Surgical Procedures - Body Sculpting

Ultrasound-Assisted Liposuction (UAL)

Removal of subcutaneous fat to improve body shape where fat is first liquefied using sound waves.

Ultrasound-assisted liposuction (UAL), is a relatively new liposuction technique that uses sound waves to reduce unwanted fat to a liquid for removal. Although not a substitute for traditional liposuction, UAL can effectively remove fat from fibrous body areas, such as the breasts or the back, and is useful for removing larger volumes of fat in a single procedure. Often, traditional liposuction is performed at the same time as UAL to help shape UAL-treated areas or to treat areas of the body not suited for UAL, such as the neck and inner thighs. 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.

RIGHT FOR YOU?

Before you decide to have any form of plastic surgery think carefully about your expectations and discuss them with your surgeon. Liposuction can enhance your appearance and so affect your self confidence, but it may not match your ideal or cause other people to treat you differently. It cannot make you young again. The best candidates for UAL are normal-weight people with firm, elastic skin who, nonetheless, have pockets of excess fat in particular areas. You should be physically healthy, psychologically stable and realistic in your expectations. Older patients may have diminished skin elasticity and so results may not be as good as those younger patients enjoy.

SOME RISK

Since 1991, UAL has been performed on thousands of patients worldwide. So far, clinical investigators have reported excellent results from the technique. UAL is extremely safe when patients are carefully selected, the operating facility is properly equipped and the doctor has completed an appropriate, hands-on UAL training course. Check with your surgeon.

Serious medical problems are infrequent. However, possible complications include clots that block blood flow, infection, excessive fluid loss leading to shock, excessive fluid accumulation requiring drainage, skin injury, perforation injury to the skin or other organs and adverse reactions to anaesthesia. Some burning caused by the heat from the ultrasound device is also one potential but uncommon complication specific to the UAL technique. Temporary collections of fluid beneath the skin surface (seromas) can also occur with this procedure.

Complications from all types of liposuction include: irregularities of the skin's surface, areas of uneven colouration, and asymmetry. Additional surgery can treat some of these cosmetic problems.

PLANNING

Your surgeon will evaluate your health, determine where your fat deposits lie and assess the condition of your skin. Together you can then agree on the body contouring techniques that will be best for you. Be frank, particularly when agreeing your expectations. Be sure to tell your surgeon about significant weight losses or gains in your history. Tell your surgeon if you smoke and if you are taking any medications, vitamins or other drugs.

PREPARATION

It's important you follow your surgeon's instructions. They may cover eating, drinking, smoking, and taking or avoiding certain vitamins and medications. If you are a smoker, it's especially important that you stop at least two weeks before and after surgery; smoking inhibits blood flow to the skin, and can interfere with the healing. If you develop a cold or an infection of any kind, particularly a skin infection, your procedure may have to be postponed. Even if you are only an outpatient arrange for someone to drive you home after your surgery, and to help you out for a day or two afterwards.

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. 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 is being removed local anaesthesia, combined with a sedative to make you drowsy, should be fine. You will be awake but relaxed and feel only minimal discomfort. Some surgeons prefer to use an epidural block as commonly used in childbirth. A general anaesthetic may be also used if you prefer it, or if your doctor so advises. You then simply sleep through the procedure.

WHAT HAPPENS?

UAL generally takes a little longer than traditional liposuction because of the extra 'fat-liquefying' procedure. First salt water containing a local anesthetic and adrenalin is injected. Then, through a small incision, a metal cannula connected to an ultrasound generator is inserted beneath the skin. The ultrasonic energy causes the walls of the fat cells to break down. The liquefied fat combines with the injected fluid to create an emulsion, which is sucked from the body. If awake, you may feel some warmth and vibration. You will probably be given some fluid through an intravenous tube to keep your overall fluid level in balance. Only a small amount of blood is lost during UAL which means less bruising, less pain, and usually a quicker recovery.

AFTER SURGERY

Some fluid may drain from the incisions for a few days. This is normal. You may also be given a snug-fitting elastic bandage or compression garment to wear over the treated area to help control swelling. This is typically worn for up to four weeks to help your skin shrink to fit its new shape. Side-effects such as discomfort, burning, swelling, bleeding and temporary numbness may be expected but these can all be controlled by prescription medications. Naturally you may feel stiff and sore for a few days. A feeling of depression is also normal in the days or weeks following surgery. This will subside as you begin to look and feel better.

Recovery

Healing will take less time if you follow your surgeon's advice. Your surgeon may recommend a post-op course of Endermologie to speed healing. Start walking around as soon as possible. You will begin to feel better after about a week. All stitches are naturally dissolving so none need be removed. You should be back to work within two weeks. Activity that is more strenuous, however, should be avoided for about three weeks as your body continues to heal. Although most of the bruising and swelling usually goes within six weeks, the last little bit may remain for six months or longer. Your surgeon will schedule follow-up visits to monitor your progress carefully.

HAPPY?

The change in your body shape will be visible quite soon after surgery. But, provided your expectations were realistic, you should be most pleased after about six weeks, when the swelling has subsided. You should find that you are more at ease with your body, and comfortable in a wider variety of clothes. Now simply eat a healthy diet and take regular exercise to maintain your new shape permanently.