Liposuction Surgery - Indications and Risks

Liposuction is a surgical procedure that involves removing fatty tissue from specific areas of the body, such as the belly, buttocks, hips and thighs, through a technique that uses suction. Liposuction is not a procedure that aims at weight loss, but rather the removal of localized fat, especially those resistant to diets and exercises.

Liposuction results
Liposuction results

How is liposuction done?

Liposuction is a surgical procedure that should be performed exclusively by plastic surgeons and should be performed in an operating room with anesthesia.

Before surgery, the plastic surgery will mark with a pen the areas that will be approached with liposuction. Your doctor may ask you to stand partially undressed so that he can make the markings correctly.

The anesthesia for liposuction can be regional (epidural or rachi) or general, depending on the amount of fat that is to be removed. General anesthesia is also used when it is desired to lipoaspiraate higher segments, such as arms and submental region, and especially when lipo is associated with another surgery, such as mammoplasty or rhinoplasty.

Once the patient is anesthetized, the procedure can be started. Liposuction is done by inserting a thin, hollow, cylindrical metal cannula through small incisions in the skin towards the layer of fat tissue. The liposuction cannula is connected to a device that creates a vacuum to aspirate the fat. When the cannula enters the layer of subcutaneous fat, it causes traumas in it, releasing the fats and facilitating their aspiration out of the body.

What I explained above is the basic principle of liposuction. Currently there are variations of this technique that allow a more efficient and less traumatic aspiration of fat.

The infiltrative technique, also called tumescent liposuction, is currently the most used and consists of the injection, in the fat that will be liposuction, of a solution composed of serum, adrenaline analogues and, in some cases, local anesthetics. This solution, in addition to facilitating the aspiration of fat, also causes a constriction of the blood vessels, reducing the occurrence of bleeding and edema.

The ultrasonic liposuction involves a cannula capable of emitting ultrasonic energy to "melt" fat, facilitating its removal. The technique with ultrasound can be used in conjunction with the infiltrative technique. Although it seems more effective in theory, this technique has some drawbacks such as the need for larger incisions, greater risk of internal lesions, higher cost and longer procedure time.

The liposuction laser is similar, except that instead of using ultrasound, uses energy from the laser to break down fats. There is currently no evidence that these two techniques are superior to isolated infiltrative liposuction.

The vibroliposuction is another variant consists of a cannula that produces quick moves forward and backward, facilitating the breakdown of fat and its aspiration.

In the end, tumescent liposuction is the most used, and may or may not be associated with other techniques.

And the techniques called Mini-Lipo, Hydrolipo, Lipo-Light? These procedures are often sold as safer variations and with less risk than liposuction, which is a lie. The Mini-Lipo or Lipo-Light are, for example, only a liposuction in which less fat is removed. In the background, they present the same indications and risks. Do not accept to be operated by doctors not specialized in plastic surgery under the claim that these procedures are simpler and can be performed by other professionals. We have a text in which we approach these types of plastic surgery in more detail.

Post-operative liposuction

The region undergoing liposuction can become quite painful and present edemas and bruises (purple spots). The plastic surgeon may indicate the use of a strap to model the body and reduce edema. The tape is usually used uninterruptedly for about 1 month, and can be withdrawn only at the time of the bath. The strap is then used only at night, at bedtime, for another month.

The patient can and should walk on the first postoperative day to reduce the risk of thromboses in the veins of the lower limbs. Return to work is usually released after 1 week. The deadline for picking up points is usually 7 days. Physical activities only after 1 month minimum.

What are the good candidates for liposuction?

As already mentioned at the beginning of the text, liposuction should not aim at weight loss. The best results are obtained by those patients who have maintained stable weight for some time, but have that impertinent fat located despite diet control and regular exercise. The patient should not do liposuction first and then resolve to change their eating habits and physical activity. The liposuction area does not usually accumulate fat again, which can cause irregularities if the patient becomes fat again.

The degree of sagging skin can be an impeding factor. Excessive sagging may indicate loss of skin elasticity, which hinders the results of liposuction. The presence of stretch marks is also a strong indicator of poor skin elasticity.

Risks of liposuction?

Liposuction is a surgical procedure and should be treated with due seriousness. Complications common to any surgery, such as bleeding and anesthesia reactions can also occur in liposuction.

Liposuction is very traumatic and causes large edemas in the subcutaneous, which means great mobilization of body fluids. To avoid complications such as anemia and bleeding or excessive water loss to the edema, the aspirated fat volumes should not exceed 7% of body weight (eg 4.2 liters in a 60kg patient) and the liposuction area should not be greater than 40% of the body area.

Another risk is the injury of internal organs through the cannula. This complication is very serious, but it is rare if the professional is experienced and well trained. The problem is that there are many adventurers practicing plastic surgery without having title to plastic surgeon.

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