Liposuction (also known as lipoplasty,lipectomy or liposculpture) is a surgical procedure used to manually remove fat deposits (subcutaneous tissues) from the body for body contouring purposes. In a few instances, liposuction is also used to remove lipoma (benign fat tumour) and abnormal build-up of fat under the nipples of men (gynaecomastia, or ‘man boobs’).
Liposuction is a cosmetic procedure which removes fat tissues from the body using air suction. A cannula is placed directly on fat deposits and sucked out of the body through the cannula and tube, along with a small amount of blood and bodily fluids.
The concept of liposuction has been around since the first half of the 20th century. However, the concept only gained prominence in the late 1970s following the invention of the hollow cannula in 1975 by Italian gynaecologists Arpad Fischer and his son, Giorgio Fischer.
The cannula is a hollow tube which allows surgeons to create safe tunnels between blood vessels to facilitate the extraction of fat out of the body using air suction.
Liposuction Surgery being performed by plastic surgeon. Image by James C. Mutter / Plastic Surgeon Vishal Kapoor, MD (courtesy of Wikimedia Commons)
Depending on the patient’s body mass index, as well as the amount and location of the fat deposits, liposuction can be performed using one or a combination of the following techniques.
• The Dry Technique: Liposuction is performed without introducing any infiltrate solution. This will lead to heavy blood loss, but allows the procedure to be performed in hard to reach areas.
• The Wet Technique: Between 200 and 300 cubic centimetres of infiltrate solution (made from saline or sodium lactate solution) is flooded into the tunnel and operating field.
• The Superwet Technique: A one to one ratio of fat to be removed and infiltrate solution (epinephrine or lidocaine is added to the saline or sodium lactate solution) is used.
• The Tumescent Technique: This technique is used primarily in critical areas of the body. A one to four ratio of fat and infiltrate solution is used.
• Ultrasonic Assisted Lipoplasty (AUL): This is an alternative method to the cannula technique. Ultrasonic energy is focused on the target area prior to suctioning to soften the fat tissues. The method reduces the chances of internal damage and amount of bleeding, but some patients complain about external skin burns and peeling. Nevertheless, AUL is the most popular liposuction method in North America owing to the support of the American Society of Plastic and Reconstructive Surgeons.
Like other invasive cosmetic surgeries, liposuction is a low risk procedure. However, before going ahead with the procedure, you should understand all the inherent and potential risks.
• Minor complications: Common complications include hematomas (bleeding), seromas (fluid build-up) and bumps (contour irregularities). The issues will usually resolve themselves. Nevertheless, please speak to your doctor if you are at all concerned.
• Major complications: Fluid overload, lidocaine toxicity and negative anaesthetic reaction can lead to death. However, symptoms will typically appear shortly after surgery, so doctors will usually be able to know if you are facing such risks and treat them accordingly.
Contour defects are rare, but if they appear, a follow up corrective surgery and hospitalisation is required. Aside from this, the risk of infection will be present until wounds and incisions are completely healed.
Note: Liposuction, like most forms of cosmetic surgery, is not available on the NHS. However, exceptions are made for special cases.
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