Liposuction (Liposculpture, Lipectomy, Lipo)

A plastic surgeon performs liposuction surgery.  Once you are anaesthetised (a procedure in which you receive a medication that numbs the area and makes you unconscious during surgery), your surgeon will perform the liposuction surgery in the following steps: 

1. Your surgeon will mark the area of your body from where the fat has to be removed.
2. The surgeon will then administer medication to ensure minimal blood loss and swelling. Next, your surgeon will administer a medication that contains epinephrine that shrinks the blood vessels to reduce blood loss.
3. After injecting the medication, the surgeon will break and remove your body’s fat cells by inserting a cannula (a thin tube inserted into a vein or body cavity) attached to a vacuum.
4. Depending on the area where the liposuction will be carried out, your surgeon will either make one cut or several cuts and insert a suction tube. The suction tube will be attached to a vacuum machine.
5. The surgeon will then move this suction tube which helps loosen the fat and remove it by suction.
6. Your operating surgeon will decide which of the following liposuction techniques should be used (Table 1):

   1. Tumescent liposuction

   2. Power-assisted liposuction

   3. Ultrasound-assisted liposuction

   4. Laser-assisted liposuction

7. Once the fat is sucked out, the surgeon will remove the excess fluid and blood from the surgery site and then stitch and apply an appropriate dressing to the site of surgery.

8. The surgeon will also insert small drainage tubes, which will remove the blood and fluid collected for the first few days post-surgery. Draining the blood and fluid will reduce your chances of getting an infection.

What to Expect Before Surgery?

Before the surgery, you will have an appointment with your surgeon. During the meeting, you can expect the following:

1. Your surgeon will discuss the liposuction procedure and how it can be successful.
2. You will also discuss your skin type, safety and effectiveness of surgery, expectations post-surgery, and cost for different liposuction procedures.
3. Talk openly to your surgeon about your concerns regarding the surgery.
4. Your surgeon will ask you about your medical history.
5. You should notify your operating surgeon if you have allergies to any prescription and non-prescription medications or anaesthetic medications.
6. You should also inform if you have any bleeding disorders or are currently using medicines like aspirin for blood thinning.
7. Your surgeon will conduct a physical check-up to ensure that you are healthy to undergo liposuction surgery.

Before undergoing surgery, based on the discussion you had with your surgeon, your surgeon will advise you to:

1. Follow a specific diet.
2. Stop smoking and alcohol consumption. Smoking will delay the healing rate after surgery.
3. Avoid certain medicines and nutritional supplements. If you use blood-thinning medicines, your surgeon will advise you to stop them before the surgery.
4. Undergo specific laboratory tests.
5. Avoid chewing gum or candy during the fasting period.

What to Expect on the day of Surgery?

You can expect the following when you are admitted to the hospital on the day of surgery:

1. When you arrive at the hospital, the healthcare staff will ask you to sign a consent form that states that you permit the hospital to conduct the surgery.
2. Your surgeon will take some ‘before’ pictures of your body. Your surgeon will use these pictures to plan the surgery.

What to Expect During Surgery?

Position during surgery: 

1. The position for surgery can change depending upon the area of your body where the surgeon will perform liposuction. Ideally, you will be placed supine (lying horizontally with face upwards).
2. If your surgeon has to perform liposuction for the back of the thighs or buttocks, you will be kept in a prone position (lying horizontally with face down).

Anaesthesia:

1. If your surgeon performs liposuction on your lower body, you will be given epidural anaesthesia (a medication given in the space surrounding your spinal cord that helps numb your lower body).
2. You will remain conscious if you get epidural anaesthesia.
3. Once you are anaesthetised, your surgeon will perform the surgery. The liposuction procedure will take one to three hours.

Cleaning and draping:

1. An aseptic solution is used to clean the surgeon's skin to perform the procedure.
2. Your body will be covered with an aseptic material to maintain a sterile environment while the surgeon performs liposuction.

Monitoring of vitals:

Your vital signs like respiratory rate (number of breaths per minute), blood pressure, heart rate, and oxygen level are monitored during the surgery.

1. The time your body needs to recover from the liposuction surgery completely will depend on what part of your body underwent surgery. This will also decide how long you need to stay at home before returning to work and driving.
2. While bathing, you can remove the compression bandage or elastic support corset.
3. Your surgeon may recommend a sponge bath for a few days post-surgery.
4. You will have some swelling and soreness at the site of surgery. Once the swelling reduces, you will be able to notice the results. This process can take months; hence, you need to remain patient to see the results.
5. Any numbness at the surgery site will go away after six to eight weeks post-surgery.
6. You should take sufficient rest for a few days after the surgery.
7. You can walk or do regular body movements; however, you should avoid any activity that can cause exertion to your body.
8. You can perform your routine activities after two weeks.
9. You can return to exercise or sports after four to six weeks.

Diet:

1. Initially, you should begin with a light diet consisting of liquids such as soups.
2. You can return to your regular diet depending on how your body tolerates food.
3. You should understand that liposuction is a body contouring procedure. The procedure will not stop you from gaining weight in the future.
4. You should follow proper eating habits to ensure that you do not gain excess weight.

First Follow up Appointment

You must remember the following:

1. You are expected to have a follow-up appointment one week after the liposuction surgery.
2. During the follow-up, your plastic surgeon will remove the stitches from the site of surgery. The surgeon will also address your concerns.
3. Your surgeon will also schedule a follow-up approximately after three weeks and three months to check how your body is healing.

Liposuction surgery is safe as the surgeons ensure that the risks are minimised. Common risks of liposuction surgery include:

1. Swollen ankles (if liposuction was performed on your legs)
2. Scars at the site of surgery
3. Numbness in the operated area
4. Fluid leak from the site of surgery.
5. Swelling and bruising that might last for up to six months after surgery.

 Rarely, the liposuction surgery may not go as planned and result in problems like:

1. Redness or swelling of the skin.
2. Numbness that lasts for several months.
3. Change in the skin colour where liposuction was performed.
4. Uneven results from the surgery (your operated area might have some irregularities and look lumpy).
5. Internal bleeding at the site of the surgery or excessive bleeding from the surgical site.
6. Damage to the organs due to liposuction.
7. Severe pain that lasts for a longer time and does not go despite taking painkillers. 
8. A fluid build-up under your skin or blood clot in your lungs (this is very rare).