What is Liposuction and what is it used for?
Liposuction is the controlled removal of subcutaneous fat in order to re-shape the contour of the face, body or limbs. A French surgeon, Dr Yves-Gerard Illouz, introduced modern liposuction in 1982. It is now known as suction assisted liposuction (SAL). His method of using tubes (cannulae), inserted under the skin, connected to a suction devise is still the most widely used method and remains a benchmark for other techniques. SAL has evolved so that it is now usually carried out after the area to be treated is first infiltrated with local anaesthetic solution. This allows the fat to be removed less traumatically and for many cases to be performed under sedation and local anaesthetic as a day case.
The different types of liposuction are confusing to the patient but the aim of all these techniques is the same. The controlled reduction of fat can be used to improve the shape of excess tissue for cosmetic problems such as flabby arms, thighs, belly, neck and face. Liposuction can also be used for patients who have deformities or asymmetries. For example, trauma can sometimes cause dents and depressions due to damage to underlying fat, and a combination of liposuction and lipofilling can help (see section on lipofilling). Some children are born with excess fatty tissue (Cheribism) and liposuction has been found to be helpful in these rare cases. Also, liposuction can be performed as an adjunct in other types of surgery. It is often used in in conjunction with abdominoplasty (tummy tucks), breast reduction and face lifts (especially under the chin).
Types of liposuction
In addition to SAL, there are several other types of liposuction such as laser lipolysis (which employs laser energy) and Vaser (ultrasonic energy). The heat energy generated by these methods can affect the collagen and may tighten damaged skin. Unfortunately these methods probably have higher complication rates simply because of the learning-curve needed to use them safely.
In my experience the degree of skin tightening is not always predicable and I believe that, as with all techniques, training and experience are really needed to avoid serious complications such as burns, seroma and contour irregularities that can arise.
Certainly some non–invasive techniques such as fat cooling (cryolipolysis) may find a place for relatively small problems, but this is still under evaluation. Lastly, to confuse matters further, there other types of SAL such as power-assisted liposuction (PAL) and water-assisted liposuction (WAL). These are standard methods widely used. The cannula automatically moves in PAL thus saving the surgeon physical strain. WAL uses sterile water or saline in conjunction with liposuction. This can reduce the bruising and immediate postoperative swelling and the amount of local anaesthetic infiltration fluid.
Types of patients
For cosmetic cases the most frequent problem encountered are patients with moderate fatty excess in the abdomen and love handles that cannot be shifted with exercise. Liposuction, in the appropriate patient, is an effective method of treatment provided that there is enough skin elasticity to conform to the desired shape after fat has been removed. Other area where liposuction is commonly used is for the double chin, flabby arms and for re-shaping thighs and the fatty areas around the knee.
Good results with tightening of skin can be achieved with SAL in the appropriately selected patient. The vast majority can be carried out under local anaesthetic with or without sedation as day cases. However patients with excess skin, which has been damaged by pregnancy (severe stretch marks called striae), or damage caused by weight loss or with the ageing process, often needs surgical treatment. The type of surgery really depends of how much and where the excess is. For example moderate excess skin in the lower abdomen (often following pregnancy with or without cesarian section), a mini-tuck can be carried out. This does not involve alteration of the position of the belly button. For larger excess skin then a full abdominoplasty may be needed (please see our page on Abdominoplasty). For the sagging face, liposuction is usually not appropriate but face lift with selective liposuction under the chin may help with rejuvenation.
Except in specialised centres, liposuction IS NOT a method for weight reduction in the obese. Major liposuction has been defined as patients who have more than 4 litres of fat removed in one go. The complexity of physiological change and the monitoring with intravenous therapy needed rises as the amount of fat removed increases. For larger volumes, an overnight stay often becomes a necessity. For all cases safety must come first; patients should be fit and have a normal body mass index and a sensible volume of fat removed. In fact, it is not the amount of fat in litres that is the yard stick but a “judged change” in shape in the appropriate area, using the correct cannula, that are the keys to success in a well-informed, fit patient. The assessment and the selection is paramount. This requires judgement and experience.
How much does liposuction cost?
The cost for liposuction varies depending upon the extent of the procedure and the areas of the body targeted. As a guideline, at The Westbourne Centre Mr Nishikawa charges between £1,390 and £5, 130. A consultation is required before undergoing any surgical treatment, following which you will be given a comprehensive quotation for your specific procedure.
Is liposuction permanent?
Liposuction can be permanent as long as the person's weight is stable, fluctuations can affect the results of liposuction.
Will liposuction work for back fat?
Yes - liposuction can work for many areas of the body including stubborn fat on the back. It can safely be performed as a day case under local anaesthetic with or without sedation.
Do I have to be asleep during liposuction surgery?
No, you don't need to be asleep during liposuction as it can safely be done with a local anaesthetic, if only a small area is involved. For larger areas, a local anaesthetic can be coupled with sedation.
Can I have liposuction done on my thighs and stomach in the same procedure?
Yes, there are many procedures that can be safely performed at the same time, liposuction to both thighs and stomach are two of them. In this instance there is a bit of a cost saving by having both of these procedures done together, talk with my secretary for the full details.
Can I have liposuction done at the same time as breast reduction?
Yes. There are several procedures that are able to be done safely together; liposuction and breast reduction are two of those.