Liposuction and Body Contouring
Liposuction, sometimes referred to as ‘lipo’, slims and reshapes specific areas of the body by removing localised excess fat deposits, and improving body contours and proportions. The effectiveness of liposuction is a testament to its sustained popularity.
It’s not a treatment for generalised obesity or for loose skin. Liposuction is generally performed under general anaesthesia, supplemented by local anaesthesia.
Who is a good candidate for Breast Augmentation?
► Those with excess localised fat deposits, located anywhere on their body, which do not respond to diet or exercise.
► Adults who are within 30% of their ideal weight (as measured by their body mass index), and who have firm, elastic skin and good muscle tone.
0203 432 3009
What can I expect in the initial consultation?
Mr Branford is a leading plastic surgeon with extensive experience in performing liposuction, and will conduct an initial consultation covering:
► Your surgical goals
► Medical conditions, risk factors, medical treatments and drug/dressing allergies.
► Medications (avoid taking aspirin, other blood thinners, and anti-inflammatory drugs as they increase bleeding)
► Vitamins and herbal supplements (which should be stopped 2 weeks preoperatively due to often poorly studied or unknown effects on post-surgical bleeding)
► Alcohol, tobacco and drug use
During the consultation, Mr Branford will also assess and agree on liposuction sites with you. This may involve taking fat from more than one area and should be done to produce a symmetrical result.
The hip region is avoided in women to maintain a feminine natural curve, with fat taken above and below this area. He will:
► Take clinical photographs, which may include three-dimensional images which can be morphed to assist in understanding patient goals and how realistic expectations are
► Pay particular attention to surgical scars as potential sources of hernias. Visceral perforations are most common in the small intestine in patients with abdominal hernias. Skin quantity and quality will be assessed, and differences between excisional procedures (in patients with loose skin) and liposuction will need to be discussed with the patients
► Take circumference measurements at the widest points
► Explore liposuction options
► Discuss likely outcomes of liposuction and any risks or potential complications.
Patients should arrange for someone to drive them home from the facility or hospital after surgery, and to stay with them for at least the first night following the procedure.
How does liposuction work?
Several assisted techniques that improve the effectiveness of liposuction have been developed. Mr Branford uses traditional mechanical liposuction often using the Microaire device, which gives predictable, effective results without the increased risks of some marketed high energy devices, which do not give better aesthetic results but are associated with increased surgical risks.
Post-surgical well-fitting garments should be worn for 4–6 weeks on the areas treated (chest, upper arms, abdomen and thighs) to reduce bruising and swelling, and help to shape the tissues as they heal.
Showering can be commenced in the days after surgery and wounds allowed to dry before reapplying surgical garments.
It is important that the surgical incisions are not subjected to excessive force, perspiration, abrasion or motion during the time of healing, which normally takes around 3 weeks.
Liposuction is contraindicated in:
► Smokers due to poor wound healing. Smoking should be discontinued 6 weeks before surgery and 2 weeks after.
► Individuals with medical conditions that can impair healing.
► Individuals who are not fit for general anaesthesia.
Liposuction can treat the following areas:
► Abdomen and flanks
► Inner and outer thighs (‘saddle bags’)
► Upper arms
► Back rolls
► Chest area, breasts and areas of fullness
► Below the armpits
► Inner knee
► Calves and ankles
► Chin and neck.
Liposuction is not a treatment for obesity, nor is it a substitute for proper diet and exercise. The procedure is most effective when directed at specific problem areas with localised fat deposits.
Liposuction is also not an effective treatment for cellulite—the dimpled skin that appears on the thighs, hips and buttocks. Moreover, it is not a procedure for loose skin, and can worsen skin laxity if performed excessively. It is not possible to improve lax skin tone with liposuction.
Complications of liposuction can be potentially life-threatening. The procedure is therefore most commonly performed by plastic surgeons, as they are comprehensively trained in the standards of care for the liposuction procedure, and are fluent in managing complications.
In the UK, liposuction should be performed in a facility/hospital that is inspected at regular intervals by the Care Quality Commission. This is to ensure patient safety and best practice by surgeons who are on the specialist General Medical Council register for plastic surgery.
► General anaesthetic risks: nausea and vomiting, or temporary confusion, may occur, or more serious complications, which are rare (less than one in every 10000 cases), such as a serious allergic reaction or an inherited reaction to the anaesthetic. Death due to general anaesthesia may occur in every one in 100 000–200 000 cases) (NHS Choices, 2015)
► Swelling: this typically lasts up to 6 weeks, but final results are only seen at 3 months
► Bruising: this typically lasts 1 week for every decade of the patient’s age. Surgery should therefore ideally be planned at least 4–6 weeks before a beach holiday
► Contour irregularities or asymmetries: these occur in the harvest areas if too much fat is removed or if this is done too superficially in the subcutaneous tissues. This may be prevented by harvesting smaller more evenly distributed volumes using a finer cannula (Mr Branford uses 2.5mm, 3mm and 4mm liposuction cannulas.
► Bleeding or haematoma: as excessive liposuction empties the tissues of fat, a cavity may be generated which fills with blood, requiring aspiration or evacuation
► Rippling or increased skin laxity: this results from excessive liposuction or where liposuction was not indicated and the patient should have had abdominoplasty, for example
► Fat necrosis: this is rare and is where fat may become infected and drain out through a wound, or may harden and be felt as a lump. This is commonest after ultrasonic- assisted liposuction. It normally softens over 12–18 months, but may need further liposuction if persistent
► Fluid shifts and physiological disturbance: this can occur with high- volume infiltration or aspiration above 4 litres in one operation
► Abnormal sensation (paraesthesia): this is usually transient but may persist.
► Very rarely, life-threatening complications may also occur as a result of liposuction, such as bowel perforation or pneumothorax (from striking the ribs during abdominal liposuction with the tip of the cannula being forced deeply, or during breast liposuction), necrotising fasciitis, or pulmonary embolism. Death has been reported in 23 out of 200 000 cases (Lehnhardt et al, 2008).
► Venous thromboembolism is a serious complication with risks of persistent morbidity or mortality. It has been shown to be the single largest cause of mortality in patients undergoing high-volume liposuction (Grazer and de Jong, 2000).
Liposuction continues to be one of the most popular surgical cosmetic procedures, which is testament to its efficacy in experienced hands. The procedure has evolved over the years in terms of its safety and quality of outcomes. Patients should be educated about heavily marketed, new treatments that may not be of benefit and could provide additional risk.