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Liposuction

Published by Bupa's health information team, July 2009.

This factsheet is for people who are having liposuction, or who would like information about it.

This operation helps to change your body shape by removing unwanted body fat. Your care will be adapted to meet your individual needs and may differ from what is described here. So it's important that you follow your surgeon's advice.

About liposuction

Liposuction, also known as liposculpture or lipoplasty, is an operation that can remove small areas of fat that you haven't been able to shift with diet and exercise. Liposuction is not a treatment for weight control or obesity, and it can't remove cellulite or stretch marks.

Liposuction can be done on your abdomen, hips, thighs, buttocks, knees, ankles, upper arms, neck and sides.

There's a limit to the amount of fat that can be safely removed from an area, so it may not be possible to reduce an area as much as you might like. Your body won't replace the fat cells, so you should have a long-lasting change in your body shape, especially if you exercise, eat a healthy diet, and maintain a healthy weight after your operation. However, putting on weight can cause the remaining fat cells to enlarge.

Getting advice

It's important not to rush into the decision to have cosmetic surgery. Discuss your options with your GP, who may be able to recommend a reputable surgeon or advise you about choosing a hospital to be treated in.

Before opting for liposuction, discuss with your surgeon what you are hoping to gain from the operation and the result you can realistically expect.

What are the alternatives?

If you want to lose fat from your abdomen, an alternative may be a tummy tuck, where excess fat and skin are removed from the abdomen. However, a tummy tuck is also not a treatment for obesity.

Many creams, diet supplements and beauty treatments claim to reduce stubborn areas of fat and even cellulite. However, there is no scientific proof that they work.

Preparing for your operation

Your surgeon will discuss how to prepare for your operation. If you smoke, you may be asked to quit, as smoking will increase your risk of getting a chest or wound infection and slow your recovery.

Liposuction is often done as a day case, but you may need to stay in hospital overnight if you are having large areas treated. The operation is usually carried out under general anaesthesia, which means you will be asleep during the procedure. If you're having a general anaesthetic, you will be asked to follow fasting instructions. Typically, you must not eat or drink for about six hours before a general anaesthetic. However, some anaesthetists allow occasional sips of water until two hours beforehand.

Your operation may be done with an epidural if you're only having your lower body treated. Local anaesthetic injections might be an option if you're only having a small area treated. This means that the area will be numb but you stay awake. You may be given a sedative to help you relax during the procedure.

At the hospital, your nurse may check your heart rate and blood pressure, and test your urine.

Your surgeon will usually visit you to discuss the operation and ask you to sign a consent form. This confirms that you understand the risks, benefits and possible alternatives to the procedure and have given your permission for it to go ahead.

Your surgeon will mark the treatment area on your body. Photographs may be taken, so that the results of liposuction can be compared with your original appearance.

About the operation

There are several different techniques. Your surgeon will explain the options available to you.

Depending on how much fat you are having removed and the technique the surgeon is using, the operation usually takes between one and four hours.

Wet liposuction

Your surgeon will inject a mixture of salty water, local anaesthetic and adrenaline into the fatty area being treated. This helps reduce bleeding, bruising and swelling and makes it easier to remove the fat.

Your surgeon will make a cut in your skin and insert a thin metal tube. This is attached to a vacuum pump or a syringe. The tube is moved vigorously inside the fatty tissue to break it up. The fat and fluid is sucked out. For larger areas, more than one cut may be made to reach all the fatty deposits that are being treated.

Once your surgeon has removed the required amount of fat, the metal tube is taken out and the cuts may be closed with stitches.

A variation of the wet technique is called tumescent liposuction where a larger volume of fluid is injected.

Dry liposuction

The surgeon uses a metal tube with suction, without fluid injection, to remove the fat. Dry liposuction can cause more bleeding and bruising than wet liposuction, so it's not often used now.

Ultrasound liposuction

If the fat is very dense (for example, on a man's torso) or there is a lot of fat, ultrasound can be used to break up the fat before it is removed.

What to expect afterwards

Afterwards, the treated area is firmly strapped with bandages. You will usually be fitted with an elasticated support garment. This will help to reduce swelling and help improve your shape.

You will be given painkillers to help relieve any discomfort as the anaesthesia wears off. You can go home once you have made a full recovery from the anaesthetic, but you will need to arrange for someone to drive you home. Try to have a friend or relative stay with you for the next 24 hours.

