Liposuction is the surgical technique of removing the fat tissue from areas where it is in excess, by aspiration through some canullae with negative pressure. This operation is neither a treatment of obesity nor a solution for losing weight. The best candidates for this operation are normal-weight people presenting localized areas of fat excess in the thighs, hips, on the abdomen, arms, knees or ankles and with a good elasticity and turgor in the teguments.
The disposition of the fat tissues in the body is influenced by the genetic predisposition, the effects of environment and the normal process of ageing. The natural effects of ageing are: the redistribution of fat, the decrease of the muscular mass that can be replaced by fat tissue, the decrease of skin elasticity.
The obesity is of two types:
- Hypertrophic: characterized by a normal number of fat cells, but bigger ones
- Hyperplastic: characterized by a big number of fat cells and larger than normal
The early removal of adipocytes through diet or by surgical means determine important physiologic and clinic modifications (for instance: diabetes mellitus).
Liposuction implies the insertion into the fat tissue of a special canullae and by repeated movements, groups of fat cells are separated and removed through aspiration. The cannulae are different as concerns their shapes and sizes and are introduced through small incisions in the closest skin fold. They are usually required 2-3 incisions for every area.
The area to be aspirated will be infiltrated with anesthetic solutions and with solutions that decrease bleeding.
The lipoabsorption improves the silhouette but does not eliminate the cellulite. The cellulite results from the tensioning of the fibrous tissue elements that connect the skin from the deep fascia as result of the exaggerated development of fat lobules. It can be accompanied by acute inflammatory phenomena.
The liposuction reshapes the fat tissue and it should be taken into account that its goal is to modify the body shape and not the patient’s weight.
The amount of removed fat depends on the amount of required correction (hundreds of milliliters to some liters). The liposuction of very large volumes can require more surgical phases, that increases the safety of the surgical act and implicitly the final result.
It is recommended the extraction of not more than four liters in a session because the possible complications can increase. According to the extracted volume, the operation takes 1-2 hours to complete.
The surgery is usually performed with the patient hospitalized for 1 day. The anesthesia can be local or general, in accordance with the patient’s wish, with the aspirated volume, the duration of the operation and the amount of local anesthetic required, the associated medical problems.
Post-operative are administered antibiotics, anticoagulants and pain killers in order to prevent the hematoma and seroma formation. Immediately after the operation an elastic bandage or a stays should be applied. In this way the skin is attached on the muscular wall. The stays should be worn permanently for 6 weeks and a rigorous massage of the operated area is recommended. This massage assures 50 per cent of the operation success. After surgery a transient discomfort can occur.
The patient can leave the bed the second day after the surgery and can resume the normal activities after a week.
The possible complications are the infections, the hematoma but they are less probable at a health skin with a good elasticity.
Liposuction is a very good technique of body remodeling: the fat that has been harvested can be used for grafts obtainment, being corrected some congenital defects or of defects acquired post-traumatic or post-operative.
The final result will be assessed at least 3 months after the surgery when the swelling has disappeared and at most one year.