Cosmetic Surgery and Beauty Magazine #64

feature
The aim of liposuction is to decrease the bulk of fat
in a specific area, but not to remove all the fat. Fat is an
important tissue which helps to maintain skin shape and
firmness and removing too much fat can cause loose skin
and surface irregularities.
Depending on the size and number of the areas being
treated, as well as the technique employed by the surgeon,
the procedure can last from around one to five hours.
The aim of liposuction is
to decrease the bulk of fat in
a specific area, but not to
remove all the fat
After surgery, the patient can expect to be swollen and
bruised. Most patients report feeling sore for a few days. It is
also common to experience some numbness in the treated
areas, although this should go away in the first few weeks.
Patients are required to wear a compression garment for
up to six weeks, but should be back to their normal routine
after two to four weeks and vigorous exercise in a month.
Although results can be seen as swelling subsides, it can
take from six months to a year to achieve the final effect.
Although different surgeons may favour certain
modalities and variations, it is important to remember that
all liposuction is surgery, requiring incisions, anaesthesia
and diligent post-operative care.
Liposuction techniques
– which work best?
There are numerous liposuction techniques available today,
however each doctor has their preferred method, all of which
offer effective, predictable results. As well as the technique
employed, in every liposuction procedure the doctor takes
into account the level of sedation administered, the type of
cannula used and the patient’s wishes.
No single technique, piece of equipment or instrument
necessarily offers better results. Most surgeons will adapt
techniques and tools to each individual patient to achieve
optimal results. Generally, the technique that the doctor is
most skilled in will cause the least complications.
There are generally three techniques used in liposuction
surgery today: ‘wet’, ‘superwet’ and ‘tumescent’. These
are all dependent on the amount of fluid preinjected –
predominantly local anaesthetic, blood vessel constrictors
and saline – into the fat cells before the actual liposuction.
Liposuction was originally performed with what is now
referred to as the ‘dry technique’. It derived its name from
the fact that it did not preinject any fluids into the fat before
surgery. While fat removal using the dry method was
effective, it was for the most part abandoned because of
its association with increased discomfort for the patient,
excessive blood loss, increased tissue and nerve damage,
as well as extensive bruising and a greater propensity for
uneven or asymmetrical results.
The introduction of tumescent liposuction was a
significant advancement in liposuction surgery and
made it a much safer and more predictable procedure.
Tumescent refers to a saline-based solution that usually
contains epinephrine (which causes smaller blood vessels
to constrict and reduces bleeding and bruising) and
lidocaine (an anaesthetic that provides localised pain relief)
which is injected into the area to be treated. Ironically, the
dry technique is wet (lots of blood loss), while the wet
technique is dry.
Performing liposuction surgery with tumescent helps to
separate tissues, allowing easier movement of the cannula
through the swollen fat cells. Suction, either manually with
a syringe or mechanically, then removes the fat tissue and
most of the injected fluid. The rest of the fluid is largely
excreted by the body in the days following surgery. As the
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