Liposuction (Surgery to Remove Fat by Suction)


Liposuction (Surgery to Remove Fat by Suction)

‘Liposuction’ is a surgical operation intended to remove the persistent fatty deposits concentrated in certain parts of the body (abdomen, thighs, hips, waist, femur, knee, ankle, breast, jowl, arm), which cannot be lost via diet and exercise, by means of thin cannulae or special injectors, thereby contouring the body and obtaining more esthetic body lines. In this intervention, fat is removed from parts where there are more fatty deposits as compared to other sites of the body in order to provide a more proportional body shape. This procedure can be applied especially in sites such as the abdomen, thighs, hips, knees, flanks, back area, ankles, arms and jowl.

What are the names used for the operation of fat removal by suction?

The only method used for fat removal and body contouring, which is scientifically recognized today and has the least number of complications, is the method for fat suction, i.e. “liposuction” in scientific terminology.  This procedure is also called “body sculpting”, “body contouring” or ” suction lipectomy” in medical literature. As for “lipofilling”, it is the term used for filling in the unwanted recesses or dents on the body by using the fat tissues removed by means of “liposuction”. Today, lipofilling is used very widely, for example, to make the cheeks more prominent and to fill in the site that we call “nasolabial” groove, which is between the ala of the nose and the upper lip border

What are the steps to perform liposuction?

A liposuction procedure can be performed using large injectors or a vacuum device. In both cases, cannulae with diameters of 2, 3 or 4 mm are used as per the body site.

Since 1970s, liposuction has been employed in plastic surgery. In earlier years, cannulae with larger diameters would be used. In recent years, the most important advance is the use of the technique termed the “wet technique” and smaller-diameter tubes. Local anesthetics and serums containing hemorrhage-reducing medicines (adrenaline) are injected into the sites from which fat is to be suction. This way, fatty deposits can be suctioned more easily and without hemorrhage from these sites.  Using small-diameter cannulae also minimizes the risk for irregularities that may develop following surgery.

Who can/cannot undergo this procedure?

Liposuction is not a weight-loss method. It cannot be performed on overweight people with a Body Mass Index of 30 or higher. Ideally, it is performed on people who are at a normal weight or slightly above normal weight, yet who have more fatty deposits in certain parts of the body as compared to the other parts. More fatty deposit concentration is seen in the thighs, hips, femurs (upper leg), abdomen and waist areas especially in women. This procedure is used to thin these areas in order to balance their proportion with the other sites.

The points to be considered carefully before surgery include: skin elasticity, stria and cellulitis due to childbirth or weight gain/loss, age, varicose veins, hernia, smoking and medication (vitamin, anti-coagulant, iron, oral contraceptive, hormone intake), diabetes, cardiovascular and pulmonary diseases, presence of health conditions in liver and kidneys, common cold, infection, skin infections, hemorrhage, diathesis, psychiatric disorders, psychiatric eating disorders such as bulimia-anorexia and unrealistic expectations.

What are the surgical steps?

The liposuction surgery can be performed under local anesthesia or general anesthesia by sedating the site from which fat is to be removed.

Since the liposuction procedure is performed by means of incisions with a length of 3-4 mm through which only cannulae would be inserted, no incision marks are noticed following surgery. Elastic corsets should be worn on the site where intervention was performed in the post-operative period. This way, it is ensured that the skin can adapt more smoothly to its new location. It is recommended to wear these corsets for about 2-3 weeks on average. Liposuction is an intervention with a very comfortable post-operative period for the patient.  Generally speaking, the patient is sent home within a few hours following liposuction procedures and is able to return to work and daily activities within a few days. If it was performed on multiple sites and general anesthesia was preferred, then it is more appropriate to keep the patient at the hospital for a period of one day. The patient is made to wear the corset immediately after surgery and this corset is used for approximately one month.

What does the recovery period look like?

Mild pain that may occur following surgery may be taken under control using painkillers. Edema and bruising would develop following the liposuction intervention in the sites from which fat was removed. It may take 3-4 weeks for the bruising to heal and it may take 6-8 weeks for the swelling to be completely deflated so that the precise result can emerge.

Patients are recommended to perform physical exercises and conduct LPG massage on the sites where the procedure was performed following liposuction. This way, it is ensured that the edemas can heal more quickly and the possibility for skin undulation can be reduced.

Would I have any problems?

The most important complication of the liposuction procedure is the occurrence of ondulations and some recessed points on the site of fat removal. Suction of excessive fat from the fat removal site or irregular suction of fat may result in such a situation while this result may also occur in persons with poor skin elasticity. It is rather difficult to correct these emerging problems. For that reason, it is of absolute significance that this procedure be performed by experts with relevant experience.

Liposuction may reduce skin irregularities such as cellulitis, however, it should be known that it would not completely eradicate them. Better esthetic results are obtained in young patients with good skin elasticity. Since the number of fatty cells in the liposuction site is reduced, fat is not concentrated especially in these sites when the person gains weight later in life. However, it is still important that the patient complies with the post-operative diet. Continuing to eat excessively may lead to an overweight appearance again.

The liposuction procedure is an intervention that yields very successful results when eligible patients are selected and the procedure is performed in competent hands. However, it should be kept in mind that it is very difficult to reverse any deformities due to excessive fat suction from certain sites during an inappropriate intervention.