Liposuction

What is liposculpture?

Liposculpture is a highly specialised procedure which reshapes the body by the immediate removal of stubborn fat from problem areas. Benefits are permanent, for once fat cells are removed, they cannot return. In effect, liposculpture is equivalent to being able to focus the effects of dieting on specific areas of the body.

Fat removal by liposculpture is one of the most exciting and effective treatments of modern cosmetic surgery. It is an excellent technique which produces very favourable results and can be judiciously employed with other techniques to enhance their effects.

Who is it for?

Women and men who, even though they have dieted and exercised, find that some parts of their body will simply not reduce in size and shape. Particular areas that usually respond well to the procedure are the hips, thighs, abdomen, buttocks, knees and ankles. The male problem of “feminine looking breasts” can also be corrected and the technique is extremely effective in removing a “double chin”.

The best candidates for treatment are in good health and have realistic expectations of liposculpture. There is no definite age limit, nor weight limit for patients who are “good candidates” for liposculpture. Most of our patients have localised accumulations of fat, however, an overweight person whose weight has been stable for many years and has certain problem areas of fatty deposits, may be excellent candidates for liposculpture.

Liposculpture – is it liposuction?

“Liposculpture” is a variation on the results obtained with liposuction. There is little real difference between liposuction and liposculpture. They are both the surgical removal of fat using suction. The main difference is that with liposculpture, the surgeon actually uses a cannula to reshape the area being reduced, Much as a sculptor would. This is effective in creating natural looking body contours, as opposed to simply removing fat.

All surgeons who perform liposuction to a very high standard incorporating some degree of liposculpting into the procedure as a matter of course in order to get the best aesthetic result possible.

What happens?

A small cannula (from the Latin word for reed, tube, cane) or syringe is introduced into the area to be treated and the excess fat removed by suction.

Is there any discomfort?

There will be some post-operative discomfort and bruising. Medication will be prescribed for this if required.

How long does it take?

The procedure time varies depending on the areas to be treated. For the hips and thighs the procedure takes approximately one hour. You are normally free to return home on the day after treatment, returning approximately one week later for your first post-operative appointment.

Where is the scar?

Because the incisions are so small (¼ inch/5mm) and normally hidden within a skin fold, scars are virtually undetectable. Prior to the development of the liposuction/liposculpture techniques the surgical removal of fat resulted in large and unsightly scars.

Is the fat removal permanent?

Yes, when fat cells are removed they cannot return. However, you can still gain weight and fatty bulges in other areas if you eat unwisely!

Will I lose weight?

The cosmetic success of liposculpture relies on removing inches rather than pounds. For example, removing an amount of fat equivalent to a half a pound of butter from each outer thigh of a woman’s saddlebag area or from a man’s love handle area would result in a dramatic change in silhouette, but would not significantly change the persons weight.

What will I look like immediately? When will I look good?

The area treated will be covered by a snug elastic dressing, girdle or body stocking. This will be removed one week after surgery by which time the area will be reduced in size although some bruising and swelling will still be evident. You will need to wear the garment during the day for a further three weeks, if possible. The bruising will normally disappear within two weeks.

How is the skin affected?

The degree of skin change after liposculpture is the same as one would expect if it were possible to lose an equal amount of fat in these localised areas simply by dieting. Because the cannulas/syringe simply makes tunnels through the fat, there remains multiple connections between the skin and the underlying tissue. These fibrous connections contract with the healing process and maintain the skin in its natural position.

After liposculpture one does not have to worry about excessive folds of skin in the areas treated. This effect is so dramatic that many patients who previously would have required surgical excision of skin called a tummy tuck, can now have excellent results simply by having liposculpture.

Can I drive myself home?

No. Because of the medications used during surgery you cannot drive for 24 hours. We have a number of patients who travel from out-of-town and from abroad for treatment. Upon your request we will be happy to send you information about special arrangements for our out-of-town patients.

When can I return to normal activities?

There is no limitations to physical activity other than what common sense would dictate. Some are able to return to jogging and light aerobic exercise within a day or two after surgery. Some patients do find the soreness after surgery more significant than others, but on average most are quite surprised at how quickly they are able to return to normal activities.

How much will it cost?

Your best investment is an individual consultation with a surgeon you trust. Cosmetic Surgery is usually a life-time investment. Our patients are treated as individuals, and costs do vary from person to person depending on their individual needs. However, the total cost of your procedure will be quoted at the consultation, fully inclusive with no hidden extras.

