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Plastic Surgery

Liposuction Fat Removal

What is “Liposuction”

The aesthetic procedure known as “liposuction”, lipoplasty, liposculpture, lipectomy or simply lipo is basically performed to remove excess fat tissue accumulated in different parts of the body by using thin cannulas and applying vacuum (negative pressure).

Liposuction is not a weight loss method. It is a surgical procedure intended to correct the body contour and proportions. Its superiority over all other fat melting techniques is the permanence of its results. Liposuction permanently reduces the number of fat cells, while other procedures only reduce the volume of fat cells.

In the body of an adult person, the fat cells are more densely distributed in different regions of the body and their number is constant. When the person gains weight, the number of these fat cells does not increase, but their volumes increase. When the weight loss is achieved exercise or diet, the volume of fat cells decreases but their number remains constant.

Even if they are of normal weight, some people have excess fat cells in some areas such as the hips, waist, abdomen, inner part of the knees due to genetic factors, and as a result, localized fat accumulations and consequent deformations in the body contour are observed. No matter how much weight these people lose, the disproportion between the regions with excess fat and other regions of the body cannot be eliminated.

For example, in a woman with excess fat accumulation in her hips, there is a disproportion between the upper and lower parts of the body and this disproportion persists regardless of the changes in the woman’s weight. In such cases, the number of fat cells in the regions with excess fat accumulation is reduced by removing the excess fat tissues from the body by the liposuction procedure. As a result, contours of the body parts look more proportional to one another.

Who are Suitable Candidates for Liposuction?

  • Those who are completely healthy, both physically and mentally.
  • Those with a body mass index (body fat calculated based on height-weight ratio) within normal limits.
  • Those who have excess fat accumulation in some parts of their body, which causes contour disorder, although they are of normal weight.
  • Those with tight and flexible skin structure that is not excessively flabby.
  • Those who have excess fat accumulation in certain regions such as the hips or waist, but not widespread throughout the body.
  • Nonsmokers.

Application Areas of “Liposuction”

  • Hip region
  • Thighs
  • Inner side of the knee
  • Abdomen, waist and back
  • Breast and chest areas
  • Neck, jowl and cheeks
  • Calves and ankles
  • Arms

What Is Not Treated By Liposuction?

  • Liposuction does not treat obesity or overweight.
  • It does not fully eliminate the cellulite appearance on the skin.
  • It does not eliminate the flabby appearance of excessively loose skin.

 “Liposuction” Techniques

  • Classic liposuction: The excess fat under the skin is removed using cannulas ranging from 2mm to 4mm in diameter.
  • Laser-assisted liposuction: Subcutaneous fat cells are melted by laser beams transmitted through thin cannulas inserted under the skin, and then the excess fat cells vacuumed out.
  • Ultrasound-assisted liposuction: In this technique, also known as VAZER Liposuction, the fat cells are first liquefied using ultrasonic waves, and then vacuumed out through cannulas.

 Which “Liposuction” Technique Is The Best?

We cannot talk about an ideal liposuction technique because each technique has its own advantages and disadvantages compared to others. In some specific cases, one of these techniques may come to the fore. The most important thing in this regard is the surgeon’s experience in, and command of, the liposuction technique. All these techniques can give successful results, but each has its own advantages and disadvantages.

For example, the technique characterized by melting the fat cells first with laser or ultrasonic waves and then vacuuming it out is easier than the classical liposuction technique, but if the fat melting process is not carried out carefully and equally (homogeneously) in all areas, collapses may occur due to excessive fat melting in one area while heights may remain in the neighboring area, that is, the body may have a wavy appearance.

To avoid such a problem, the procedure should be performed very slowly and carefully. This, on the other hand, leads to excessive prolongation of the operation time. When performed by inexperienced people, the procedure can also cause thermal damage due to overheating during the melting of the subcutaneous fatty tissues.

In my own practice, I use the classical liposuction technique. If it is necessary to remove fat with liposuction from a region where this surgery has been performed before, or if there are small areas where the skin is not tight enough, I recommend laser or ultrasound-assisted liposuction to my patients.

Dos and Don’ts before Liposuction

  • Taking blood thinners such as aspirin, green tea, vitamin E and nutritional supplements should be discontinued 15 days before the operation. You can find the full list of such products on our webpage about the preoperative period.
  • Smoking should be stopped at least 1 month before the operation.
  • The operation should be performed after the necessary medical examinations, in the period when you are in your best condition both physically and mentally.
  • COVID-19 precautions should be strictly followed. Priority should be given to the coronavirus vaccine. The operation should be performed at least 2 weeks after vaccination.

 How is Liposuction Performed?

