Liposuction
Liposuction is one of the most common cosmetic surgical procedures and is used to remove excess areas of discrete fat from the tummy area, hips, thighs, buttocks, upper arms breasts, and neck. It is often used in combination with other procedures, including breast reduction surgery, neck lift surgery and abdominoplasty (tummy tuck surgery). It is NOT a substitute to achieve weight-loss. Titus Adams usually favours liposuction as an adjunct to other surgical procedures – commonly during abdominoplasty surgery to help improve contouring of the body.
Mr Titus Adams performs several types of liposuction and lipofilling to get the best results for each patient:
- Dry liposuction
- Wet liposuction
- Superwet liposuction
- Tumescent liposuction
Mr Adams will discuss the best procedure for you during your consultation.
Types of liposuction techniques
Dry liposuction
This involves directly removing fat from under the skin without any infiltration of fluid. Unfortunately, this has been associated with significant bleeding/bruising, damage to the remaining fat, irregularities in contour and can cause significant discomfort. It is rarely employed nowadays.
Wet liposuction
Superwet liposuction
Tumescent liposuction
Liposuction is performed under local or general anaesthetic and depends on the extent of liposuction required and patient choice. The suction techniques involve the insertion of a fine metal cannula just under the skin, attached to suction apparatus via tubing. The quantities of both fat and infiltration fluid is carefully measured during the procedure and gives the surgeon a clear indication of successful treatment. This is termed suction-assisted liposuction (SAL). Sometimes the cannula is attached to a machine that provides fine movements of the cannula tip, which can help the surgeon in the removal of large quantities of fat. This is termed power-assisted liposuction (PAL). New developments of the cannula tip have employed ultrasound (UAL) and Laser (LAL) during liposuction procedures. However, there are reports of significant thermal (burn) injuries to the remaining fat and overlying skin, following the use of both UAL and LAL, which can cause fat and skin death (necrosis) and greater degrees of irregularities in body contouring. Mr Adams does not use UAL or LAL in his current practice on safety grounds.
Mr Adams routinely employs the technique of both liposuction and lipofilling in breast aesthetics and breast reconstruction, for example. This dual combination of removal (from unwanted areas using very small cannulae) and then filling to other sites of the body is termed liposculpture. Liposuction can also be used in combination with under-skin scar release in cases of “fat fracture”, during which tethered scars are divided within the fat to improve body contouring following significant soft tissue trauma.
Liposculpture
What You Need to Know
Patients are admitted on the day of surgery and checked by the nursing staff. The anaesthetist will see you, as a general anaesthetic is often required. Mr Adams will take photographs and consent will be obtained.
The details of the procedure will have been discussed. Small (usually 3-5mm) access holes are made in the skin to allow the cannulas to remove the fat. These holes are stitched with a single dissolving suture which falls out over tow weeks. Dressing pads are worn over these sites (under the pressure garments) and changed routinely for the first 48 hours until the fluid leakage stops. Liposuction alone does not require tubes or suction drains post-operatively.
There will be swelling and bruising in the hours and days following surgery. Bruising may last for up to 2-4 weeks. Your liposuction garment is fitted before waking up. This helps reduce swelling, and helps to support and contour your treated area. This will be required for 4-6 weeks, but can be removed for washing and showering etc. Baths should be avoided for 4 weeks. Patients who have major liposuction stay one night usually; others may go home the same day if safe to do so. Standard analgesia will be provided at discharge and should be taken regularly for up to 2 weeks. You should be expected to remain mobile as possible after your surgery. Two garments are often provided for you (one to wear and one to wash).
Patients return to the hospital at one week for routine checks and replacement of dressings as necessary. Patients are seen by Mr Adams at 6 weeks and 6 months in clinic; appointments are sent by email.
Bruising is not a complication but to be expected for up to 2-4 weeks following liposuction. As with all surgery complications can occur. In the initial stages, there is an extremely small risk of bleeding, which might manifest by greater than expected oozing or discomfort/pain in excess of what is normally expected. Infection is also largely uncommon as the wound sites are very small. If redness (with soreness) does occur around the liposuction holes, then antibiotics may be prescribed. Tiny scars will be noted, and these can remain red and occasionally lumpy for a few months after surgery. Rippling or dimpling irregularities can occur at the site of treatment, especially in those with loose or poor quality skin or where concurrent cellulite is noted. Large quantities of fat removal can result in small degrees of asymmetry in shape or volume. Many individuals have areas that are not symmetric to begin with, and this will be pointed out at the initial consultation. Swelling can be present for up to 4-6 weeks. Numbness of the skin can occur but settles spontaneously after a few months.
Venous thrombosis is a rare but recognised risk. This complication can be reduced significantly by adhering to the advice given pre-operatively. Keeping mobile, well hydrated and the use of leg stockings both during and after surgery, all help to lower this risk significantly.
