Liposuction, or liposculpture, is a method for removing stubborn deposits of localised areas of fat. The procedure is performed by passing a suction cannula through the area being treated and the fat is removed by suction.
Of all the methods of performing liposuction, the one we tend to favour is called tumescent liposuction, using a VASER, which we feel is the most gentle to the surrounding tissues. This involves defining the area for treatment, injecting that area with a solution to minimise pain, bruising, swelling, tissue injury and blood loss both during and after the procedure. Small incisions are made at the edges of the areas being treated and then VASER liposuction is performed to reshape the area.
Coleman fat transfer
Fat which has been gently sucked out of one area may be reinjected into another area, in a procedure called Coleman Fat Transfer. This is sometimes done in a volumetric facelift in which the face is rejuvenated using a combination of skin and muscle tightening and lifting, as well as restoring some of the youthful fullness in various parts of the face. This type of liposculpture may also be performed for a variety of reconstructive procedures and occasionally for lip enhancement.
Liposuction is not a good treatment for cellulite and can make it worse. To understand why, it is necessary to learn some anatomy about fat distribution. Between the skin and muscles, we have fat. This fat is divided into two layers - a superficial layer and a deep layer. These two layers are separated by a thin layer of fascia. From this fascia, the superficial fat is compartmentalised by septae. As a result, there are tiny pockets of fat within the superficial fat layer, just under the skin. If there is too much fat for the compartment to hold without buldging, cellulite will result. Liposuction works best on the deep layer of fat. If too much and too vigorous liposuction is performed on the superficial fat, then the skin will become ridged, bruised and in severe cases may undergo necrosis. For these reasons, liposuction is best performed on the deep layer of fat, and because cellulite is as a result of too much fat in the superficial fat layer, then liposcution is not an effective treatment for cellulite.
Good areas and bad areas
There are some areas that respond well to liposuction and other areas that do not respond so well. The areas that respond well are the areas of fat excess that can be moved around quite readily from the deeper structures - for example the neck, the abdomen, the sides (or flanks), the inner parts of the thighs, the inner knee region, the chest region in men. Some other areas do not do well with liposuction, for example ankles, the lower outer thigh and arms. Liposuction is not a good treatment for large areas of fat removal and is best used in localised pockets which don't respond to exercise and dieting.
What you need to know about liposuction
Although the majority of people that undergo liposuction are very happy with their results, as with all surgery, there are risks. In liposuction, the risks include:
- bleeding, bruising, swelling
- contour irregularities in the skin overlying the area treated
- permanent lumpiness
- hard scarring for several weeks around the area treated
- removing too much
- removing too little
- asymmetry when two sides are being treated
- changes in skin sensation over the area treated (this can include hypersensitivity)
- other rare complications have been described in people who have had too much removed and their general fitness is not able to tolerate this
- burns to the skin have been reported with ultrasound assisted liposuction and for this reason we do not use this method