General anaesthesia can temporarily affect your co-ordination and reasoning skills, so you should not drink alcohol, operate machinery or sign legal documents for 48 hours afterwards.

Before you go home, your nurse will advise you about caring for your stitches, hygiene and bathing. You will usually be given a date for a follow-up appointment.

Recovering from liposuction

Your surgeon will advise you on the exact post-operative care required as this varies according to the areas treated, how much fat is removed and your natural skin elasticity.

You can usually take over-the-counter painkillers such as paracetamol or ibuprofen if you need them. Always follow the instructions in the patient information leaflet that comes with the medicine.

You will usually need to wear your elasticated garment or bandages for up to three weeks. Don't do strenuous exercise for up to four weeks, but walking and gentle exercises are encouraged. If you had treatment to a large area, you may need to take up to 10 days off work.

If you have had dissolvable stitches, the amount of time they will take to disappear depends on the type of stitches you have. They usually disappear in around two to three weeks, but it can sometimes take longer. Other stitches may need to be removed after about seven days.

It may be several months before you see changes to your body shape as the swelling can take time to settle down. If you have skin with good elasticity, it's more likely to shrink down to fit your new body shape well. It's possible that you still won't be happy with your appearance after the operation.

What are the risks?

Liposuction is a commonly performed and generally safe surgical procedure. However, in order to make an informed decision and give your consent, you need to be aware of the possible side-effects and the risk of complications.

Side-effects

These are the unwanted but mostly temporary effects you may get after a procedure. Side-effects of liposuction include:

  • considerable bruising - this can be painful and can sometimes take more than a month to clear
  • swelling - this may not completely settle for up to six months
  • scars - these are typically 1 to 2 cm long, pink and noticeable at first, but should become fainter after a few weeks
  • raised, bumpy veins (thrombophlebitis) around the inside of your knee and inner part of your upper thigh if these areas are treated - this is not the same as deep vein thrombosis and should settle after a few weeks
  • swollen ankles

If you have large areas treated or are prone to anaemia, you may need to take iron tablets for about a month afterwards.

Complications

This is when problems occur during or after the operation. Most people are not affected. The possible complications of any operation include an unexpected reaction to the anaesthetic, excessive bleeding and infection. Antibiotics may be needed to help prevent infection.

Other complications specific to liposuction are rare, but can include:

  • lumpy, uneven results, which may need another operation
  • fat getting into the blood vessels and travelling to the lungs - this can cause a blockage, called a pulmonary embolism, which can be fatal
  • numbness - this may last for several months
  • damage to internal organs - this may require surgery to repair
  • build up of fluid in the lungs (pulmonary oedema) as a result of the fluid injected into the body

The exact risks are specific to you and differ for every person, so we have not included statistics here. Ask your surgeon to explain how these risks apply to you.

Related topics

Further information

  • The British Association of Aesthetic Plastic Surgeons (BAAPS)
    020 7430 1840
    www.baaps.org.uk
  • The British Association of Plastic Reconstructive and Aesthetic Surgeons (BAPRAS)
    020 7831 5161
    www.bapras.org.uk

Sources

  • Liposuction (or lipoplasty/liposculpture). Department of Health. www.dh.gov.uk, accessed 27 February 2009
  • Liposuction. British Association of Aesthetic Plastic Surgeons. www.baaps.org.uk, accessed 27 February 2009
  • Liposuction. British Association of Plastic Reconstructive and Aesthetic Surgeons. www.bapras.org.uk, accessed 27 February 2009
  • Body contouring surgical procedures physician's guide. American Society of Plastic Surgeons. www.plasticsurgery.org, accessed 27 February 2009
  • Abdominal Surgery. British Association of Plastic Reconstructive and Aesthetic Surgeons. www.bapras.org.uk, accessed 19 March 2009
  • Smoking and anaesthesia. British Association of Day Surgeons. www.daysurgeryuk.org, accessed 18 February 2009
  • Liposuction, Techniques. eMedicine. www.emedicine.medscape.com, accessed 26 February 2009

This information was published by Bupa's health information team and is based on reputable sources of medical evidence. It has been peer reviewed by Bupa doctors. The content is intended for general information only and does not replace the need for personal advice from a qualified health professional.

Publication date: July 2009

 

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