Liposuction
Liposuction, or one of its related terms, including liposculpture, lipoplasty, lipocountouring etc, is a popular procedure in many parts of the world. This is for the simple reason that it is able to “sculpt” or shape the body.
There are many different types of liposuction, and all have varying applications, results and side effects. However, the latest techniques have one thing in common, which is decreased downtime, pain and increasing safety.
In Singapore, the most common procedure performed is VASER, or ultrasound assisted liposuction. If the history of liposuction is understood, then one will understand why new techniques like VASER are preferred for their safety and lesser incidence of side effects. As an example of a new generation liposuction technique, VASER utilizes ultrasound to selectively liquefy fats without damaging surrounding nerves and vessels, producing less collateral damage than traditional liposuction techniques.
In addition, because latest techniques are becoming less and less invasive, liposuction has gradually evolved from an inpatient procedure to increasingly being done in the ambulatory/day surgery setting. This minimizing of downtime has made liposuction an increasingly popular procedure.
High Definition Sculpting
In addition to traditional liposuction which usually aims to reduce fat bulk, there are new applications to liposuction, such as VASER Hi-Def sculpting. VASER® – Assisted High Definition LipoSculpture, or VASER Hi Def™, is an advanced body sculpting technique. Using a technique to precisely remove very superficial fats, the procedure creates a sculpted, athletic appearance in males and females. Deep fat around muscle groups are also removed in order to enhance the visibility of the underlying musculature. Similar to 3-dimensional sculpting, VASER Hi Def takes into account the shape and form of structures underneath the skin that create body contours.
Therefore, the procedure is reserved only for generally fit men and women who have good muscle tone without excessive amounts of fat or excess skin. The typical patient maintains a healthy lifestyle through diet and exercise, but is unable to achieve the desired definition. The procedure can be performed on multiple body areas including the abdomen, female breast, male chest, back, arms, thighs, buttocks, hips and waist.
It is important to remember that liposuction is not a procedure to lose weight, rather, it is used more as a part of a complete weight loss programme to address difficult to treat areas which are resistant to non-surgical weight loss methods.
Often patients need a kickstart to become more conscious about their bodies, and treating the trouble areas which are the most resistant to weight loss is one of the frequently resorted-to measures.
Before Your Procedure
Techniques – No one liposuction technique is best suited for all patients in all circumstances. Discuss with your plastic surgeon which technique is appropriate for you, depending on your body mass index, overall health, and the amount of fat to be removed.
Anesthesia – It’s important to discuss with your doctor which anesthesia or anesthetic combination is right for you. Also, a physician should have the primary responsibility for providing and/or supervising your anesthesia.
Patient Eligibility – You should receive a thorough preoperative history and physical examination from your surgeon before having liposuction. Even though liposuction is generally a safe elective procedure, you must be assessed using the same standards as those used for anyone undergoing any type of surgery, this is to further increase the margin of safety for performing this surgery. Often, it is when procedures are not followed that accidents will happen.
Liposuction Volume – If your plastic surgeon agrees to perform large-volume liposuction consisting of more than 1 litre of total fat, the procedure should be performed in a day surgery, or inpatint hospital setting recognized by the Ministry of Health of Singapore.
Multiple Procedures – Having multiple procedures done at the same time increases the potential for complications, particularly with large-volume liposuction. Patients having large-volume liposuction should discuss with their plastic surgeon about having one surgery at a time to limit their risk for serious complications. The commoneset complication of liposuction from too many procedures done at once is venous thrombo-embolism, also know as blood clots forming in the inactive calves, which then dislodge and find their way into the lungs, a potentially dangerous problem.
Postoperative Care –Attend every one of your follow-up appointments. During these appointments your plastic surgeon will assess your postoperative recovery and satisfaction, as well as wound healing and scar maturation.
Facility Selection – In Singapore, according to MOH guidelines, liposuction for small volumes less than 1 litre can be done in clinic settings. For liposuction requiring the removal of more than 1 litre of fat, the operation must be done at least in an ambulatory/day surgery setting. A handful of clinics offer day-surgery services as part of their facilities. It is advisable to check with the surgery before your operation.
Training and Qualifications – Patients should understand that liposuction is a surgical procedure. In Singapore, all graduates from medical school are qualified as Bachelor of Medicine and Bachelor of Surgery (MB, BS). However, the specific training in liposuction requires that the physician be trained in the specific procedure according to the technique he is using (e.g. A doctor using VASER Liposelection should be trained in VASER operations).
Facility Accreditation – Patients should make sure plastic surgery performed under anesthesia, including liposuction, is performed in a surgical facility that is accredited by the Ministry of Health, Singapore as an Ambulatory/Day Surgery facility.
(Adapted from Source: ASPS – The American Society of Plastic Surgeons)
After Liposuction
As with any cosmetic surgery, liposuction carries potential side effects. Scars, bruises, and swelling may be apparent following surgery. It may take a few months for the lumpiness to completely disappear after the liposuction procedure. It will also take some time for your body to get used to the new shape, but most patients are pleased with the results despite the adjustment time.
Liposuction Swelling
Some post- liposuction swelling is inevitable. During follow-up visits with your doctor, it is important that you inform him or her of any changes in the amount of post- liposuction swelling or other side effects that you are experiencing. After liposuction, the swelling should be on a gradual recovery. If the swelling is not recovering or getting worse, inform your doctor immediately.
Swelling in the ankles and treated areas is common. This may be accompanied by a lumpy appearance in the area from which fat was removed, which will settle and appear more natural within six months after surgery. If the upper thigh has been treated with liposuction, patients may experience thrombophlebitis, or inflammation of the veins, in this area. Within a few weeks, this should go away. Discuss your expectations with your cosmetic surgeon before the procedure, and be aware of the possible complications that may arise as a result of the surgery.
Liposuction Bruises
One of the more minor complications of liposuction is bruises. These tender areas may cause some pain, but bruises are frequently short-lived and usually disappear after approximately one month. Bruising can be expected during any type of invasive medical procedure, but can be minimized depending on the technique that the cosmetic surgeon uses. Newer techniques like VASER are associated with less post-operative bruising due to the fat-selective effect of the treatment. Be sure to discuss with your doctor before the surgery to address all your concerns about post-liposuction bruising. Post- liposuction side effects, including bruises and scars, may be minimized with proper care.
Sutures and Scars
There will be small scars at the regions where the liposuction cannulae are inserted. These scars are typically small and heal well. Sometimes, the doctor will leave the incisions open in order to allow fluid to drain out. Since the incisions are small, and the amount of fluid that must drain out is large, some surgeons opt to leave the incisions open, the better to clear the patient’s body of excess fluid. They find that the unimpeded departure of that fluid allows the incisions to heal more quickly. Others suture them only partially, leaving space for the fluid to drain out. Others delay suturing until most of the fluid has drained out, about 1 or 2 days. In any case, while the fluid is draining, dressings need to be changed often. After one to three days, small self-adhesive bandages are sufficient.
Surface Irregularities
It’s very likely that there will be minor surface irregularities. These can be ironed out with post-liposuction compression, ultrasonic massage and lymphatic drainage.
