Liposuction is cosmetic surgery to withdraw fat deposits from selected areas of the body like stomach, breast and buttocks. In 2017, liposuction accounted for 8.2% of all cosmetic procedure performed in the U.K.
Despite its apparent ease, it is important to remember that liposuction is neither a substitute nor replacement for weight reduction and weight management, and instead, is a surgery to help eliminate stubborn storage of fat in the body that are resistant to exercise or diet.
Although frequently performed on its own, liposuction, which is also known as lipectomy, is regularly used in conjunction with other cosmetic procedures, such as abdominoplasty and facelift, to produce more comprehensive solutions to patients.
Contrary to popular belief, liposuction is actually best for slightly overweight patients – not morbidly obese ones as the stretched skin and gravity-caused tissue sagging will lead to difficulties in body contouring. For obese patients, multiple corrective surgeries may be required to tighten excess skin and contour the body into shape.
A surgeon preparing for liposuction. Image courtesy of Wikimedia Commons.
Liposuction is performed by inserting a 3mm to 5mm wide cannula - a hollow, needle like device - into an incision made near the target area. General and local anaesthesia are administered on patients to ensure they do not feel the pain during the surgery. The cannula must be navigated away from blood vessels before the vacuum suction can be performed. Otherwise, patients run the risk of contracting fat embolism syndrome (FES), a fatal condition where loose fat molecules blocks the circulation of blood in the body.
A saline-based liquid infiltrate solution is usually used to flood the tunnels created by the cannula to facilitate the suction of fat cells out of the body. However, some surgeons, particularly in North America, prefer an alternative technique using ultrasonic energy beam to break and liquefy fat deposits before being vacuum-sucked through a cannula.
Liposuction carries a variety of risks that correlates directly with the level of aggression of the treatment. In layman’s term, the more subcutaneous and fat tissues are remove, the higher the probability that a complication may occur. However, the common complications and issues that patients should look out for are:
• Lack of Asymmetry: Unbalanced removal of fat from two locations in the body (breast, thighs, buttocks, etc.) could create an asymmetrical body shape that will require corrective surgeries.
• Bleeding and Hematoma: The tumescent liposuction technique has greatly reduced the level of bleeding during surgery. However, the risk of excessive bleeding and formation of hematoma remains, especially involving patients with high blood pressure. To minimise such risks, patients must avoid consuming anti-inflammatory and non-steroidal pills such as aspirin and ibuprofen two weeks before surgery. Speak to your doctor if you are currently taking such medications.
• Edema: The accumulation of fluid to fill recently created gaps in fat deposits can lead to venous thrombosis and embolic disorder.
• Irregular Shaped Surface and Depressions: Inefficiently performed liposuction could leave the surface of your skin irregular, with visible bumps and depressions. This will require corrective invasive surgery.
• Fibrosis: The thickening of inflamed tissues in the body could grow into troubling-sized fibrosis, leading to hardened growths underneath the skin that needs to be surgically removed.
• Hyperpigmentation: Exposure of still bruised areas could lead to hyperpigmentation, or dark spots. Treatment is topical, but the problem may reappear if the area is exposed to the sun in the future.
• Infection: Infection of wounds affects roughly 3% of all surgical patients. However, as long as the wound is kept clean and antibiotics are taken as prescribed, infections rarely escalate to serious levels.
The key in managing all of the complications above is timely detection and treatment. With that in mind, please consult your physician if any of the above symptoms appear.