Should I have liposuction/liposculpture?

Only you can answer that question. Be sure you are doing it for the right reasons: your own sense of self confidence and self esteem. No matter what anyone else thinks, if you are happy with your appearance there is no reason to have it changed. So before making that decision, attend a consultation, get the facts. Be realistic in your expectations and make an educated decision that is right for you.

Liposuction

Liposuction is a technique used to remove unwanted fat deposits. It was developed in the 1970’s and is therefore well tested and gives predictable results. It is best suited to removing localised deposits of fat from the hips, tummy, waist or thighs. It can also be used in combination with other procedures such as facelifting, to remove fat from the neck, or with a tummy tuck (abdominoplasty) to remove fat from the waistline. It is a technique for improving body shape rather than helping with weight loss.

More recent developments, known as liposculpture, have added considerable refinement to our ability to reshape the contour of the body. However it is not a substitute for a controlled diet and results are best in patients who are not overweight but who have localised collections of fat. Good results also depend on elastic skin that will adapt to a new contour when the underlying fat is removed. With age skin becomes less elastic but the condition of the skin rather than your chronological age is the most important factor.

What are the different types of liposuction?

Liposculpture
Liposculpture is an adaptation of liposuction which employs the use of much finer cannulae allowing the removal of fat in a more controlled manner. As it causes less trauma to the tissues it can be used closer to the surface of the skin therefore giving superior results.

Tumescent Liposuction
This is a technique in which a medicated solution is injected into fatty areas at the time of surgery. The fluid is a mixture of intravenous salt solution, local anaesthetic and adrenaline (a drug that constricts blood vessels). This allows the fat to be removed more easily and reduces pain following the operation. Tumescent fluid injection during surgery also helps to reduce the amount of bruising after liposuction / liposculpture.

Ultrasound-Assisted Lipoplasty (UAL)
This technique requires the use of a special cannula that produces ultrasonic energy. As it passes through the areas of fat and the energy liquefies the fat making it easier to remove.

UAL has been shown to improve the ease and effectiveness of liposuction in fibrous areas of the body, such as the upper back or the enlarged male breast.

How do I prepare for surgery?

It is very important to avoid taking any Aspirin or products containing Aspirin for 2 weeks either side of the operation since Aspirin causes bleeding and has a very adverse effect on bruising. The same is true for non-steroidal anti-inflammatory drugs (such as Brufen and Neurofen). If you are a smoker it is helpful to stop for two weeks before surgery and for a week afterwards so as to help the circulation of blood to the skin. If you are taking the contraceptive pill it may be wise to stop it and use an alternative method of contraception for one cycle before the operation as this can improve the circulation in the legs following surgery.

What type of anaesthetic will be used?

Liposuction and liposculpture is usually performed under a general anaesthetic, so you’ll sleep through the entire operation. Occasionally with very localised areas it may be possible to perform liposuction under local anaesthetic with some sedation.

What does the operation involve?

Liposuction and liposculpture is performed via small 5 mm incisions through which the fine cannulae remove unwanted fat. Before performing the liposuction, fluid is injected into the fat as this allows the fat to be removed more easily and reduces pain following the operation (tumescent technique). The small incisions usually result in scars that are barely visible once healed and which are carefully positioned to be as inconspicuous as possible. At the end of the procedure an elasticated garment is applied over the area treated. This should be worn for 4-6 weeks in order to maximise compression and remodelling of the skin. In most cases liposuction requires one night stay in hospital depending on the volume and areas treated.

What happens after the operation?

Discomfort following the surgery varies from one patient to another but is not usually great. It is important to mobilise as soon as possible after the operation as resting in bed is not good for the circulation in the legs. You should keep the scars clean and dry until the sutures are removed between 10-14 days after surgery. Returning to work will depend on the extent of the liposuction but is usually between 10 and 14 days after surgery.

It is important to wear an elasticated garment to apply light pressure over the treated area for 4-6 weeks following liposuction. This helps to reduce the swelling and encourages the skin to conform to its new shape. Vigorous exercise should not be resumed until all bruising has settled which usually takes 3-4 weeks. After 4-6 weeks you will have a good idea of the result, but this continues to improve for 3-6 months as the skin and fat becomes softer and smoother. The best results are obtained in slim people with localized fat deposits, as the tighter the skin the better it will adapt after fat removal.

