Liposuction means to remove fat by suction method. It is also referred to as Lipoplasty, Liposculpturing or suction assisted lipectomy. In liposuction, the surgeon loosens and removes the fat from an area by using special instruments. It is the most commonly performed cosmetic surgery procedure in the world. Localized or generalized fat collection of the hips, thighs, buttocks, abdomen, waist, back, arms, cheek, jowls and neck can be reduced by this procedure.

Can one’s weight be reduced by this operation? Who is a good candidate for liposuction? Liposuction is neither a substitute for dieting nor a cure for obesity. Persons, with reasonably normal weight and healthy elastic skin, with extra localized fat in certain areas, get the best results from this procedure. Healthy elastic skin has the capacity to shrink after the surgery. Even though liposuction can be done on patients of any age, it is not normally done if the skin is too loose in a particular area. One could have loose skin after losing a lot of weight, after pregnancy or due to old age or other reasons. In these patients, in addition to liposuction, some of the skin should also be removed to get a satisfactory outcome.

In liposuction along with fat, fat cells are suctioned out and removed forever, and do not come back again. Most of the fat cells are situated under the skin. The total number of fat cells present in a person’s body usually does not increase after the age of 18 years. When a person gains weight, the size of fat cells increase as more fat is being deposited in it. When one looses weight, the fat is mobilized out of the fat cells and so these cells become smaller in size. Only liver and skin have the capacity to regenerate in the human body. Fat cells cannot regenerate or multiply. And so the fat cells that are removed are removed forever.

The results of liposuction can be permanent provided you eat sensibly and exercise regularly. If you gain weight, you will gain it more uniformly throughout the body and not just in the form of bulges.

Surgical Procedure:

Area to be treated is cleaned and prepared with antiseptic solution and Betadine. Then a specially formulated fluid also called as tumescent solution is infiltrated into the area. This makes the fatty layer loose and also minimizes the bleeding. A small cut about 3-4mm is made a few inches away from the area to be suctioned and the suction cannula is inserted. The cuts are usually made in the skin folds and these scars are hardly noticeable. Depending upon the areas to be suctioned or reduced, upto 3-6 litres of aspirate is removed in one sitting. The removed material usually consists of 60 – 85% fat and the remainder would be plasma, blood and serum.

Liposuction is totally painless procedure as it is done under anaesthesia. Total time taken for the procedure depends upon the area and amount of fat to be aspirated. Procedure may take from 45 minutes to 3 hours to complete. Amount of fat removed may vary from 10 ml to up to 3 to 6 Litres.

Post Surgery:
After the surgery snug or tight dressing are applied for 5-8 days to promote the shrinkage of the skin and to minimize the swelling. In most instances, one is required to wear a support for few weeks or months after the operation. One could feel localized areas of hardness or firmness in the suctioned areas for 1-4 months after the surgery.

One may require pain medication by mouth after the surgery. During the healing period, numbness or discomfort may be present for varied periods of time. After the surgery, there will be swelling in the areas of surgery. Even though most of the swelling is gone in first 2-3 weeks, it takes 2-4 months for all the swelling to go away. Discoloration could last upto several weeks after the surgery.

The patient is required to stay for 1-2 days in the hospital. Even after multiple areas of liposuction, one is able to be up and around in 2-3 days and back to most normal activities in 10-14 days.

Limitations & Complications:
Liposuction helps in removal of excess of fat present under the skin. It cannot remove fat from the internal regions around the organs. It is more of reshaping surgery of a particular region, and not primarily weight reducing surgery. For weight reduction one has to undertake diet control and exercise along with liposuction.

For obesity and excessive fat deposits liposuction can be a good starter in reshaping the areas and removing a few litres of extra fat. There are no serious problems associated with liposuction. The person undergoing this procedure has to be a healthy individual without any active systemic disease.

Results depend upon the expectations of the patient and the amount of fat that is suctioned from the given area. Usually, patients with good elastic skin who come for the recontouring of a particular area are very happy. Older patients and the patients who are overweight could be unhappy. Perfection and symmetry are not possible in every patient. Also in some patients all unwanted fat cannot be removed in certain areas in one sitting. In these patients, liposuction may have to be repeated. But, a second liposuction cannot be done until all the swelling is gone from that particular area (i.e. about 4-6 months).

On rare occasions, rippled or uneven skin or areas of loose skin could result from this surgery, which might require further surgeries to correct them. Post operative problems like collection of fluids or blood, irregular skin surface, swelling, infection, numbness, have been reported in some cases. These can be well managed. General anaesthesia, if used, carries its own disadvantages, though few.

Pre Op. Instructions:
1. Wash whole body with liquid Betadine surgical scrub soap 24 hours prior to surgery and on the morning of the
2. Nothing by mouth (not even water) for 6 hours prior to surgery.
3. Please take medicines according to the instructions given.
4. No Aspirin or Aspirin containing drugs or Vitamin E or Birth control pills for 2 weeks before the surgery.
5. Stop smoking or drinking alcohol at least 2 weeks before the surgery.
6. Please do not wear any jewellery (nose rings, ear rings, toe rings, bangle)

Post Op. Instructions:
1. Diet – as directed. Normal diet can be resumed the next day after the operation.
2. See the doctor as advised in 3-5 days after the surgery.
3. Take medicines according to the instructions given in the prescription.
4. Do not take Aspirin or Birth control pills for 2 weeks post surgery.
5. Do not get the areas of surgery wet for 5 days from the day of operation.
6. Do not lift heavy objects for 4 weeks.
7. Do not undertake any strenuous activities or exercises for four weeks after the surgery.
8. The areas of surgeries may be massaged starting from 3 weeks to 4 months, until all the swelling disappears.
9. Elastic support garments should be worn in place of surgery starting from day 1 to 2 months after the surgery.
10. Short distance travel may be undertaken after 3 days of surgery and long distance travel can be undertaken 10 days after the surgery.