The tumescent technique is so effective at minimizing blood loss that the majority of patients lose approximately 15 to 30 ml (1 to 2 tablespoons) of blood during large volume liposuction. This is the same volume of blood that is taken for routine pre-operative laboratory studies. In the days before the advent of the tumescent technique the biggest risk of liposuction was excessive loss of blood during surgery. In fact, many of these patients needed blood transfusion. With the advent of the tumescent technique, blood transfusions are no longer a part of liposuction surgery.

How many incisions are made?

The number of linear incisions or adits (tiny round holes) that are placed in the skin is determined by a number of factors including size and location of the area being treated. In general, when we use small diameter microcannulas, we typically make multiple (4 to 8 or more) tiny adits in an area, which are so small (less than 1/8 inch in diameter) that no stitches are required.

How long will take for the incisions to heal?

Incisions or adits usually close up in a week or two, and become completely healed with no scabs within 2 to 4 weeks. The incisions sites slowly disappear completely.

How long does it take to complete a typical liposuction procedure?

The length of time that it takes to complete a liposuction depends on the size of the patient, the number of areas being treated. Because it takes a certain amount of time to inject local anesthesia, it usually takes longer to do liposuction using local anesthesia than it does using general anesthesia. A tumescent liposuction procedure may take any where between 2-5 hours.

Are there any risks of Liposuction?

As with any surgical procedure, liposuction is associated with possible side effects. However these are rare and minor with our technique. They include bruising, swelling, temporary numbness, and discomfort in the surgically treated areas. All these are minor side effects , are temporary and can be easily taken care of. Worldwide experience has shown that liposuction using the tumescent technique is amazingly safe. Serious complications, such as blood clots, infection, or allergic reactions, which have been reported with conventional liposuction under general anesthesia are extremely rare.

Is there any pain with liposuction?

In the initial phase of injection of tumescent solution, patient may experience some pain. This is avoided by giving preoperative tranquillizers. Once the tumescent solution is inside the body, the rest of the procedure is usually painless. Most importantly, the tumescent solution usually provides about a day of continuing numbness in the suctioned areas so that patients can move, do their routine house work. Movement and activity help to avoid blood clot formation in the legs.

What is LIPOSUCTION SWELLING (EDEMA)?

Whenever the body is injured, inflammatory cells and other mechanisms usually cause a release of water-based fluid (edema). When this water-based edema fluid builds-up in a significant amount, it causes what we outwardly see as swelling. In the older conventional liposuction under general anesthesia , this swelling used to persist for several weeks. Under tumescent technique, the swelling is minimized by:

• Using microcannulae and hence less tissue damage
• Keeping small incisions or adits open-this open drainage allows the accumulated fluid to be drained for the first 24-48 hours , there by reducing the risk of swelling.
• Bimodal compression ( compression by two layers of garments) to hasten outflow of fluid

What are seromas?

Seromas are small blebs which contain clear fluid caused by damage to lower layers of skin. Seroma is a frequent sequel of ultrasound assisted liposuction (see below). Seromas are rare with the use of microcannulas and open drainage technique for post-liposuction care.

How does the tumescent technique reduce bruising after liposuction?

There is dramatically less bruising with tumescent liposuction totally by local anesthesia compared to other liposuction techniques under general anesthesia. There are two reasons for this significant decrease in bruising. First, because there is so little blood loss with the tumescent technique, there is almost no blood that remains beneath the skin to cause bruising after surgery. The second reason for decreased bruising is that with the tumescent technique, there is a considerable amount of post-operative drainage of the blood tinged anesthetic solution. The incisions are so small (about 1.5 mm), the incisions do not require stitches. By allowing these wounds to remain open for two to three days after the surgery, most of the residual blood-tinged anesthetic solution drains out. This minimizes bruising and swelling and accelerates the rate of healing.

How long will it be until I see results?

Most patients will see 90% of their ultimate liposuction results with in one to three months after surgery. Full results will be seen after 6 months.

Can more than one area be treated in one session?

Generally, it is advisable not to be very aggressive (the so called mega liposuctions) to avoid complications. It is possible to treat both buttocks, both thighs in one session. However, different areas such as abdomen and thigh or buttock are not done in one session. What is important from a safety angle is the amount of fat removed. Large or mega liposuctions are associated with an increased risk. It is important to keep in mind that in any cosmetic procedure including liposuction , final safe and satisfactory result is far more important than quick results.

When can the procedure be repeated in a different area?

The procedure can be repeated any time after a week However, it is ideally done after one month.

Will liposuction improve the fat stomach I acquired after my last baby?

Yes. Liposuction typically provides excellent improvement of the abdomen after pregnancy. In fact, for the vast majority of patients, liposuction provides a better and more natural appearance than a tummy tuck.

What factors determine the success of liposuction surgery ?

A key factor in liposuction results is the width of the surgeon’s cannulae (internal suction probes). Wider and bigger cannulae are helpful for the surgeon to save time as they can remove more fat in less time. However, they usually are a DISADVANTAGE to patients. These wider cannulae need larger skin incisions and also create wider ridges in the fatty layer leading to noticeable scarring. Small cannulae do not cause these ridges and usually provide a more natural result.

What is tummy tuck?

Tummy tuck is the name given to the operation in which the skin-including the subcutaneous fat is removed and skin is sutured-also called abdominoplasty, it is a major surgical procedure requiring general anesthesia, and involves liposuction and excision to remove fat, plus a large excision of skin. The typical result is usually a flatter tummy with a large scar extending from the pubic area to the lower abdomen to anterior hips. Before the invention of liposuction, a tummy tuck was the only surgical method for removing excessive abdominal fat. In many patients (but not all) liposuction of the abdomen can often provide equivalent or better results than a tummy tuck. Because liposuction is safer and causes less scarring compared to tummy tucks, tummy tucks are less often preferred now.

