Liposuction

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Indications

Areas

Types of liposuction

Contraindications

Rehabilitation

Result

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Liposuction is a plastic surgical procedure aimed at removing fat deposits from specific areas (or multiple areas) of the body, such as the abdomen, thighs, or buttocks. Liposuction is also known as "liposculpture" because it is recommended for patients with normal weight to improve body contours and proportions. Liposuction is not a treatment for obesity - it targets localized fat deposits resistant to diet and exercise. The amount of fat that can be safely removed is limited. Removing too much fatty tissue can result in indentations or irregularities on the skin.

Both slim and curvy women have almost the same number of fat cells (adipocytes), but these cells differ in volume: in terms of their water and fat content. Adipocytes do not divide, which is why if a portion of these cells is removed from a specific area, their number will not be restored. This is the essence and durability of the effect of liposuction. However, it is important to understand: you can gain weight again after fat removal in other areas if you do not adhere to the principles of proper nutrition and an active lifestyle.

Indications for Liposuction

Liposuction is recommended for patients who typically have stable body weight but would like to remove unwanted subcutaneous fat deposits in specific areas. These fat traps may have appeared due to hormonal changes, poor dietary habits, a sedentary lifestyle, etc. The most common areas for such deposits are the abdomen, waist, thighs, back, buttocks, shoulders, chin, and neck.

Additionally, liposuction can be used to eliminate fat deposits in the male chest (gynecomastia).

The best candidates for this procedure are individuals with good skin elasticity, muscle tone, overall health, and without obesity.

In the video: Liposuction with the formation of a sports abdomen, changing the shape and size of the buttocks by transferring the lateral apex upward using lipofilling

Fat Harvesting and Injection Areas

The diagram below shows the layout and approximate size of fat harvesting (liposuction) and injection (lipofilling) areas.

Diagram of liposuction and lipofilling areas

Diagram Explanation

Liposuction Areas:

1,2 - Abdominal liposuction
3,4 - Flank liposuction
5,6 - Lower back liposuction
7,8 - Subscapular back liposuction
9,10 - Outer thigh liposuction
11,12 - Inner thigh liposuction
13,14 - Knee liposuction
15,16 - Calf liposuction
17,18 - Arm liposuction
19 - Chin, neck, and jowl liposuction
20 - Buffalo hump liposuction

360 Liposuction: areas 1-6

Lipofilling Areas:

1,2 - Breast lipofilling
3,4 - Hand lipofilling
5,6 - Buttock lipofilling
7,8 - Hip contour lipofilling
Facial lipofilling (cheeks, cheekbones, under-eye area, temples, chin, jawline)

BBL Liposculpture "Waist-Buttocks": liposuction of areas 1-6, 9,10 + lipofilling of areas 5,6

Types of Liposuction, Technique Features

Tumescent Liposuction

This is the safest, most effective, and widely used method. It is recognized as the best liposuction method and has the fewest complications compared to laser and ultrasonic techniques.

Technique: Before inserting the cannula, Klein solution is injected into the adipose tissue, providing anesthesia, narrowing all blood vessels, and almost completely eliminating hematoma. Fat removal is performed using PAL vibro-cannulas, which break down fat much more evenly than traditional liposuction, which simply sucks out fat. Liposuction is not done completely to zero. To create a beautiful smooth line without bumps, it is necessary to leave a part of the layer of adipose tissue (about 40% of the original amount of fat).

Modern tumescent liposuction techniques are so minimally invasive that patients can return to work the next day. The effect intensifies with each passing week, reaching its peak after several months.

Duration of the operation: depends on the number of areas. Usually 1.5-2 hours.

Anesthesia. Tumescent liposuction is performed under general anesthesia

Tumescent Liposuction, Lipofilling, and Abdominoplasty

Photo before and after: Tumescent Liposuction, Lipofilling, and Abdominoplasty

GO TO BEFORE AND AFTER WORKS GALLERY

Dry Liposuction

A cannula connected to a suction device is inserted into the adipose tissue.

Disadvantages: Simultaneously with damaging and aspirating adipose tissue, blood and lymphatic vessels are damaged, which is the cause of postoperative hematomas and seromas.

Combined Thermal Techniques

Laser, ultrasonic liposuction utilizes the principle of destroying fat cells using the physical properties of laser and ultrasound, simultaneously with mechanical tissue damage.

Advantages: Thermal exposure not only destroys fat cells but also coagulates all surrounding tissues including blood vessels, causing mild skin tightening simultaneously. Unfortunately, the main advantage of tissue heating becomes a major disadvantage, resulting in the formation of subcutaneous scars (nicely called "new collagen") in large and small burns. The effect is comparable to mesotherapy with sodium deoxycholate (Aqualyx preparation). Such a method is used for small volumes of liposuction.

Combination with Other Surgeries

Abdominal liposuction can be combined with almost any surgeries that do not require extensive intervention. In my practice, I often combine 360 liposuction with lipofilling (liposculpture) and rib reshaping, complementing them with corset wearing, diet, and exercise. In this case, there is an opportunity not only to remove local fat traps on the lower back and make the buttocks more rounded, but also to reduce the waist circumference. Rib reshaping (controlled fracture of the lower ribs) is suitable for girls with a wide chest frame and minimal fat layer, when liposuction does not provide the desired result.

