Mrs Dalia V Nield FRCS(Ed)   FRCS(Eng)

Liposuction

Liposculpture

The fat deposits that do not change or "move" with dieting and exercising are the ones that do not come back after liposuction even if the patient puts on weight. Like "saddle bags", "love handles", large hips and thighs, thick ankles, double chin or large upper arms.

On the other hand, tummy (abdominal) fat will come back after liposuction if the patient puts on weight. This is the type of fat that can be mobilized with dieting and exercising. So, liposuction used in the abdomen helps but is not permanent.

This is why Liposculpture is such an attractive refinement of liposuction. It helps us achieve an attractive body contour. It is about all those little humiliations when buying clothes or in the changing-room at the gym, about friends and relatives saying "But you don't need liposuction, you are slim!", about removing your T-shirt while on the beach.

The violin deformity ("pear shape"), for instance, is not the sufferer's fault. It is nothing to do with diet or exercise. It is genetic and can only be changed by re-sculpting the body using liposuction.

Liposuction is also used incidentally in other cosmetic procedures like the reduction of a double chin, or fat removal during a face-lift.

I also use liposuction in reconstructive surgery, for example to sculpt a flap to achieve a better shape in breast reconstruction after mastectomy or to achieve a good contour after abdominal wall reconstruction following bowel or gynaecological surgery with an unfavourable scar.

In Liposuction and Liposculpture the quality of the skin is very important. Noticeable dimpling (cellulite) will not always be improved by liposuction. Delicate, soft, inelastic skin needs to be prepared before surgery with a 'Skin Tonic' massage and lymphatic drainage machine. Two to six sessions may be needed.

The operation:

In most cases the operation is performed under general anaesthesia with a one-night stay in the hospital. Some cases can be treated as day cases, letting you go home on the same day. A few can be done under local anaesthesia.

The skin incisions are small ( 0.5 cm) and are placed carefully within skin lines or folds so they are camouflaged.

There are many ways to carry out liposuction: mechanical, electrical or with the aid of ultrasound. The most common is the 'wet technique' in which the fat is infiltrated with saline solution containing adrenaline to facilitate removal and diminish bleeding.

We monitor the amount of fat removed and replace lost fluid accordingly. It is usually safe to remove 5,000 ml.

Fat removed can be used to augment deformities (lipoaugmentation).

After Surgery:

I advise that you arrange for a relative or a friend to take you home when you leave hospital. The nurses on the Plastic Surgery Floor at the London Clinic are specialized in Plastic Surgery are always available to advise and to call me if necessary.

You may need to restrict sports and driving during the recovery period and wear an elastic garment for up to 6 weeks to help skin remodelling.

Anti-embolic (TED) stockings should be worn for 10 days or until you are fully mobile to avoid Deep Venous Thrombosis (clots in your legs). Keep the scars and skin clean with daily showers and Aloe-Vera spray. We will provide an information sheet for post-operative care.

Sutures are removed within 2 weeks.

Contour irregularities (dents) are common and can easily be corrected either by revision surgery or with injections as an outpatient.

Skin wrinkling is very difficult to correct and usually involves surgery and probably scars. This is why skin preparation, toning, nutrition and garment wearing are so important.

Skin loss is very rare and is connected with serious infections or smoking.

Infection is not common and is rare when there is screening for infection before surgery. If there is any infection we treat it with the correct antibiotic.

During the pre-operative consultation you will be given written information and fact sheets to help you remember what you have been told and also to list the most common complications and their treatment.