Will the fat come back?

If you maintain a steady weight the short answer is no. People are born with a fixed number of fat cells in the body and fat is laid down in proportion to their distribution. After liposuction fat cells are removed and so if you gain weight it will preferentially be laid down elsewhere rather than at the site of your liposuction. However if you are careful with your weight and diet, the change in contour will be permanent.

What are the risks?

Complications following liposuction/liposculpture in correctly selected patients are extremely uncommon.

Some irregularity in the skin is occasionally seen but with modern instrumentation this is rare. However in the period after surgery it is not uncommon to see some waviness in the contour of the skin which is related to swelling and this resolves over 2-3 months.

Infection is a theoretical risk of any operation but extremely unusual after liposuction.

Bruising and some swelling is to be expected after liposuction. Some people bruise more easily and so will see more discoloration in the skin than others. This almost invariably resolves soon after surgery.

Deep venous thrombosis (blood clot in the deep leg veins) is a potential risk of any operation and so is a potential risk with liposuction. Its risk can be lowered by mobilising after surgery and this will be encouraged following your operation.

Liposuction

Liposuction is popular among men and women and involved the removal of unwanted fat, usually from the hips, tummy, waist or thighs. It is also used in combination with other procedures such as a tummy tuck (abdominoplasty) to remove fat from the waistline, and also in facelifting, to remove fat from the neck. It is not a substitute for weight loss but offers the opportunity to improve shape or reshape areas – such as define a waist.

Operation details

There are different types of liposuction. In Liposculpture, a much thinner cannula (tube) allows fat removal which is less traumatic to the surrounding tissues and is used closer to the skin. Tumescent Liposuction involves a medicated solution, made up of intravenous salt solution, local anaesthetic and adrenaline, being injected into fatty areas at the time of surgery. The fat can then be removed more easily and pain and bruising is reduced following surgery.

Ultrasound-Assisted Lipoplasty (UAL) uses a cannula which uses ultrasonic energy to liquefy the fat, which makes removal easier. This technique is particularly effective for the removal of male breasts (gynacomastia correction). All of these types of liposuction are performed under a general anaesthetic. Small incisions are made for the insertion of the cannula, and these are barely visible once healed so scarring is minimal.

Post-surgery

An elasticated garment is used on the treated area following surgery and this should be worn for 4-6 weeks. This procedure usually only requires an overnight stay in hospital. Some discomfort will be experienced following the procedure and scars will need to be kept clean Yo and dry until sutures are removed (usually 10-14 days after surgery). This procedure usually requires between 10 and 14 days off work. An elasticated garment is worn over the treated area for 4-6 weeks following liposuction and exercise should be avoided for this time. The final result can take up to 6 months to show as the skin and fat becomes softer and smoother but there is an indication of the end result after around 4 weeks.

Potential risks

Complications as a result of liposuction are extremely rare, but after effects can include:
Infection.
Irregularity in the skin. In the period following surgery some unevenness in the contour of the skin occurs and is usually related to swelling. This normally resolves over 2-3 months.
Bruising and swelling. Some people bruise more easily than others but bruising is normal and doesn’t last long.
Deep venous thrombosis (blood clot in the deep leg veins). This is a potential risk of any operation, but can be lowered by moving around regularly after surgery.

We always recommend a healthy diet and exercise before considering Vaser Liposuction . This is not an alternative to those basics, but a method of reducing areas resistant to those basics. It is designed for patients who already have a normal Body Mass Index. Vaser Liposuction is a specialized technique that is best used by plastic surgeons experienced in standard liposuction. It is variously called Liposelection, Liposculpture and the more advanced 3 and 4D High Definition Lipo alluded to in the next section.

What is Vaser?

This innovative device uses ultrasound technology and liposuction methods to remove unwanted fat deposits and to sculpt and contour the body. Unlike traditional liposuction methods, the Vaser has significantly lower downtime and the body shape is also defined. It is minimally-invasive, meaning patients will get great results, without resorting to fully-invasive surgery. It is a three stage technique with infiltration of fluid, ultrasonic vibration to emulsify fat, and liposculpture to reshape fat.

How much session will I need, and how far apart can I have them?

