Liposuction, Liposculpture, and Lipofilling

Q: Is liposuction a safe kind of surgery?

A. Thousands of liposuction operations are performed successfully every year all over the world. When this operation is performed by a specialist plastic surgeon, experienced in body contouring, in a top hospital and with the right anesthetic assistance, the results are usually very good.

However, it is essential not to make light of this operation and not to give in to temptation by going to non-specialists who perform low-cost surgery at basic facilities (health centres, consulting rooms, etc.). As a surgical procedure it can carry with it complications (infection, haematomas) that although rare, may occur and can be easily resolved only if the operation is performed by a trained surgeon in an appropriate environment.

Q. Can liposuction be a substitute for diet?

A. No. Liposuction and liposculpture allow the removal of localized deposits of fat that cannot be eliminated otherwise, but they don’t replace dieting. However, the body contouring achieved through liposuction and liposculpture is often an incentive to take more care of one’s body and weight and can complement an individual’s efforts to diet and exercise.

Q. I am considering thigh liposuction and would like to know if it is useful to follow a diet before the operation.

A. Normally, we advise patients to undergo liposuction when they have reached a weight they think they can maintain. However, a balanced diet should be followed and a programme physical exercise should be maintained even after surgery.

Q. How much weight can one lose through liposuction?

A. Liposuction is not a surgical operation that results in weight loss but is effective in contouring the body and removing deposits of fat which are localized in some specific areas of the body and which are not removable by dieting or through physical exercise. Normally, no more than 3-4 litres of fat are removed from the specified area through liposuction or liposculpture.

Q. Is the cosmetic result achieved by liposuction definitive or is it possible that the rolls of fat previously removed will re-form after some time?

A. The result of liposuction and liposculpture may be considered as permanent, provided that you have the discipline to follow a balanced diet and do some form of physical exercise regularly. Liposuction and liposculpture can eliminate a certain amount of adipose cells (fat) but if you tend to put on weight and don’t moderate your eating, the remaining adipose cells will end up spreading and creating the unsightly rolls of fat once again.

Q. What time of year is preferable to go for liposuction?

A. The liposuction operation can be performed all year round, but (this is true for all surgical operations) it is preferable to perform it in winter, in order to avoid the detrimental effects of photoexposure which is scar pigmentation and excessive heat and oedema in the treated area. This can be more of a problem in the warmer summer months.

Q. Is liposuction a painful kind of surgery?

A. No. Straight after the operation and for 2-3 days, you will feel a sensation of pain in the treated area, which varies depending on the individual and on the extent of the operation. However, it is a tolerable pain that can be relieved by analgesics.

Q. I’ve heard that after liposuction it is necessary to wear a body bandage. Is it true?

A. Straight after the operation you’ll have to wear a compressive sheath or 140 denier elastic stockings for at least one week. However, this garment is not troublesome at all and is useful for better compressing the treated tissues and for limiting puffiness. After removing the stitches, we recommend that patients wear the sheath for another 3-4 weeks, depending on the amount of the fat removed and on the area in which the operation was performed.

Q. What’s the difference between liposuction and liposculpture?

A. Liposuction allows the body to be sculpted by removing the undesired depot fat from specific areas such as the abdomen, the sides, the calves, the thighs, the knees, the upper limbs, the chin, the cheekbones and the neck.

Liposculpture derives from liposuction in that it makes use of microcannulas to "sculpt" very selected areas of the body. Sometimes, liposuction and liposculpture can be performed in association with the lipofilling technique (also called lipostructure) which consists in taking small quantities of fat through a thin needle or a cannula and then injecting them into the areas presenting small depressions.

Q. I’m 39 and, despite the continuous diets I follow, my calves, knees and ankles are still very large. I would like to know if liposuction can solve my problem or if there are other kinds of surgery or cosmetic medicine treatments available that are able to contour the lower part of the leg.

A. Since the liposuction technique consists in sucking out the deposits of fat found in some specific areas of the body (for example, thighs, buttocks, knees, etc.), it is possible to achieve good results even through calf and knee liposuction, if your surgeon assesses you and thinks you meet the key criteria for surgery.

Having said that, if the size of your calves and the ankles are due to a particularly developed bone and muscle structure rather than localized deposits of fat, liposuction will not make that improvements that you are looking for.

Unfortunately, there are no other kinds of plastic or cosmetic surgery to reduce the size of the calves and the ankles, even though a few Japanese surgeons have recently used botulinum toxin (Vistabex) or botox to induce temporary atrophy on the calf muscles, indirectly reducing the size.

Q. How long should we wait to resume work after liposuction?

A. After liposuction, the duration of the convalescence depends on the extent and the number of the treated areas, as well as on the amount of fat removed during the operation.

Normally, from the third day after the operation, you will be able to resume your normal life, avoiding, nevertheless, any tiring activity. After 4 or 5 days, you will be able to resume work (provided that it is not too tiring) and, starting from the third week, you will gradually resume all your normal activities, including sports activity.

Q. I have poor circulation : will I be able to have liposuction?

A. Liposuction and liposculpture can usually be performed on patients with poor circulation. In an initial consultation, we would always advise an arterial and venous Doppler test in order to exclude the presence of vascular diseases.

Q. What instructions are to be followed before liposuction surgery?

A. As for any surgical operation, smokers should reduce the use of cigarettes before surgery, because smoking can increase the risk of complications and slow down the recovery. Moreover, it is advisable not to take NSAID-derived drugs - such as aspirin, ibuprofen, etc. - which thin the blood and might induce bleeding.

Q. Is it necessary to have lymphatic drainage after liposuction?

A. After liposuction or liposculpture, undergoing lymphatic drainage can be useful - but not indispensable - to speed up the recovery and to reduce puffiness; however, it should not be performed until at least two months after the operation.

Q. Can liposuction be performed in hospital or inside facilities operating within the National Health Service?

A. No. Liposuction cannot be performed within the NHS.

Q. I have the typical “orange peel” skin: can liposuction improve the texture of my skin?

A. No. Liposuction acts beneath the skin by removing deposits of fat, but it is not able to smooth the skin nor to improve its quality.