It is the procedure that involves the removal of the excess fats accumulated under the skin, through 2-4 mm cannulae and vacuum. In the United States, 198,000 liposuction operations were performed with in 2009, and the procedure has been the 4th most commonly performed plastic surgery in the country.
It is not a general method of weight-loss. It is the process intended for removing the regional excess fats from the body for normalizing the body contour, after the person loses weight and his/her body mass index reaches to normal or overweight level.
Regional fat accumulations in the face, neck, arms, legs and trunk can be treated with this procedure.
Big breasts in men (gynecomastia) and the large lipomas can be treated with liposuction, as well.
In many local weight-loss methods, the volume of the fat cells is reduced but their number remains unchanged. For this reason, the fat cells are likely to re-grow and create the same deformity. However, the number of the fat cells is permanently reduced in the liposuction procedure. Even if the person regains weight, the previous deformity does not occur.
When the subcutaneous adipose tissue is removed through liposuction, the skin tissue is expected to shrink for accommodate itself to the new form. Therefore, the flexibility of the skin is of great importance. More successful results are achieved in patients with healthy, firm and elastic skin, whereas operations in patients with loose skin that has lost its tension requires us to be more careful.
Fat Removal (Liposuction)
Determining the amount of fat to be removed from a certain region and removing equal and the optimum amount of fat from each region are very important and require experience. Most of the conditions of undesirable aesthetic appearance after liposuction are caused by an inadequate, irregular or excessive fat removal.
The amount of fat that can be removed at a time is one of the debated issues. It is stated that liposuction does not strain the overall body balance, as long as the amount of the removed fat does not exceed 5% of the total body weight. For example, it is safe to remove 3.5 L fat from a patient of 70 kg. It is possible to remove fat in a ratio over this. However, it is very important to provide appropriate anesthesia and intensive care conditions and ensure that the doctors are trained and prepared in this regard. The patient should be closely monitored.
The surgery is performed in an operating room and under local or general anesthesia, depending on the area to be treated.
Incisions of 2-4 mm are made for the insertion of the cannulae into the skin. These incisions are hidden in the body curves and do not attract notice in the long term.
Fat Suction (Liposuction)
Before starting the liposuction procedure, a special solution is injected subcutaneously to reduce bleeding and pain. Then, the location of the fats under the skin is accessed and the adipose tissue is vacuumed by means of blunt-tipped fine tubes (cannulae) with various thicknesses. The removed fat can be used for fat injection (lipofilling).
The operation time ranges from 45 minutes to 2 hours.
At the end of surgery, the patient wears an elastic corset to control edema and bleeding, which is also intended for enabling the skin to accommodate itself to the new condition by shrinking. The corset is used for a period of 4-6 weeks.
The patient stands up and walks a few hours after the surgery, and this reduces the risk of clot formation in the legs. In addition, massage devices are used on the legs, which accelerate the blood circulation there, by applying compressions at certain intervals.
It is recommended to consume plenty of fluids after surgery.
Fat Removal (Liposuction)
Swelling, bruising, numbness and pain may occur in the application area of liposuction. All these disappear within a couple of days. In the early postoperative period, fluid accumulation occurs in the location of the removed adipose tissue. After the surgery, the patient’s weight may be found to be higher than the weight before the surgery.
Assessing the operated area aesthetically requires the edema to go down completely, and this process takes 1-3 months.
Active and strenuous exercises are avoided for a period of 1-2 weeks after liposuction. Three weeks later, some processes such as massage can be applied to facilitate local blood flow.
After liposuction, the person should take care of his/her diet and exercises, and should avoid gaining weight. The fat gained will definitely be settle in somewhere in the body and impair the body contour, even if its extent will not be the same as the previous.
Ultrasonic and Laser-Aided Liposuction:
The subcutaneous adipose tissue is first melted with ultrasound or laser beams, and then is vacuumed out. The procedures have both advantages and disadvantages. With these procedures, liposuction is applied more easily in the areas where liposuction has been applied before, and where the adipose tissue cannot be easily removed. However, the amount of the melted fat should be controlled very well, and excessive subcutaneous heat development should be avoided.
Performing the surgery safely is directly associated with the patient’s age, general health status, coexisting diseases, amount of the fat to be removed, operating room and hospital conditions and the experience of the doctors and medical staff. Extremely satisfactory results are obtained when liposuction is applied with the right techniques to the right patient, under appropriate conditions.
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Prof. Dr. Cengiz Açıkel, Aesthetic Plastic Surgeon, Liposuction, Fat Removal, Fat Elimination, Fat Removing, Fat Suction