Many clinics suggest one procedure, however to obtain the best results sometimes more than one treatment is required. I believe in safety. It is not safe to remove huge amounts of fat in one session. Although clinics in other countries and even in the UK routinely do this, there have been serious problems. It is better to limit aspirate removal to under 2.5 liter’s in each session. Most patients will only have the one area of concern, but it is important to treat the neighboring areas in order to blend, this will be discussed fully upon examination.
Healthy diet and exercise is still a dependent variable pre and post VASER Lipo.

Am I a suitable candidate for VASER?

Vaser is ideal for those with stubborn areas of fat, or those wishing to get more definition around their muscles.

Who will perform the treatment?

Our fully qualified, NHS Consultant Plastic Surgeon, with 30 years experience in plastic surgery will perform the consultation and treatment.

What areas can be treated?

Most areas of the body can be treated, but the most common are the abdomen, breast/male chest and upper arms. It is particularly popular amongst male and female patients who are seeking a more toned appearance.

Is there any downtime?

There is a small amount of downtime associated with this procedure as it is minimally-invasive. Patients can resume their normal activities soon after treatment, though they may experience some slight swelling, mild discomfort and bruising. Patients will need a bespoke post-op care programme involving ultrasound, deep tissue and MLD massage to help improve results.

How much will it cost?

The consultation fee with the Consultant Plastic Surgeon is £100, and prices of treatment start at £3200. Follow up treatments are often cheaper.

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3D and 4D Vaser Liposculpture

VASER (stands for Vibration Amplification of Sound Energy at Resonance) is an ultrasound-assisted liposuction that utilizes ultrasound energy to selectively remove fat without harming the surrounding structures of the area being liposuctioned.

Before & After Photos of 4D VASER High Definition Liposculpture Note that final definition is typically seen 3-4 months after surgery. Patient went from a size 14 to a size 10. Result will vary between patients. This patient required two treatments

How Does the VASER Liposuction Work?

VASER liposuction is a minimally invasive liposuction procedure performed in conjunction with tumescent anesthesia that utilizes advanced ultrasound technology designed to gently reshape the body. The ultrasound energy is transmitted through the small VASER probes that diffuse the ultrasound waves and liquefy the fat for easy removal. The ultrasound energy is gentle enough that it can break apart the fat with minimal damage to surrounding tissues, creating smooth, predictable results with fast patient recovery.

Clinical Study

A multicenter, prospective randomized controlled trial in 2012 recently showed that the VASER-assisted liposuction resulted in a statistically significant improvement in skin retraction of 53 percent relative to the traditional regular liposuction (17 percent per liter versus 11 percent per liter, p = 0.003). Moreover, the VASER-assisted liposuction group also resulted in a statistically significant reduction in blood loss of 26 percent relative to the traditional liposuction (p = 0.019 with n = 20 using a two-tailed t test).

Fast facts about VASER LIPOSUCTION

• The VASER-liposuction method demonstrated improved skin retraction compared with traditional/conventional liposuction.
• The VASER-liposuction method demonstrated reduction in blood loss compared with traditional liposuction.
• No serious complications reported in a clinical study involving VASER liposuction in over 70,000 VASER liposuction procedures.
• No burn complications, contour irregularities or prolonged swelling seen in one clinical study.
• No revisions needed after a VASER liposuction found in a multi-center pilot study.

Key Benefits of VASERlipo:

• Single procedure results with speedy recovery times

• Less bleeding & more skin retraction

• Improved body contouring over traditional liposuction

• Refines and accentuates appearance of muscles
, it’s the best type of liposuction for treatment of gynecomastia in men

Recovery after a 4-D VASER High Definition Liposuction


• May return to work 10 days after surgery

• May resume exercise or work out 6 weeks after surgery

Who is this for?

3D Vaser Liposculpture is the standard Vaser treatment, and the UK unlike in other countries, we normally restrict fat removal to under 2.5 litres of aspirate using a wet technique with Kleine’s Solution. This is prevent the risk of rebound shock (due to blood loss). This means that several treatments are often required. In other countries larger volumes are removed in one treatment, and transfusions are used to resuscitate, many of us try to avoid this method in the UK. This treatment is not an alternative to weight reduction and a BMI of under 30 is required to be considered suitable.

4D Vaser Liposculpture is an advanced technique, with a higher rate of complications, such as skin burning and ulceration. This is for athletic, slim individuals, who want muscle definition.