What Is Liposuction?


Almost everyone has areas of fat on their body they just can’t seem to shift. Whether it is your thighs, your love handles or your tummy that is causing your confidence to crash, liposuction (also known as lipoplasty, liposculpture, or lipectomy) can help. Contrary to popular belief, liposuction is not a quick-fix weight loss treatment, it is designed to contour and improve the shape of your body and is best suited to people who are a healthy weight but have stubborn areas of fat they can’t get rid of with diet and exercise alone. Traditional surgical liposuction is done under general anesthetic and involves a lengthy recovery period, however there are now new forms of liposuction, such as liposculpture, which can be done under local anaesthetic and involve less down time. As a non-surgical alternative, some candidates may be suitable for laser lipolysis, a less invasive treatment that is also done under local anesthetic.

The ideal liposuction candidate is someone who is a stable, healthy weight who has pockets of stubborn unwanted fat which cannot be removed with diet and exercise. The best candidates also have good skin elasticity as the skin fits easier to the reduced contour (younger people may get better results for this reason) and good overall physical and mental health. Liposuction is not a quick fix or a solution to excessive weight gain, so you need to have realistic expectations. Liposuction will not help you achieve significant weight loss and is not actually suited to people who are massively overweight or obese. Fat itself does not weigh much so even if a litre of fat is removed during liposuction it may only result in 1kg of weight loss. Liposuction can also not get rid of cellulite or help with saggy or stretch-marked skin.

Liposuction is a very effective way of removing small, targeted pockets of fat to improve the shape and contour of your body.

People who are not suitable for liposuction include:

  • Pregnant or lactating women
  • People suffering from certain medical conditions such as diabetes

If you are having traditional liposuction (under general anesthetic) and you are a smoker, you will be asked to stop at least two months before the procedure, as smoking causes increased risk of complications and can also delay the healing process.

Having a thorough consultation with a qualified surgeon is the only way to discover if the procedure is suitable for you. As with any cosmetic surgery procedure it is important to do your research so that you have a good knowledge of the risks and benefits associated with the procedure. Consult with a surgeon to find out more about whether you are a good candidate for liposuction.

Improved Health and Well-Being

Weight loss is the best way to reduce your risk of heart disease, diabetes and certain types of cancers. Even though liposuction cannot be used to remove large quantities of fat. Liposuction can help by reducing small stubborn areas that have been resistant to dieting and exercise. Liposuction is also sometimes used for breast reduction (in men and women), which can help with both physical and emotional problems such as back and neck pain, headaches and migraines and low self-esteem.

Improved Appearance

Body contouring can dramatically change the way you feel about your appearance. Liposuction can remove stubborn areas of fat that had been resistant to dieting and exercise thus improving a person’s overall appearance. Although liposuction is not a weight loss procedure you will look slimmer because of the dramatic body re-contouring. Clothes will also fit better in certain areas.

Cellulite Reduction

Liposuction does not totally eliminate cellulite from the body but it can help improve the appearance of cellulite in some areas. The success of cellulite removal can be dependent on many factors including genetics, age, gender, and thickness of your skin.

Liposuction is a surgical procedure and therefore carries the same risks as any other types of surgery. Usually these are rare.

Risks can include the following:

  • Infection
  • Bleeding
  • Nerve or skin damage
  • Damage to vital organs
  • Blood or fat clots
  • Friction burns
  • Drug reactions e.g. to medication or anesthesia
  • Complications as a result of anesthesia
  • Excessive fluid loss which, if left untreated, could lead to shock
  • Fluid Accumulation – fluid must be drained

Less severe risks include bruising, scars, numbing of the skin, changes in skin pigmentation. Some pressure, movement and stinging can be felt as fat is removed, but it is rarely painful.

Excessive liposuction can cause problems such as dents, lumps, and sagging skin.

It is important to fully understand both the risks and benefits of liposuction and to have realistic expectations about the results of the procedure. It is best to find a cosmetic surgeon that can explain clearly and thoroughly the possible risks and side effects that could occur with this type of surgery. There should be clear instructions on both pre- and post-operative care.

Liposuction is a cosmetic surgery procedure which can be performed using local or general anesthesia depending on how many areas are being treated. With local anesthesia, only the area that is being targeted will be numbed and you will actually be conscious during the procedure. General anesthesia can be administered as a gas or injection and you will be unconscious during the procedure, although the targeted area will be numbed as well. Small areas of liposuction may be performed in a clinic room but larger areas would usually be done in a hospital or outpatient surgical facility.

Small incisions (around 5mm in length) will be made in the targeted area through which the fat deposits will be removed. A cannula will be inserted into the deep fat layer and moved back and forth to break up and remove the fat cells with the assistance of suction from an attached vacuum pump or syringe. A significant amount of blood and other fluids will be removed at the same time therefore you will receive replacement fluids intravenously during the procedure.

A small layer of fat is left under the skin to help prevent rippling or bumpy skin occurring after the procedure. The incisions will then be closed using a few stitches or may be left open to limit the amount of bruising and swelling after the procedure. A drainage tube may be inserted for a few days to prevent any fluid build-up.

Recovery from liposuction can last from days to months depending on the size of the treated area and what type of procedure you have had. Mostly recovery progresses to the point of continuing normal daily life after one to two weeks and a full recovery is made within a few months.