  • It is performed under general or local anesthesia, depending on the size of the area to be treated.
  • 2-4 mm incisions are made on the skin of the area to be treated, and then a liquid that contains analgesics and anti-bleeding medications is injected.
  • Excess fat tissue under the skin is vacuumed through the cannulas into the scaled chamber of the machine that applies negative pressure.
  • It requires experience to know how much fat should be removes, and removing excessive amount of fat causes other problems.
  • If necessary, sutures and then dressings are applied to the skin incisions.
  • A special corset is put on the patient to apply a controlled pressure to the liposuction area, and the surgery is terminated.
  • The duration of the procedure varies from 45 minutes to 2 hours, depending on the technique used and the area to be treated.

Recovery Process after Liposuction

  • 2-4 hours after the operation, the patient starts taking nourishment orally and he/she is prompted to stand up and take a short walk.
  • It is useful to spend the first postoperative night in the hospital (except in cases where the operation is performed on very small areas). A hospital bed can be positioned more accurately than any bed at home. Vital functions are closely monitored, and painkillers, antibiotics and therapeutic fluids are administered more effectively through vascular access.
  • The control examination is performed 5 days after the operation, and then the sutures, if any, are removed.
  • In the postoperative week, the patient’s weight may be higher than before the operation due to edema. After the second week, the edema begins to subside.
  • The patient returns to daily activities after 5 to 10 days depending on the size of the treated area.
  • It is recommended to wear a corset for a period of 4-6 weeks to help tighten the skin and to prevent blood and fluid accumulation in the liposuction areas.
  • Heavy exercises are not recommended in the first postoperative month.
  • It is recommended to consume plenty of fluids, eat a high-protein diet, and take short walks.
  • For the aesthetic evaluation of the liposuction areas, it is necessary to wait for 1 to 3 months on average. Subsidence of edema, tightening of the skin and its adaptation to its new condition, and softening of the hardness under the skin is a process that takes months, and the duration of these may vary from person to person.
  • It is necessary to keep following the diet and doing exercises in the post-operative period, and care should be taken not to gain weight.

 Risks and Complications

  • Anesthesia-related risks
  • Infection
  • Fluid or blood accumulation under the skin
  • Changes in the touch sensation of the skin
  • Damaged deep structures (nerves, vessels, intra-abdominal organs, lungs, etc.) under the skin of the liposuction area
  • Clot formation in the veins of the legs, cardiac and pulmonary complications
  • Long-lasting edema
  • Wavy appearance and folds in the skin
  • Contour defects and asymmetries
  • Increased appearance of cellulite
  • Discolorations of the skin
  • Poor wound healing at the sites of the incisions made for the insertion of cannulas

Most of these complications are preventable if the person’s suitability for the procedure is duly evaluated during the preoperative examination, and if the operation is performed under appropriate operating room conditions by a Plastic, Reconstructive and Aesthetic Surgery Specialist who has been trained in this field for years.

How Much Fat Is Safe to Remove in A “Liposuction” Operation?

There are different scientific studies on this subject. In a study conducted in the USA in 2015, an average fat volume of 2 liters was removed from 4,500 patients with the liposuction procedure, and no fatal complication was observed. In this study, the rate of minor complications was found to be 1.5%.

The complication rate was reported to increase as the amount of fat removed exceeded 3.4 liters. According to another approach in this regard, will not cause a serious problem as long as the amount of fat removed does not exceed 5% of the body weight.

Is Liposuction Dangerous?

It is a surgical procedure that can be dangerous when performed under unsuitable conditions and on a person who is not a suitable candidate for it. It is not a procedure that can be performed on anyone, by any physician, or under any condition.

A person who considers this procedure should first consult an Aesthetic Plastic Surgeon and find out if he/she is a suitable candidate. For example, if liters of fat tissue are removed from a patient of advanced age who is a smoker and has some accompanying chronic diseases, or from an obese person, in a hospital that is not fully equipped, the probability of vital complications increases.

What Happens If The Patient Regains Weight After Liposuction?

Since the number of fat cells in the areas treated with liposuction is permanently reduced, these areas do not return to their previous state even if the patient regains weight, but excess caloric intake causes fat accumulation in other parts of the body. Therefore, it is of great importance to keep the weight within normal limits after the operation, with the help of diets and regular exercises.

Who Performs Liposuction Surgery?

The Department of Plastic, Reconstructive and Aesthetic Surgery is the only department where liposuction training is given during residency training. It should not be remembered that serious complications are encountered in consequence of operations performed by people who are not a specialist in the field, and operations performed in places other than hospitals. 

2024 Prices of Liposuction in Istanbul

Liposuction prices vary depending on the number of the regions to be treated, the hospital where the operation will be performed, the technique to be used, and the physician who will perform the operation. By contacting our office you can learn the current surgery price specific to you.

