SURGICAL PROCEDURES - BODY SCULPTING

Liposuction

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Removal of subcutaneous fat to improve body shape.

Liposuction can help restore a more pleasing shape to specific areas of your body by removing unwanted fat. These areas include the abdomen, hips, buttocks, thighs, knees, calves, ankles, upper arms, chin, cheeks and neck. Essentially your surgeon inserts a hollow metal tube (or cannula) through an incision and the fat is removed by suction. The technique has been refined considerably in the last ten years and various improvements have been developed. These include ultrasound-assisted lipoplasty (UAL) and the 'tumescent' technique both of which offer today's patients more precise results and quicker recovery times. If you want to look fit and healthy there is no substitute for diet control and exercise, but liposuction can remove stubborn areas of fat that do not respond to the standard methods of losing weight.

What can and should be done in your case will depend on a Consultation with your surgeon. However, the following introductory paragraphs will, we hope, be helpful.

Liposuction

RIGHT FOR YOU?

You should be realistic in your expectations before deciding on liposuction. It can enhance your appearance and, therefore, your self confidence, but it will not necessarily achieve your ideal or change the way other people treat you.

The most suitable candidates for liposuction are average weight people with firm, elastic skin who have pockets of excess fat in specific areas. They should also be physically healthy and psychologically stable. Age is not a major consideration but older patients with less elastic skin should not expect the same results as younger patients with firmer bodies.

There is greater risk for individuals who have medical problems such as diabetes, significant heart or lung disease, poor circulation, or who have recently had surgery near the area to be contoured.

PLANNING

Your surgeon will evaluate your health, determine where your fat deposits lie and assess the condition of your skin. He will also recommend the body-contouring methods or combination of methods that will best answer your needs. Be frank about your expectations. Your surgeon should be equally frank, describing the procedures in detail and explaining their risks and limitations.

PREPARATION

Follow your surgeon's specific instructions, including guidelines on eating and drinking, smoking, and taking or avoiding vitamins, iron tablets and other medications. If you develop a cold or an infection of any kind, especially a skin infection, your surgery may have to be postponed. Be sure to arrange for someone to drive you home after the procedure and, if necessary, to help you out for a day or two.

WHERE?

Our surgeons perform liposuction in the operating theatre in the Hurlingham Clinic or in one of the London private hospitals where they serve as a Consultant. The length of the procedure depends on the volume of fat being removed and its location in the body. Many patients are able to go home on the day of the surgery; some remain in the hospital for one or two days.

ANAESTHESIA

If only a small amount of fat and a limited number of body sites are involved, liposuction can be performed under a local anaesthetic. To help you relax completely during the procedure, intravenous sedation may be added if you wish. For more extensive operations regional anaesthesia such as the epidural block used in childbirth can be a good choice. Again, if a large volume of fat is to be removed, a general anaesthestic may be best.

Liposuction traatment

WHAT HAPPENS?

Your surgeon will describe the various liposuction techniques available and recommend the most suitable one for you (see also Ultrasound Assisted Liposuction and Tumescent Liposuction).

In all liposuction, local deposits of fat are removed to recontour one or more areas of the body. Through a tiny incision, a narrow tube or cannula is inserted and used to suction away the fat layer that lies deep beneath the skin. Suction is provided by a vacuum pump. The incision sites will be carefuly chosen so that scarring is as inconspicuous as possible. Naturally fluid is lost along with the fat. To prevent shock, therefore, patients are carefully monitored and given intravenous fluids during and immediately after surgery.

SOME RISK

Liposuction is normally safe as long as your health is good, the operating theatre is properly equipped and your surgeon has adequate training and experience. Advanced surgical skills are essential for the safe removal of large amounts of fat. Ask your doctor about previous successes he has had using the procedure you are contemplating. More extensive liposuction procedures also require particularly attentive after-care, so find out how your surgeon will monitor your condition closely after the operation.

Keep in mind, however, that, even with an excellent surgeon and a state-of-the art operating theatre, there are no guarantees. Though rare, complications can and do occur. Risks increase if a number of areas are treated at the same time, or if the site of the operation is large and the procedures relatively long. Factors such as these can combine to increase the possibility of: infection; extended healing times; the formation of fat clots or blood clots which may migrate to the lungs and even cause death; excessive fluid loss which can lead to shock; excess fluid accumulation that must be drained; friction burns or other damage to the skin or nerves; perforation injuries to vital organs; or unfavourable drug reactions.

Scars from liposuction are small and surgeons place them where they will not attract attention. However, imperfections in final appearance are not uncommon - the skin surface may be irregular, asymmetric or even a little 'baggy', especially in older patients. Numbness and pigmentation changes can occur. Sometimes, additional surgery may be recommended.

With the newer techniques there are also some additional risks. When UAL is used, the heat from the ultrasound device may cause injury to the skin or deeper tissues. Again, with the tumescent technique, the anaesthetic fluid that is injected can cause lidocaine toxicity if the solution's lidocaine content is too high. Fluid can also collect in the lungs if too much fluid is administered to the liposuction site. Again, a surgeon's skill and experience are key in minimizing your risks.

Hurlingham Clinic Liposuction

AFTER SURGERY

It is normal for some fluid to drain from the incisions. You may be fitted with a snug elastic garment to wear over the treated area for a few weeks to control swelling and to help your skin take on its new contours. Do not expect to look or feel wonderful immediately. The newer techniques have reduced post-operative discomfort but you may still experience some pain, burning, swelling, bleeding or temporary numbness. Normally any pain can be controlled by medications that your surgeon will prescribe. However, you may still feel stiff and sore for a few days. Again it is quite normal to feel a bit anxious or depressed in the days or weeks following surgery. This feeling will subside as you begin to look and feel better.

RECOVERY

Healing takes time and patience will be required. Your surgeon will probably urge you to walk around as soon as possible to reduce swelling and to help prevent any blood clots that may form in your legs. You should be able to return to work within a few days and you will begin to feel better after a week or two. The stitches will dissolve on their own after 7 to 10 days.

Strenuous activity should be avoided for about a month. Although most of the bruising and swelling usually disappears within three weeks, some may remain for six months or more. Your surgeon will schedule follow-up visits to monitor your progress and to assess whether any additional procedures are needed. He may recommend a course of Endermologie to speed the recovery process. If you have any unusual symptoms between visits, such as heavy bleeding or a sudden increase in pain, or you wish to ask any questions about what you can and cannot do, always check with your surgeon.

HAPPY?

Your body shape will be noticeably different quite soon after surgery, and the improvement will become even more apparent after about four to six weeks when most of the swelling will have subsided. After about three months, any persistent mild swelling will usually have disappeared and the final contour will be visible.

If your expectations were realistic in the first place, you will probably be very pleased with the results. Most people are. You may find that you are more comfortable in a wider variety of clothes, and generally feel more at ease with your body. By eating a healthy diet and taking regular exercise you can help to maintain your new shape.