Liposuction

Fatty bulges on the tummy, the outside of the hips and thighs, the inside of the knees and around the ankles can prove frustratingly resistant to exercise and a healthy lifestyle. They may be appropriately treated by liposuction which is sometimes called liposculpture.

Liposuction is not a means of managing general obesity but if you have your weight under control and are pursuing that healthy lifestyle in terms of a good diet, moderate alcohol intake and exercise and are still troubled by these unsightly bulges then seek a consultation with a surgeon at Bristol Plastic Surgery. They will be happy to discuss the management of these discrete areas. There is a fee for this consultation and advice. This information is intended to complement your consultation.

Prices start from £3,300

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Assessment

As well as recording your general health, you will be carefully assessed to be sure that you can benefit from liposculpture. Your weight and build and body fat distribution will be taken into account. You must be prepared for the advice that liposuction is not the appropriate solution. If you are suitable, you will be measured for a support garment.

Preparation for surgery

Please read any information your surgeon provides and heed the advice. It is important for your wellbeing that you take this procedure as seriously as you would any other surgical procedure. Remember too the advice not to use moisturiser or bath oil on the day of admission.

Procedure

You will be admitted on the day of your procedure and the areas to be tackled will be carefully mapped out on your body. A general anaesthetic will be administered when large areas are to be treated.

Small incisions are made in the skin close to the mapped target areas and local anaesthetic and adrenalin solution will be instilled.

Liposuction cannulas of varying dimensions will then be introduced under the skin and in a carefully planned pattern of crisscrossing fan-shaped passes, the fat is sucked out of the target fatty mound creating tunnels. By using this pattern from several directions the fat is removed in a gradual and even manner leaving behind enough fat and structural support for the overlying skin. Beneath the skin, the fatty mound now resembles a compressible natural sponge. When enough fat has been removed, the surgeon moves on to another area. The small entry ports for the cannulas are stitched.

Depending on the area treated, you will then be fitted with a closely fitting support garment.

Aftercare

You may need to stay in hospital for a night. Painkillers are likely to be required for several days and these will be supplied to you before discharge home.

You be up and about in the 48 hours after the operation and then gradually increase your activity over the next two weeks as you feel able. Avoid strenuous exercise in this period.

There will be small dressings in place and these need to be kept dry and clean until suture removal and dressing change at your outpatient appointment in one week. The support garment fitted in hospital must be worn day and night for five weeks and then only during the day for a further four weeks.

Depending on your occupation, the size of the area treated and how comfortable you feel, you may consider returning to work in 7 to 14 days.

Implications

You will have some bruising over the area that has been treated. Sometimes this can be extensive and can last for three weeks or more.

The treated area will be swollen and will feel lumpy and very tender. This will take several months to completely settle. If your abdomen has been treated then you may experience temporary swelling in the genital area. Similarly, liposuction in the knee area may result in ankle swelling. If the ankles themselves have been treated, the swelling there may persist for several months.

The scars although small will be red initially and will then fade over time. The time taken to settle varies between individuals and some will form raised scars that take a long time to fade.

There may be some numbness of the skin overlying the treated areas; this should slowly recover. You may also experience the occasional sharp stabbing like discomfort during the healing phase which will last between 3 and 6 months.

You may not see the full benefit of the surgery for six months and surface imperfections and skin dimpling (cellulite) may persist.

Expectations

When fat is removed, we rely upon the elasticity of the skin to contract or shrink to fit. In some cases, permanent sagging of the skin can occur when the amount of fat removed exceeds the capacity of the skin to contract. This can be corrected but there would be additional cost implications for any secondary procedure. The irregularity of a cellulite appearance cannot be changed. This is more common in older patients.

If you do not maintain a steady weight after the procedure, then there will be consequences for the appearance and the skin firmness. To benefit from liposuction there must be strong patient motivation and compliance.

We aim to make you as even and symmetrical as possible, but you should expect some difference between the two sides of your body after the operation. In some cases, a secondary procedure may be possible but this would have cost implications.

Although we sound many cautions, we believe there is a very definite place for liposuction, either as an adjunct to other operations or as a carefully targeted sculpting procedure. Most of the undesirable outcomes and complications have been reported following extensive liposuction procedures that we would deem too large and inappropriate.

Complications

Infection after this surgery is extremely uncommon and we take all precautions to avoid it. If blood collects underneath the skin of the treated area, this may need to be drained to avoid infection. Skin loss and other major complications are very rare.

The process of liposuction leads to the destruction of the fat globules, and there is a very small risk that some of the fat may enter the blood stream and be deposited elsewhere in the body (fat embolus). In very rare instances, these fat globules have lodged in the lungs or brain where symptoms may result. These events probably relate to extensive liposuction procedures the like of which we at BPS are not willing to perform.