Typically, in less than a week, most people can move normally and with minimal discomfort.

Compression garments may be recommended to be worn for the first few days after the liposuction to speed the recovery time. Patients should rest as much as possible over the next few days and simple pain medication may help with any minor discomforts.

Some improvement will be seen immediately after liposuction surgery but optimal results will be seen in three to six months.

Swelling will go down over a few weeks as will any bruising. The skin surrounding the treated area may seem loose, but it will tighten with time, usually about six months, depending on skin elasticity. Incision sites should be monitored for healing.

Returning to work may depend on the number of areas that have been treated and the extent of any bruising and swelling. Some people may return to work straight away and others may require four to seven days off work, although, during that time, they should be able to continue with normal daily life.

Before making the decision to undergo liposuction, you should find out as much information as possible about the procedure, the surgeon and hospital you are being treated at.

Always discuss the procedure with your clinic or hospital first and then go away and think about it before making your decision. You should also have a consultation of at least an hour with your surgeon before going ahead. Do not be afraid to ask any questions and make sure all of your concerns are addressed before you sign on the dotted line. The most important thing is to make an informed decision that you feel confident about. During your consultation your surgeon should take a thorough medical history and give you a consent form to sign to make sure you fully understand the possible risks and complications. The consultation will also be a time to discuss what type of liposuction is suitable for you and whether or not you need to have a general anesthetic. You should also inform your GP about having the surgery in case there are any problems later on.

If you are having liposuction under general anesthetic you should avoid taking aspirin or anti-inflammatory drugs for a period of 10 days before your surgery, because they cause the blood to thin and make surgery more dangerous. If you are a smoker then you should also give up smoking at least two months before the procedure, as it increases the risks and can delay the healing process.

There are a variety of different types of liposuction, which vary in the way they are performed.

These include:

  • Traditional liposuction
  • Tumescent Liposuction
  • Super-Wet Liposuction
  • Ultrasound-Assisted Liposuction (UAL)
  • Power Assisted Liposuction (PAL)

Traditional Liposuction

Traditional liposuction is based on the technique originally invented for surgical suction assisted fat removal. It is performed under general anesthetic so you will be asleep throughout the procedure. The surgeon will make an incision and insert a cannula into the deep fat layer. This will be moved back and forth to break up and remove the fat cells with the assistance of suction from an attached vacuum pump. When the required amount of fat has been removed, the incisions will be closed using a few stitches or may be left open to limit the amount of bruising and swelling after the procedure. A drainage tube may be inserted for a few days to prevent any fluid build-up. There is an increased risk with this type of liposuction because it requires going under general anesthetic, however because you are unconscious it enables the surgeon to treat larger areas and multiple areas at one time.

Tumescent Liposuction

Many cosmetic surgeons regard this technique as the safest and most effective form of liposuction surgery. Large amounts of saline fluid (possibly up to three times the amount of fat to be removed) consisting of lignocaine (local anesthetic) and adrenaline (temporarily contracts blood vessels to reduce bleeding) are injected, via small incisions, into the fatty area to be treated. The saline solution helps separate the fat from muscle by causing the compartments of fat to swell and firm up, thus making for easier removal and also reducing blood loss. A cannula is then passed back and forth through the areas of excess fat and removed via a vacuum pump or syringe. Some remaining fat and fibrous cells will break down over the next few weeks as a result of the motion of the cannula, so it is important for the physician to have this in mind and to not remove too many of the fat cells which could result in dents or scarring in the skin afterwards. This procedure takes a bit longer than basic liposuction (sometimes up to four to five hours for large areas) as the fluid has to be allowed to have its effect first. General anaesthesia is avoided in this technique.

Super-Wet Liposuction

The amount of fluid used in this technique is less than with the tumescent technique (usually only equal to the amount of fat being removed). General anesthesia is required for this technique. The treatment takes between one and two hours and is ideal for people who want to undergo other procedures at the same time as you are already under the general anesthetic.

Ultrasound-assisted liposuction (UAL)

This technique is used in areas where the fat is denser and more difficult to remove such as the upper back, male breast area, chin, neck, cheeks, knees, calves and ankles. It involves using ultrasonic energy (high pitched sound waves) via a cannula to break up the fat and liquefy it and then using traditional suction to remove it. It is often used after tumescent liposuction as a ‘fine tuning’ method as it allows for more precision. An added advantage is that it tightens the skin during the process, making it a great alternative to tummy tucks or body lifts designed to remove excess or baggy skin. It does generally take longer than basic liposuction.

Power assisted liposuction (PAL)

This technique uses a powered cannula, which produces tiny, rapid vibrations (about 5,000 times a minute) from its tip, to loosen and break up fat cells. It allows the doctor to remove fat with controlled and precise motions and even though it sounds rough, it is actually gentler than traditional liposuction because the vibrations are also helping to break down fat cells. This means that the procedure allows more fat to be removed than with other techniques, can be performed more quickly and causes less discomfort for the patient as well as less post-operative bruising. PAL uses the tumescent Liposuction technique for smooth fat transfer through the cannula and out of the body. This technique is especially useful for treating difficult areas such as the inner thighs, belly button area and male breasts.