What happens before and during the liposuction operation?
Before the operation – patients will need to undergo some health tests to ensure that they are fit for surgery. The medical team will ask the patient to:
Stop taking aspirin and anti-inflammatory drugs for at least two weeks before the surgery.
Women ( beauty ) – if undergoing an extensive operation, they may be asked to stop taking the contraceptive pill for a specific period before the operation.
Patients with anemia – they will be asked to take iron supplements for a specific period before the operation.
Consent form – the patient will be asked to sign a consent form, which confirms that they are fully aware of the risks, benefits and possible alternatives to the procedure.
During the operation
The surgeon will mark out lines on the patient’s body, indicating where treatment will take place. Photos of the target area, and sometimes the patient’s whole body may be taken; they will be compared to pictures of the same areas taken afterwards.
Anesthesia – the patient will most likely be under a general anesthetic; they are put to sleep before the procedure and remain so during it. A liposuction operation may last from 1 to 4 hours. The doctor may use an epidural for treatments on the lower body – the anesthetic is injected the epidural space surrounding the dura (fluid-filled sac) around the spine, partially numbing the abdomen and legs. A local anesthetic may be used when liposuction is done on very small areas.
Patients may feel a dull rasping during the procedure as the cannula moves under the skin. This is normal. If any acute or different pain is felt the doctor needs to be told, as the medication or movements may need modification.
If the patient requires only local anesthesia, he/she may be asked to stand up during the procedure to ensure proper fat removal.
One of the following liposuction techniques may be used:
Tumescent liposuction – several liters of a saline solution with a local anesthetic lidocaine and vessel-constrictor epinephrine (adrenaline) is pumped subcutaneously (below the skin) in the area that is to be suctioned. Epinephrine helps minimize bleeding, bruising and post-operative swelling. The fat is suctioned (sucked out) through small suction tubes (microcannulas). This is the most popular form of liposuction. beauty
The amount of liquid pumped into the area may be up to three times the amount of fat to be removed. This volume of fluids creates a space between the muscle and the fatty tissue, allowing more maneuverability for the cannula.
Wet liposuction – a small amount of fluid with less volume than the amount of fat to be removed is injected into the target area. The fluid is similar to the one used in tumescent liposuction and minimizes bleeding and bruising. The fluid helps loosen the fat cells. The fat cells are suctioned out.
Super-wet liposuction – this technique uses less liquid that tumescent liposuction; about the same amount of liquid as fat to be removed. Otherwise, the technique is very similar to tumescent liposuction. The patient may need a separate anesthetic.
Dry liposuction – no fluid is injected before fat is removed. This method is seldom used today. There is a higher risk of bruising and bleeding.
Ultrasound-assisted liposuction (UAL) , also known as ultrasonic liposuction – the cannula is energized with ultrasound. This makes the fat melt away on contact – the ultrasound vibrations burst the walls of the fat cells, emulsifying the fat (liquefying it) and making it easier to suction out. This method is a good choice for working on more fibrous areas, such as the male breast, back, and in areas where liposuction had been done before.
UAL is especially useful for stubborn fat accumulations. However, longer incisions in the skin are needed for this procedure, and there is a risk of skin or internal burns. This procedure takes longer than the others, because it is often done alongside tumescent liposuction. It is also more expensive. After ultrasonic liposuction, it is necessary to perform suction-assisted liposuction to remove the liquefied fat.
UAL techniques were initially linked with cases of tissue damage, generally because of over-exposure to ultrasound energy. A third-generation UAL device beauty – the Vaser Lipo system – prevents this problem by using pulsed energy delivery and a specialized probe that allows surgeons to safely remove excess fat.
Power-assisted liposuction (PAS) , also known as Powered liposuction – uses a specialized cannula with a mechanized system that rapidly moves back-and-forth, allowing the surgeon to pull out fat more easily. It is similar to traditional UAL, but the surgeon does not need to make so many manual movements, as in other methods.
This method may sometimes cause less swelling and pain, and may allow the surgeon to remove fat with more precision, especially in smaller areas.
Laser Assisted Lipolysis (LAL) , or laser-guided lipo – requires the use of tumescent fluid. It is a far less invasive and bloody procedure than the traditional liposuction method for removing fat. A microcannula is inserted through a small incision to deliver laser energy and heat into subcutaneous fat (fat under the skin).
The liposuction cannula – this is a stainless steel tube, which is inserted through an incision in the skin and is used to suction the fat (suck the fat out).
The liposuction microcannula – is a very small cannula with an inside diameter of less than 3 mm (some experts define them with less than 2.2mm diameter).