Liposuction
- Important information about liposuction under tumescent-anaesthesia
- Suctioning
- Local anaesthesia
- What can I expect from liposuction?
- Preparing for a liposuction
- The day of the operation and the liposuction
- The liposuction procedure
- The time after a liposuction-operation
Important information about liposuction under tumescent-anaesthesia
Liposuction (suction-assisted fat removal or liposculpture) makes body contouring possible by removing fat from different parts of your body.
Unwanted deposits of fat that just won't go away through exercise and diet can be removed for good. Although liposuction/liposculpture is still quite new a method in the field of plastic surgery, it is already very advanced. We think it is important that the operation is done under local anaesthesia - it is safer and therefore superior to general anaesthesia.
In the course of an intake interview we ask numerous questions about your health in the past, previous treatments and potential complications, medication and allergies. You need to tell us everything that might affect the operation – that helps us to keep the risks at a minimum.
About four days before the scheduled operation we would like you to have a blood test done by your GP (e.g.) as well as an ECG (electrocardiogram), an APTT (Activated Partial Thromboplastin Time) a PT (Prothrombin Time) and a G6PD (Glucose-6-phosphate dehydrogenase). The records of the results of those examinations should be available on the day of the surgery.
Suctioning
After the area in question has been anaesthetized a tiny incision is made. Through that we insert a narrow tube into the fat layers deep beneath the skin. We push and pull the tube through the layers and suction them out by a vacuum pump.
The incisions we need to make are not longer than five to ten millimetres and in most cases you cannot tell where they have been a few weeks later. It takes only a few little incisions to remove a large amount of fat. Removed fat cells won't grow back. Furthermore this method knows only a minimum risk of damaging nerves or larger blood vessels.
Local anaesthesia
With the tumescent-anaesthesia (tumescere, Latin: swell) a large volume of a highly diluted local anaesthetic drug is injected into the fatty tissue beneath the skin. If necessary, a little cortisone is added to the dilution in order to stop the inflammation of the tissue and to kill the pain that follows the operation. Furthermore this dilution contains epinephrine, which makes the blood vessels smaller, and bicarbonate, which makes a painless infiltration of the dilution possible. Both bleeding and bruising in the course of the operation are reduced enormously by tumescent-anaesthesia. This is why most patients can get back to work after a day or two, or go in for sports, etc.
With approximately 90 % of all patients an improvement of the body contours can be seen immediately after the surgery. However, it takes two to four weeks for the haematomas and bruises to disappear completely. The final result can be evaluated after three to four months, in some cases even only after six or more.
What can I expect from liposuction?
The fat cells that have been removed by suctioning will not return, i.e. your body doesn't reproduce them. In other words: the body contour that has been shaped is lasting. When you gain or lose weight later, your “new” body shape will change proportionally, e.g. without forming another pair of “riding breeches”, replacing the one you have had removed.
Preparing for a liposuction
- A recent blood - and ECG-examination
- Overweight and cigarette consumption (less than five a day) must be reduced
- Two weeks in advance: stop taking drugs that stop blood from clotting, especially painkillers such as aspirin and anti-rheumatic drugs
- Two weeks in advance: stop taking vitamin- and herbal pills
- On the day of the operation take a shower and carefully wash your head
- No make-up please
- Please don't schedule the operation on a day you are menstruating, since that increases the risk of secondary bleeding
The day of the operation and the liposuction
You may eat or drink something before you come, a light breakfast or lunch is permitted. You need to be sober, though. Please do not forget to bring the diagnosis of your blood test and the results of your ECG and don't forget to inform us about any medicine you are currently taking or have been taking until one week before the liposuction.
The liposuction procedure
After we have welcomed you in the operating room you will receive a lab coat. We will mark the areas of your body that are going to be sculptured and we take pictures. Then you will be asked to lie down on the operating table.
As it has been said before, we prefer performing liposuction under local anaesthesia. Only those parts of your body will be numbed where excessive stubborn fat is eradicated from. That means that you will be conscious all the time during the surgery. After anaesthesia has been administered the surgeon will create tiny incisions in the targeted body parts. After 20-30 the anaesthesia is effective.
With a 'vacuum cleaner' the fat is removed. By moving the tube back and forth in zigzag moves an even look is the result. 
It might be that the surgeon asks you to stand up and even to walk around a bit because this helps us to check if the suctioning leads to a smooth look. After the liposuction the incisions are closed with a few stitches and we help you to put on compression trousers. This is to prevent haematoma. To prevent secondary bleeding you must not take aspirin or other drugs that interfere with the blood clotting. Normally you feel well after the surgery and you don't have a hangover as it is often the case with general anaesthesia. Nevertheless you are not allowed to be the driver of a car. If you want to get back to your hotel or home, you have to take a taxi, or someone has to give you a lift.
The time after a liposuction-operation
The compression trousers are a necessary supportive elastic and have to be worn night and day for at least two weeks.
We recommend you taking a nap in the afternoon of the day of the operation and/or going to bed early. Gentle walking is also important, though, for the anaesthesia completely fading. A walk is fine but beware excessive strain! You have to drink a lot (fruit juices, water, herbal tea, soft drinks) on the day but no alcohol of course. Dinner shouldn't be too solid. Having a shower (with the plasters) is allowed. You can remove the plaster yourself after five days.
The next day you may drive a car again albeit no longer distances, unless you pause after one hour to walk around a bit. Many patients start working again after a day or two, but you should feel free to recover a couple of days. After one week the body part in question has either to be massaged or you use a professional lymphatic drainage. If you suffer from pain, influenza, secondary bleeding or redness after the liposuction you have to contact us immediately. We'll provide you with the necessary telephone numbers after the operation.
How much does a liposuction cost?
© Dr. Darius Alamouti, MD — www.dariusalamouti.de
