Background

Modern Liposuction was introduced by French and American surgeons in the early 1980's. Techniques advanced rapidly, and now the so called "tumescent technique" is used almost everywhere. This method incorporates the use of large volumes of very dilute local anaesthetic and vasoconstrictor to prepare tissues before liposuction. Benefits of this method include patient safety and comfort, absence of bleeding, and quick recovery. There is no fundamental difference in technique between liposuction, liposculpture, lipoplasty, suction lipectomy or 3 dimensional lipo-sculpture. It is the skill and artistry of the surgeon, combined with each patients uniqueness that determines the end results.

Liposuction is a surgical procedure for removing localized deposits of subcutaneous fat anywhere in the body. This technique uses small openings and a vacuum to remove fat cells in selected regions, thereby improving contour in the treated areas. More recently, Ultrasonic Liposuction has become available. This is generally a little more expensive because of the specialised equipment required, and because it takes longer, but results can be superior in selected cases. A separate information sheet is available about this technique. The Australian Clinic for Cosmetic Surgery uses the latest 3rd generation Ultrasonic Liposuction equipment. We also have the latest vibrating cannula system called the Microaire.

Regardless of technique, an incision of 2-5mm is made near the area from which the fat is to be removed, and a specially designed surgical cannula (tube) is placed through the opening into the fat. The cannula is attached by flexible tubing to a vacuum pump, or ultrasonic generator. The fat is removed by suction as the cannula is manipulated beneath the skin. The latest cannulas are less than 2mm in diameter, allowing true fat sculpturing.

Although the procedure was originally developed for the torso and thighs, it is now used on all areas of the body and has even proved particularly helpful in contouring the area under the chin, or the jowls as an adjunct or replacement to face lifting, or laser skin rejuvenation.

About Fat

Fat distribution is determined by two factors, heredity and diet. Heredity determines the location and number of individual fat cells, which are fixed and unchanging after puberty. Diet can increase or decrease the amount of fat in each cell but will not affect the total number of cells or their distribution. For example, if you have inherited large numbers of fat cells on your thighs and small numbers of fat cells on your chest, you will always have more fat on the thighs than on the chest, and strenuous attempts at weight loss can leave you with a thin upper body and persistently bulky thighs.

Your appearance after liposuction will be influenced by your general state of health, the overall condition of your skin, age, weight, hormonal influences, and other factors. Each patient is unique, and during your consultation, we will discuss with you in detail how these general factors apply to you in particular. Liposuction is not a substitute for a healthy diet nor is it useful for generalized weight reduction. While the foregoing may seem obvious, we mention it because some patients may expect localized fat removal to effect a dramatic weight loss. This is not possible.

Liposuction selectively removes fat from those areas in which the patient desires reduction. Since the actual fat cells are removed, the procedure is permanent, and following liposuction the body will always have less fat in the treated areas. Recent research has shown that liposuction can reduce the severity (and possibly the risk) of diabetes.

Skin Elasticity

Good skin elasticity is a desirable attribute in all patients since it makes for a smooth surface contour. Tight skin is universally seen in the very young and is gradually lost as we age. Even through middle age, however, we retain some elasticity. The skin envelope almost always shrinks to adjust to the reduced contour following an appropriate liposuction. Some parts of the body, such as the inner thighs, and triceps area, have poor skin elasticity, and removal of large amounts of fat from these areas, or aggressive removal from other areas, may leave some skin irregularities.

Ultrasonic liposuction can give better results, as it can stimulate skin tightening.

In some cases, the success of the procedure will be limited by the skin elasticity, as too much fat removal would lead to skin unevenness and laxity. When this happens, a second procedure after about 3 - 6 months can often give a worthwhile further improvement. Severe cases of skin laxity may require an Abdominoplasty (tummy tuck) or thigh lift for permanent improvement.

Cellulite

The word "cellute" has no precise medical meaning. There are believed to be about 9 different causes of cellulite. Most people use the word to refer to dimpling and irregularities that occur on the surface of the skin. It is seen most frequently over the lower torso and thighs, worsens with age, and is frequently associated with loose skin. In many cases liposuction will lessen the appearance of cellulite.

Loose Skin and Musculature

Some individuals have lax musculature and loose skin with or without excess fat. These patients may require additional procedure such as Abdominoplasty (tummy tuck) or thigh lifts. During your consultation we will evaluate your skin and musculature as well as localized fat deposition. We will advise you if you require a thigh lift or Abdominoplasty for optimal results.

Permanency of Results

The number of fat cells is fixed after puberty. Adults become thinner or fatter by reducing or increasing the amount of fat in each cell. Since liposuction reduces contour by removing fat cells, the procedure is permanent. Should you gain weight following liposuction you will tend to deposit the fat more in areas other than those treated, but so far, after thousands of cases, we have never seen a patient where this has caused a problem with body proportions.

Scars

In the past, scars from body contouring were sometimes long and conspicuous. Today, liposuction scars are usually less then 4mm long and can be placed in natural body creases or in other places where they are inconspicuous or easily hidden by clothing or bathing suits. In most patients the scars will be red or pigmented for up to 6 months and gradually fade thereafter until they are not noticeable by about 12 months after surgery. The scars are rarely troublesome. Nevertheless, you should know that all scars are permanent and their height, width, and final colour are not totally predictable. Special treatments are available for troublesome scars.

Complications and Untoward Results

Serious complications are uncommon with this kind of surgery. All patients have bruising, which lasts 3 to 6 weeks, occasionally longer. A certain amount of temporary numbness or reduced sensation in the treated area is also to be expected. Sometimes, a small area of numbness may persist for longer. As with any surgery, bleeding, infection, DVT and other complications are possible, although rare. In a recent journal review of liposuction, the incidence of all complications was 0.1%.

Patients may experience contour irregularities in the treated areas following surgery. Usually this is temporary, but in occasional patients, may be permanent. Perfect symmetry is the goal, although small side to side differences can occur. To some extent, this is a limitation of current techniques. We make every effort to give you as smooth and symmetric a result as possible.

Five percent of patients have secondary surgery or a "touch-up" after 6 months, most frequently for removal of additional fat - for example, if there is some asymmetry etc. This is usually done for a nominal fee. Sometimes, skin retraction after liposuction may not be strong enough to give a smooth contour, and follow-up treatments with further liposuction or surgical removal of excessive skin may be required.

Fat Transfer

Advances in technology and techniques allow us to carefully take fat from one area, and place it in another part of the body. For example, fat could be taken from the abdominal area, and used to fill out sunken cheeks, boost lip size, smooth out scars, or even help contour other body areas (within limits). Fat survival is usually quite good during this process, but variations in success can occur, due to individual response etc. There is an extra charge for this added service, which must be done with different, very delicate instruments.

I am very excited about the results of these fat transfer procedures, and invite you to review my clinical photos.

Some cosmetic surgeons advise their patients that it is better if the patient remains awake during a liposuction procedure, relying only on local anaesthetic, so that they can stand up and show the doctor how things look in that position. Whilst we can certainly offer this method to our patients, we feel, as do most other liposuction experts, that the comfort of a more effective anaesthesia allows better fat removal, with more even skin and contours, than an awake procedure in almost all circumstances. Interestingly, any practitioners that advocate "awake" liposuction do not have the training, experience, equipment, or access to facilities to allow them to perform comfortable liposuction with patient sedation or anaesthetic.