DEFINITION, AIMS AND PRINCIPLES
Liposuction can radically and definitively diminish localized
areas of protruding fat.
These localized areas of protruding fat do not go away with
strict diet and exercise.
Conversely, liposuction is
not a method for losing or
controlling weight. Thus, a
liposuction will not replace
an improvement in
lifestyle. Liposuction is not
a treatment for obesity.
The principle of liposuction (as presented in 1977 by Yves-Gérard ILLOUZ)
is to remove fat
through very small skin
incisions, with atraumatic
and blunt-tipped cannulas.
These cannulas are
attached to a closed
negative pressure system,
which permits safe and sterile aspiration of excessive fat
Practically, liposuction can be applied to numerous body
areas: hips, outer thighs, abdomen, knees, calves, ankles and
Technical improvements have permitted to
extend its action to the face and neck (ie, double chin and
Recent progress in the field of superficial liposuction,
performed with very thin cannulas have reduced skin trauma
or bruising. It has even improved the final result by enhancing
skin shrinkage, when performed with great attention and skill.
Meanwhile, it must be kept in mind that liposuction, however
common a procedure it has become, remains a genuine
surgical intervention, that ought to be performed by a skilled
and qualified Plastic Surgeon, specially trained for this
technique, in a truly surgical environment.
BEFORE THE PROCEDURE
A preoperative check-up is made following your surgeon’s
HOSPITAL STAY AND TYPE OF ANESTHESIA
Type of anesthesia
Liposuction can be performed, depending on the amount of
areas to be treated, either under local anaesthesia, local
anaesthesia associated with intravenous sedation or general
anaesthesia. In some cases, regional anaesthetics, such as an
The type of anaesthesia will be chosen after a discussion
between yourself, your surgeon and your anaesthesiologist.
The duration of hospitalisation depends on the amount of fat
removed. It can be short (a few hours) for small liposuctions
under local anaesthesia, or longer (1 or 2 days) for larger
liposuctions under general anaesthesia.
Skin incisions are small (3 to 4 millimeters) and discrete,
usually hidden in a natural fold. Fat cells from deep and
superficial fat layers are aspirated through smooth cannulas tunneled though ubcutaneous tissue layers, taking care to
avoid nerves and blood vessels.
The amount of fat removed is adapted to the amount of the
overlying skin, which represents a fundamental factor for the
quality of the final result.
Post-operatively, a pressure dressing is made with an elastic
bandage. Very often a special pressure garment is put on top
The duration of the procedure depends on the amount of fat
removed and on the number of body areas to treat. It can vary
from 20 minutes to 3 hours (average time is 1 to 2 hours).
AFTER THE OPERATION
The necessary time needed to recover from surgery is
proportional to the amount of excess fat removed.
After surgery, you will observe swelling and bruising in the
Pain can vary from one patient to another, but it is usually
mild, due to the use of very thin cannulas.
Fatigue is common in the first few post-operative days,
especially after large liposuctions.
You can go back to your usual activity 4 to 7 days after
surgery, again depending on the extent of your liposuction
and your type of professional activity.
Bruising usually disappears 10 to 20 days after surgery.
It is strongly recommended to wear a pressure garment for 2
to 4 weeks.
It is possible to start sports again at least 3 weeks after
There is no dramatic improvement of body contour in the first
2 to 3 weeks, because of the tissue swelling (edema) in the
It is only after 3 weeks and with the resorption of this edema,
that results will begin to appear. The skin will retract
completely in 3 to 6 months over the new contours and
readapt to the new silhouette.
The final result can be best appreciated 6 months after the
procedure. It is most satisfactory when the patient selection
and technique are properly done, permitting removal of
localized fat deposits and producing skin retraction.
It has already been explained how liposuction, when correctly
indicated and performed, can offer a real improvement to
patients in terms of satisfying results and conformity to their
In some cases, localized imperfections can be observed,
which must be distinguished from genuine complications:
insufficient corrections, residual asymmetry, surface
irregularities. These can be corrected secondarily under local
anaesthesia after 6 months.
- Thrombo-embolic accidents (blood clot in the veins of
the legs, pulmonary embolism) are rare, but can be lifethreatening.
They can be prevented by strict prophylactic
measures, such as standing and walking as soon as
possible after surgery, wearing compression stockings, or
heparin therapy (low doses of heparin injected under the
- Blood clots (haematomas) are quiet rare but can occur.
They can be evacuated to prevent an impairment of the
final aesthetic result.
- Infection, though common, can be treated with drainage
- It is common to notice 8 days after surgery a lymph
collection accumulating under the skin. Such a collection
can be drained and will dry up rapidly without sequela.
- Localised skin necrosis. Large areas of necrosis is rare.
They can be prevented by a proper surgical examination
and a cautious and well-executed operation, with
moderate tension on sutures.
- Numbness of abdominal skin may be observed,
frequently in the lower abdomen. It is usually transient
and most patients recover normal skin sensation after 3 to
- In some patients with very damaged skin or skin with
poor circulation, the healing process may be delayed
resulting in conspicuous scars, which may necessitate a