Liposuction is a procedure where fat is removed from the body by loosening & sucking it out with the help of a suction apparatus. Fat collections around the hips, thighs, buttocks, abdomen, arms, upper chest, etc. can be reduced by this procedure.
Liposuction is neither a substitute nor a cure for obesity. It is a procedure more useful for body contouring by removal of fat from particular areas. But, of course there is an overall reduction in body weight.
In men the paunch and the love handles are the areas most sought after and of course the male breasts, which are dealt with in a separate section.
People with mild to moderate obesity, with healthy elastic skin or patients with localized collections of fat in certain areas, get the best results after liposuction as the healthy elastic skin shrinks after the removal of fat from those areas.
People having loose skin like after losing excess weight, in old age and after multiple pregnancies, who need excision of the excess skin to get a satisfactory contour, are good candidates for lipectomy rather than a liposuction.
The fat cells in the body are constant from birth to death much like the nerve cells. But each fat cell may accumulate as much fat as is consumed. The cells removed during liposuction, are removed permanently & do not come back again.
When the patient gains weight, the size of the fat cells increases & when he or she looses weight, the size decreases. So some amount of control, restraint and exercise schedule has to be maintained even after the procedure.
The procedure is performed under general or spinal anesthesia. Before the operation, the areas to be sucked are marked out carefully in erect position. The most common method used now is the “TUMESCENT technique” but sometimes the “SUPER WET technique can also be used”
A solution of local anesthetic, some drugs and saline is injected into the areas to be sucked. A small cut of 0.5 – 1 cm is made in well concealed areas usually within skin creases so that they are not noticeable. Then, suction cannulae of different sizes depending on the area to be suctioned are inserted & fat is sucked out. The suction is evenly done in such a way that wrinkles are not seen and it doesn’t produce any areas of depression. The edges are smoothened out using smaller cannulae.
The removed material usually consists of 80-85% fat & the remainder being blood, plasma, injected fluid,etc. The same procedure is repeated in all the areas to be sucked.
MEGA LIPOSUCTIONS:
“Mega Liposuctions” which is a procedure where the aspirate is more than 5 liters at a time, is becoming more relevant in today's context. This is more for overweight people but are who are well motivated ,are on a steady weight pattern and on a proper exercise and diet schedule and of course are not in the “Morbidly Obese” category.
Usually done in multiple sittings of two or more, spaced 3-6 months apart.The amount of aspirate which can be safely removed according to world literature is @10% of Body weight in females and about 8% of body weight in males.
This procedure is coming into vogue because, this can help the patients kick start their weight loss schedule by taking care of the initial reduction of certain areas which helps them follow their exercise schedules more regularly. So, the motivated patient is a very important criteria. Secondly, these patients are not in the morbidly obese category to go in for a Bariatric Procedure which again has its limitations and indications.
After the Surgery Snug or tight compressive dressings are applied for 6 – 8 days to help in shrinkage of the skin, to decrease swelling and prevent any blood or serum collections. In most instances, the patient will be required to wear a pressure garment or girdle for several weeks to months during the healing period. This helps in reducing the swelling and shrinkage of the skin to its new position. One might feel localized areas of hardness or firmness in the suctioned areas for 2-4 months following surgery.
Pain is usually present for a day or two after surgery. During the healing period, numbness or discomfort may be present for variable periods of time. Sometimes discoloration (bluish black) may be present which may last up to 2-3 weeks following surgery. Swelling takes 2-3 weeks to come down & it takes 2–4 months for the swelling to completely disappear.
Results:
Depends on the expectations of the patients and the amount of fat that is suctioned out. Usually patients with good elastic skin & those who come for limited contouring are very happy. Older patients & grossly obese patients may not be very happy with the results.
Perfection & symmetry are aimed for but are not possible in every patient.
Also in some patients all unwanted fat cannot be removed in one sitting, in these patients, the procedure may have to be repeated, but only after all swelling resolves anywhere between 3 – 6 months.
Rarely rippled or uneven skin or areas of loose skin could result which might require minor revision surgeries to correct them. | 
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