Who is a good candidate for liposuction?
Mr Morritt regularly performs liposuction at the Claremont and the Thornbury Private Hospitals in Sheffield. Liposuction which is a surgical procedure that is used to remove areas of unwanted fatty deposits. It works best when the unwanted fat is localised in specific areas and should not be thought of as a method for losing weight but rather of body reshaping. Patients often have a genetic tendency to store excess fat in certain body areas and may recognise similarities between their own body shapes and those of their parents. The most commonly affected areas are the abdomen, hips, thighs, neck and chin. Many patients will have noticed that these localised fat deposits frustratingly do not tend to respond much to exercising or dieting.
The best results from liposuction are seen in people who are at or near to their ideal weight and have good quality stretchy skin as it is able to shrink down and become tight around the new body contours. Patients with skin that has many stretch marks can be left with wrinkly skin after liposuction as the skin itself has lost its elasticity and can’t shrink down fully to grip the underlying tissue tightly. Patients who have significant amounts of excess baggy skin are not good candidates for liposuction alone as they would be left with saggy folds of skin and the best treatment for this is surgical excision.
Liposuction – procedure
Liposuction is performed under General anaesthetic as either a day case or overnight stay procedure. Sometimes it is possible for small areas to perform liposuction under local anaesthetic. On the day of surgery Mr Morritt will mark the areas of the body requiring treatment.
The procedure starts with an injection of fluid into the area of fat that is to be removed (this is called tumescent infiltration). The fluid is saline (salt water) but also contains adrenaline to reduce bleeding and local anaesthetic to reduce discomfort. It may seem strange to increase the size of the unwanted fatty area by injecting fluid but research has shown that by doing this, more fat can be removed with less bleeding, bruising and discomfort. A few small incisions (these are usually only a few millimetres long) are then made in inconspicuous areas where possible and the liposuction tool (which looks like a metal wand that has holes in at the end) is inserted into the area being treated. The tool is moved backwards and forwards to loosen the fat and the constant suction applied to the tool then removes the loose fat from the body.
At the end of the procedure the incisions are closed with a self dissolving suture and a small dressing or glue applied. A firm support garment is then used in order to help squash the tissues into their new flatter position and support them as they heal and also to reduce bleeding and swelling.
Patients either go home on the day of surgery or on the day following surgery. The recovery following surgery depends both on the amount of liposuction that has been performed and on the patient themselves as different patients heal at different rates. It is normal to experience some discomfort in the first few days following surgery. Patients are instructed to wear the support garment continuously for 6 weeks following liposuction (it can be taken off for showers). It is recommended to avoid heavy exercise for 6 weeks following surgery, however patients are advised that they should regularly undertake short walks in order keep the circulation moving and reduce the risk of DVT (deep vein thrombosis; blood clots in the legs). Most patients can return to work approximately 1-2 weeks following surgery. It is normal for the tissues to be swollen in the first few weeks following surgery and patients are advised that it will take at least 6 weeks following surgery for the swelling to wear off and the new body shape to become visible. It normally takes approximately 4-6 months before the final results are seen and the scars from the procedure to settle.
Risks of liposuction
Bruising – this is normal following liposuction and can take a number of weeks to resolve
Numbness – this is very common following surgery as the nerves can get bruised. It does usually recover with time but in some instances may be permanent.
Infection – a rare complication following liposuction. In severe infections, sepsis can occur. An extremely rare infection following liposuction is necrotising fasciitis which has been described and this may require emergency life saving surgery.
Contour irregularity – It is not possible to remove all of the fat under the skin in an individual as to do so may result in significant lumpiness and skin irregularity etc. It is therefore normal practice to leave a thin layer of fat under the skin for safety. In the early healing phase it is common for there to be some irregularity of the skin related to post operative swelling. This usually improves with time but can take a number of months to fully resolve.
Poor scars – generally the scars from this procedure heal very well. Scar formation differs between individuals with the majority of patients ultimately forming good scars (thin, flat, pale, painless). Some patients are at increased risk of thickened, raised, red, painful scars and these include those who are very young, those with darkly pigmented skin and patients with white skin and red hair.
Deep vein thrombosis (DVT) – blood clots can form in the legs following any operation. We take precautions to minimise the risk of this complication with compression stockings, calf compression devices in theatre, blood thinners and early mobilisation. It is possible for a DVT to spread to the lungs (PE, Pulmonary embolism) and this can sometimes be fatal although this is very rare.
Injury to underlying structures – an extremely rare complication of liposuction is damage to underlying structures such as the bowels. This may necessitate further emergency surgery and can be potentially fatal.
Fat embolism – in exceptionally rare cases fat particles can enter the bloodstream and travel to the lungs or brain which could cause brain damage, respiratory failure (requiring mechanical ventilation) or death.
Frequently asked questions – liposuction
Are the results permanent?