How does abdominal liposuction differ from a “tummy tuck?”

1. A tummy tuck can result in an unsightly scar that extends across the entire lower abdomen, just above the pubic area in addition to an unnatural appearance of the belly button.
2. Tummy tucks are far more risky than abdominal liposuction. Tummy tuck surgery has a much higher risk surgical complications such as blood clots in the lung (pulmonary embolism) compared to liposuction.
3. The recovery after liposuction is much safer, quicker and easier than the recovery after a tummy tuck.
4. Tummy tucks are more expensive.
5. The recovery time required before a person can return to work after a tummy tuck is typically two to four times longer than after liposuction of the abdomen.

Does liposuction produce permanent results?

After liposuction the new body’s shape is more or less permanent. If a patient does gain a moderate amount of weight after liposuction, then the figure will simply be a larger version of the new body shape. Fat cells that are removed by liposuction do not grow back. If the patient does not gain excessive amounts of weight, then the new more pleasing silhouette is permanent.

How much weight can I lose by liposuction?

Patients should not expect to lose a dramatic amount of weight with liposuction. Weight lost is equal only to the amount of fat removed – about 1 - 1.5 Kgs. However, because fat is removed from cosmetically important areas, liposuction should produce significant improvements in aesthetic appearance. Although liposuction should not be regarded as a method for weight loss, in appropriate patients it can produce significant cosmetic improvements.

Will the fat cells grow back after liposuction?

Liposuction removes fat cells permanently. The fat cells that are removed by liposuction can never come back, however if the patient gains a significant amount of weight, then new fat cell can develop. With a small weight gain, existing fat cells simply get bigger by accumulating more fat within the existing cell. However, with an increase of more than 10% of body weight one can expect new fat cell development in all areas of the body, including areas previously treated by liposuction. As an adult gains larger amounts of weight, increasing numbers of fat cells (lipocytes) are formed. Hence it is important to note that patients do not gain further weight after liposuction.

If I gain weight after liposuction, does fat come back in the treated areas?

Fat usually does not come back in treated areas provided the patient does not gain a significant amount of weight after the surgery. If the patient gains a significant amount of weight, then fat can return to an area previously treated by liposuction. With increasing weight the degree of fat accumulation in a previously treated area is proportionately less than in untreated areas. After liposuction relatively less fat accumulates in treated areas compared to untreated areas.

If I do not gain weight, does fat come back in the treated areas?

If a patient does not gain weight after liposuction, then fat does not come back in the treated areas.

What can I expect if I get pregnant after liposuction?

Pregnancy does not permanently alter the results of liposuction. If a woman has liposuction and subsequently becomes pregnant, gains weight, gives birth and finally loses the excess weight of pregnancy, then her original liposuction improvements will return, just as if she had never been pregnant.

Is there any age restrictions on liposuction?

No, there is no age limit on liposuction. Patients of any age, from twenties to seventies, can undergo the operation.

Can liposuction be performed on obese patients?

It can be done on obese patients, after proper medical check up to rule out systemic diseases and after proper counseling to understand the motivation of the patient towards weight reduction by diet and exercise. It is important to make sure that patient realizes that liposuction is not a supplement for weight reduction by other means.

Does liposuction remove cellulite?

Cellulite is the puckered appearance of the skin which comes with age and weight reduction. Liposuction improves the silhouette of the body, but does not necessarily eliminate the pre-existing subtle "puckering" of the skin that is often referred to as "cellulite." Liposuction does reduce the degree of cellulite to a minor degree but it is unlikely to produce a significant improvement or to completely eliminate cellulite.

Will my skin contract to fit my new profile?

Skin is stretched by underlying fat. When this additional fat is removed, the stretched skin shrinks, and returns back to normal as it has a certain amount of elasticity. It will not develop folds and hang loosely.
However, in an elderly patient or a person with gross obesity this may not happen completely, as the ability of skin to shrink is limited. Such patients may need an additional procedure to excise loose skin.

What is the role of powered liposuction?

Power assisted liposuction is the use of cannulae with powered suction. They suck the fat at a greater speed and reduce the time of operation. However, powered cannulae are only beneficial with cannulae that are greater 3.5 mm diameter or greater. Moreover these larger cannulae cause significantly more pain. Usually power assisted liposuction also needs concomitant IM or IV narcotics and sedatives, as well as sometimes using nitrous oxide which in turn makes liposuction more dangerous. Hence the two biggest advantages of tumescent liposuction (safety because it is done under local anesthesia) and the use of Microcannulas (diameter <2.8 mm to et less scars) are lost if one opts for power assisted liposuction.

What is ultrasound assisted liposuction (UAL)?

UAL was introduced to damage the fat cells and there by facilitate the removal of fat. Initially it attracted media attention and gained some popularity in Europe, as a "high tech" method. However the method had significant side effects such as burns of the skin. The damaged fat also lead to small cysts containing fluid called seromas. Ultrasonic assisted liposuction (UAL) is associated with significant bruising and prolonged postoperative swelling. Most importantly the ultrasound machines are expensive and hence this cost is added to the patient , making it more expensive. Hence UAL is not preferred by most authorities.

What is the cost of liposuction?

Like any cosmetic procedure, liposuction has it’s cost. In most western countries, a single session can cost between 3000-6000 US dollars. Cost also depends on the area and the amount of fat removed. However, in our centre, costs are significantly lower and cost only a fraction of the cost in the west, while we maintain the same standards of care.

Once I decide to undergo liposuction what should I do?

See patient instructions