Contraindications to Liposuction

Like any other surgery, liposuction has a number of contraindications, including:

diabetes mellitus
coagulation disorders
pregnancy and lactation period
severe somatic diseases (diseases of internal organs)
thrombophlebitis (varicose vein enlargement in the area of the planned surgery)
recently undergone surgeries in the area planned for liposuction
oncological diseases.

Rehabilitation, Postoperative Period

The recovery period after liposuction is relatively short and painless.

Hospital Stay. In most cases, patients go home the same day or the next day
Pain Sensations. As anesthesia wears off, discomfort and pain in the area where fat tissue was removed may increase. This is a normal process, and discomfort and pain gradually subside. Sensitivity disturbances in the intervention area may occur due to nerve damage and are considered normal. Sensitivity usually returns within a few weeks. In case of severe pain, the doctor prescribes pain relievers
Bruising and Swelling. After the operation, bruises are most pronounced on the 2nd-3rd day, as well as swelling, and starting from the 4th day, swelling gradually subsides. Swelling and bruises completely disappear within 2-3 weeks, superficial bruises are no longer visible after 5-15 days. A slight asymmetry or irregularity in the contour may occur, which usually disappears along with the swelling.
Compression Garments. Compression garments are worn immediately after the operation and should be worn for at least 2-3 weeks.
Physical Activity and Sports. Should be limited for 1 month after the operation
Avoid visiting saunas, baths, tanning beds

The first evaluation of the results of liposuction is recommended no earlier than 2 months after the medical intervention.

The effect of liposuction intensifies over the course of 6 months depending on the individual characteristics of the patient and proper postoperative care.

Duration of Results

Since the number of fat cells in the areas where fat is removed becomes significantly less, no additional volume will accumulate in these areas in the future.

The result is lifelong, but only with stable weight! If you do not monitor your weight and diet, an increase in volume is possible due to the remaining fat cells.

Abdomen liposuction

Arm liposuction

Liposuction of chin and jowls

Frequently Asked Questions About Liposuction

Does fat reappear in the areas where liposuction was performed?

Our body has a predetermined number of adipocytes (fat cells), and when we gain weight, the number of fat cells does not increase; they simply grow in size. During liposuction, the quantitative indicators of adipocytes are reduced, resulting in fewer cells capable of storing fat. Therefore, even if you gain weight again, calories will primarily be deposited in other areas rather than where liposuction was performed. However, it's important to note that completely removing fat cells is not feasible. Without the subcutaneous fat layer, the skin would appear unattractive, becoming transparent and developing irregularities. Therefore, during liposuction, only a certain percentage of adipocytes are removed to maintain the natural appearance of the skin.

How many liters of fat can be removed in one operation?

The maximum amount that can be safely removed is 3-4 liters of fat. Removing a larger amount is dangerous. Many surgeons often claim to have removed 7-10 liters of fat, but in reality, this figure includes the volume of fat along with the Klein solution, which is injected in large quantities before liposuction. Therefore, out of the stated 10 liters, only 3 liters would be actual fat, while the rest is the solution.

How to avoid the appearance of lumps and unevenness during liposuction?

To perform liposuction effectively, the surgeon must possess significant experience. At first glance, it may seem simple: insert the cannula, apply vacuum, suction out fat, and achieve results. However, this approach often results in unevenness. To achieve smooth results, it's essential to consider multiple factors: suction pressure, cannula diameter, size of the cannula holes, amount of solution injected to lift the fat, and proper distribution of the solution before suctioning using innovative equipment. Currently, the most advanced instrument for liposuction is the vibrating cannula. When the solution is injected initially, the fat is already broken down by the vibratory motion of the cannula, turning it into a mush. Consequently, with gentle pressure, the fat can be cleanly removed to produce a smooth result without lumps. Time also plays a crucial role. For instance, during my liposuction procedures, to achieve a smooth and symmetrical effect, I precisely time the fat removal in each area to ensure consistency. All these nuances are crucial for optimal results.

How can you correct irregularities after liposuction?

I correct irregularities using lipofilling. I perform infiltration, lift the skin, and if necessary, I undermine it with a tool, forming a pocket, and then reintroduce fat into that area.

Age restrictions for liposuction?

I focus more on the condition of the skin. If the skin is in good condition and retains its elasticity, then yes, I would consider performing liposuction, whether the patient is in their 30s or 50s. However, there are cases where even a 30-year-old patient may have poor skin condition. In such cases, I would still perform liposuction but would caution that the safe percentage of fat removal needs to be reduced. Typically, if I can safely remove 50% of the fat tissue and achieve smooth results, with poor skin condition, this percentage may only be 20-30%.

At what body mass index is liposuction contraindicated?

I never consider liposuction based on the body mass index. The patient's request is important. They show the area they are not happy with, and I explain what I can do with that area, regardless of body mass. Even if a patient has a very high body mass index but, for example, wants to reduce the back of their arms, it is possible regardless of BMI.