Liposuction continues to the most common plastic surgery procedure all over the world, and also in India. It is basically a permanent removal of fat cells by the use of a suctioning device. It is a safe procedure, with minimum down time, and fast recovery. It has been shrouded in small controversies, and bad results, but this has been due to the procedure being done by untrained personnel, and other medicos who are not Cosmetic Surgeons. So it is important that a potential client look through the profile of their treating physician and asses really whether that person is actually capable of delivering all that he promises. Do not be led away by claims that they can remove 10 kgs or 12 kgs of fat and make you superthin. Please remember that the safe limits of liposuction are between 3-5% of the total body weight.
The procedure involves infiltration of fluid into the areas to be liposuctioned. This has multiple benefits. It helps to loosen the fat, reduces the bleeding dramatically, and allows pain control after surgery as well. Usually I would infiltrate fluid in a ratio of 1:1 with the amount of fat that I plan to aspirate, ie, if I feel that I will aspirate about 1000 cc of fat from an area, I would like to infiltrate less than 10000 cc of the fluid in that area. I actually infiltrate much less than that, only about 0.5 :1 ratio. This has the benefit that I never face the risk of fluid overload ( potentially dangerous condition, where there is too much water in the body, and the lungs get filled with water). The other benefit is that, what is aspirated is pure fat, and not water mixed with fat. This gives an exact estimate of the amount of fat taken out. We surgeons have a bad habit of including the amount of fluid aspirated into the total volume taken out also, so that we can boast of having done large liposuctions. What is important is not the amount taken out, but how much of actual fat there is.
The procedure is done with small incisions over selected areas of the body, after first discussing with the patient, and planning the site of the incision. These incisions generally are not visible and heal very well. They are only about ½ cm in length. There may not be a need to admit the patient in the hospital, so that the patient can go home the same day.
After a liposuction, there is a need to wear specially designed pressure garment, over the areas liposuctioned to allow better skin redraping. This may take upto 6 weeks. Any anticoagulant use such as aspirin should be stopped 1 week prior to surgery; smoking should also be stopped 2 weeks before to 2 weeks after surgery for best results
Power liposuction, vibro-liposuction, VASER, and laser liposuction are some of the newer innovations in this field.
In Power and Vibro Liposuction the mechanical effort to carry out liposuction is reduced by the use of special machines, which produce a to and fro rapid motion, thus reducing mechanical fatigue and making the procedure faster. However these are significantly more expensive than conventional liposuction
VASER is the use of internal ultrasound device to melt fat. The advantage is that this is significantly faster, and allows the surgeon to work closer to the skin, and thus better skin draping is achieved, and thus better figure control is achieved. However this is a very expensive device, and expects the surgical cost to double if you ask for a VASER. Laser lipo allows very good redraping action on the skin; however its role in actual fat reduction is a bit controversial. Thus this has not found use in general practice.
Please remember that liposuction is not a weight reducing procedure, but a figure correcting/ or a body contouring procedure