Liposuction is a procedure during which localised deposits of fat are removed in order to improve the contour of certain areas of the body. It is not designed as a weight-loss operation, and is most effective when used to target stubborn areas that persist despite best efforts at weight loss/ toning/ dietary modification.

Although liposuction is most successful for the treatment of localised fat deposits, it is extremely important to view the area for treatment in the context of the body as a whole. I always aim for balance and proportion when performing cosmetic procedures, and this is every bit as important with liposuction as with other operations. I carefully assess quality of the overlying skin as this has a strong bearing on the final result.

The surgery is usually performed under general anaesthesia, although smaller areas may be treated successfully under local anaesthetic. The areas for treatment will be carefully marked with your input before you come to theatre. Once asleep, a mixture of saline and local anaesthetic is injected to the area to be treated (tumescent liposuction). A narrow metal tube is then inserted through a small skin incision. It is attached to a strong vacuum pump and is moved back and forth within the area of excess fat. The process removes tunnels of fat leaving the small blood vessels and nerves intact.

Certain areas of the body will respond better to liposuction than others: for example the outer thighs/ saddlebag area responds better than the inner thighs. The elasticity of the skin plays a major role in the result obtained, and will often determine whether liposuction alone will achieve the desired result can only be obtained by a more extensive surgery. Having said this, many patients are happy to accept some loose skin after the procedure, rather than going through a more involved procedure with extensive scarring, providing they have been warned in advance. As fat cells are not believed to regenerate in adulthood (rather the existing cells store more or less fat depending on body weight), removal of these cells by liposuction will give a permanent change in contour independent of your body weight. This may result in an abnormal appearance if you gain a lot of weight after surgery.

Considerable bruising is common after liposuction. Some people bruise more easily than others, and certain medications (including some herbal remedies) increase the likelihood of extensive bruising. The discolouration of the bruising usually lasts about a month, but the lumpiness and swelling of deep bruising can take up to six months to disappear (particularly in the abdomen). Swelling can take a number of months to fully settle, and therefore you may not see the full benefit of the procedure until that time has passed. There will be a variable number of small scars situated in inconspicuous areas, which depend on the area that is treated: like all scars, they will initially be red and raised, but should settle with time.

It is important to remember that liposuction is not a treatment for obesity. The amount of fat that can be removed from a localised area is limited by safety considerations and a natural end-point beyond which removal of further fat is not possible. Thus, it may not be possible to slim down a particular area as much as you might like. It may be possible to perform a further treatment in the same area after a minimum period of six months.

Some irregularity of the treated area may occur. This may be due to scarring between the undersurface of the skin and the underlying tissues. Massage of the affected area usually results in an improvement, which may take weeks to months to be seen.

The minimal scarring that results from the procedure can lead people to regard this as a minor procedure. While this it a very safe procedure when correctly performed, liposuction is one of the few plastic surgery operations that has resulted in patient deaths. These have been related to removal of very large volumes of fat (and therefore fluid including blood), or unrecognised injuries to deeper structures such as the bowel. These complications are avoidable by placing safe limits on the amount of fat removed, careful monitoring of fluid balance levels during surgery, and providing appropriate aftercare. An appropriately-trained surgeon is obviously essential to reduce the risk of complications and maximise the chances of a satisfactory result.

This procedure is not covered by health insurance, and is provided on a self-pay basis at Fitzgerald Plastic Surgery.