References

  1. Liposuction

Frequently Asked Questions (FAQ)

Is It Possible to Lose Weight With Liposuction?

Although a weight loss equal to the weight of the removed adipose tissue is achieved as a result, liposuction is not intended for weight loss. The most appropriate practices of liposuction are those intended to remove disproportionately accumulated excess fat tissues in the bodies of individuals with normal weight.

Does It Cause Postoperative Pain?

The patient feels no serious pain, as long as there is no complication such as postoperative infection or blood accumulation under the skin (hematoma). It is normal to feel some pain while getting out of bed and sitting down. There is no need for potent pain relievers. A simple pain reliever like paracetamol will be adequate.

Is the Result of the Procedure Permanent?

Since the number of fat cells in the areas treated with liposuction is permanently reduced, these areas do not return to their previous state even if the patient regains weight. However, if the person regains excessive weight after the surgery, it will be inevitable to observe fat accumulation in the body, especially in the areas other than the application areas, so the patient should pay attention to his/her weight after the surgery.

What are the Differences between Weight Loss and Liposuction?

When weight is lost, in an area such as the hips or belly where there are more than normal fat cells with increased volume, the size of the fat cells decreases, but their number does not decrease.

Therefore, when the patient regains weight, the cells increase their volume again by storing fat, and the area in question returns to its former state. However, in the liposuction procedure, some of the fat cells are vacuumed out of the body. New fat cells are not produced to compensate the removed fat cells; in other words, the number of fat cells in the problem area is permanently reduced.

Therefore, in case of weight regain, fat will be stored by fewer fat cells and excess fat will be distributed to other regions of the body. In short, the appearance obtained after normal weight loss can be temporary, in other words, the body returns to its previous state when weight is regained, but the appearance obtained after liposuction is permanent, that is, even if the patient regains weight, the body does not return to its previous state.

Is There an Age Limit for Liposuction?

The lower age limit is 18, except in very special cases. The upper age is determined based on the general health status and skin structure of the person rather than considering his/her chronological age. In general, those over 50 years of age, those with chronic diseases such as diabetes, hypertension, obesity, COPD, etc. and those whose skin structures have lost their elasticity are not suitable candidates for liposuction.

When performed on people with extremely loose skin, liposuction may not provide the expected aesthetic improvement because the skin is likely to become even more folded after surgery due to its inability to show the expected shrinkage and tightening. Whether a person is a suitable candidate for liposuction is determined based on a comprehensive evaluation made during the examination.

When Will I Be Able to Return to Work After Liposuction?

The return-to-work time varies depending on which areas the liposuction procedure is performed on, how large these areas are, and what kind of job you have. An average of five days after a limited surgery performed on a single area, patients can return to office work provided that they wear a corset, but if a procedure has been performed on larger areas and large amounts of fat have been removed, patients, especially those who work in jobs that require physical strength and movement, return to work later. More accurate information about this can be obtained during the preliminary consultation with a plastic surgeon.

Will The Surgery Leave Any Scar?

3-4 mm incisions made on the skin for the insertion of liposuction cannulas may leave some scars. These scars usually become hardly visible after a year.

What Is Jowl Liposuction?

It is a liposuction procedure performed on the area called the jowl under the chin, in order to reduce the excess subcutaneous fat accumulated in this area. This procedure can be performed alone or as a part of mini face lift. The fat tissue in this area is vacuumed out of the body through a two mm thin cannula.

Who are Suitable Candidates For Jowl Liposuction?

Suitable candidates are those with localized fat accumulation in the jowl area, where their skin is not loose and has sufficient tightness.

Is Fat Removal Difficult?

Liposuction is not a difficult procedure when duly performed on a limited number of areas for a person who is a suitable candidate for fat removal. However, with the increase in the number of application areas and the amount of fat removal, the degree of difficulty increases.

How Many Kilos of Fat Is Removed With Liposuction?

It would not be appropriate to give an exact figure in this regard. As a general rule, if fat removal is 5% of the body weight of a person of normal weight, the complication rate is very low. For example, removing 3.5 liters of fat from a healthy person who weighs 70 kg is within the safety limits. More than this amount of fat removal is possible, but requires very close monitoring of the patient during and after surgery and providing the necessary fluid, plasma and blood support.

Does Liposuction Cause Death?

When performed on a person unsuitable for this procedure, under unsuitable conditions, and by someone who has not received adequate training, fatal complications can be encountered. In some cases, complications may also arise from the patient or the anesthesia process, independently from the surgery performed. The physician who performs the procedure cannot be held responsible for all such complications that may develop after the liposuction procedure.

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