liposuction. This is an extremely rare event, and great care is taken to identify this risk during the preoperative examination and at the time of surgery through careful operative technique.

Unevenness or lumpy areas can be a problem and are most often related to failure of the patient to wear the garment after surgery as prescribed. Any minor irregularities that persist beyond 6 months and may easily be addressed by further liposuction or fat grafting.

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