It is a procedure where excess fat located just under the skin is suctioned out. It is performed using a thin stainless steel tube called a cannula, which is connected to a vacuum. Its goal is to reshape the body. It could be said that it is a contouring surgery.
Why are small-caliber cannulas preferred?
Because they allow for smaller incisions, which do not require stitches and allow the anesthetic fluid previously injected to drain after the procedure. Additionally, they penetrate fatty tissue better, are less traumatic, and ensure more precise results.
Is anesthesia required?
Absolutely. However, it is local anesthesia. Therefore, the result can be checked immediately after the procedure by examining the patient standing up. This way, necessary touch-ups can be made to achieve the desired result in one go. General anesthesia should be avoided in modern liposuction.
Is everything well explained before the procedure? Does the patient fully understand what to expect?
At our clinic, extremely detailed instructions are provided before and after the procedure. Additionally, during the evaluation meeting with the doctor, the patient is given all the time needed to fully understand the process. The patient can also call the coordinator or even the doctor as often as they wish to ask any questions that come to mind. This coordinator has herself undergone liposuction and can provide information and advice based on her own experience.
Is the procedure painful?
The only thing that might cause discomfort is the local anesthesia that initiates the procedure. To minimize this discomfort, the skin is first numbed with a micro-needle; small dermal bumps are created. Once the epidermis is frozen, the needle can be inserted without any pain. And since fat is poorly innervated, it can be anesthetized with minimal discomfort. As for the procedure itself, it is painless since the fat is completely frozen. Several patients have compared the experience to a massage. During the operation, conversation is held in a relaxed tone. After liposuction, the local anesthesia keeps the patient comfortable for 18 to 24 hours, after which some sensitivity may persist for a week or two, depending on the case. Painkillers are then prescribed.
Who should be refused for liposuction?
Obviously, one must be in good health to undergo liposuction. Since it is a purely aesthetic procedure, it would be inconceivable to risk one’s health for the sake of appearance. Patients with liver or kidney problems will be refused due to the large amounts of medication involved in anesthesia, which are eliminated by these organs. Similarly, diabetic patients or those suffering from abnormal bleeding or heart disorders. But the least suitable candidates for liposuction, by far, are psychologically immature individuals, those who have unrealistic expectations, who demand absolute guarantees, who want to regain their lost youth, who hope for the impossible, who do not understand the purpose or limits of liposuction, who want to resemble their idol.
What medications should be taken in preparation for liposuction?
Each patient receives a prescription for antibiotics to prevent any possibility of infection, as well as a painkiller for the first few days following the surgery. The night before the procedure, a mild sedative ensures a good night’s sleep.
Should one follow a diet before?
It is the last thing to do. If fatty tissues are emptied of their fat, they become more fibrous, the reshaping is less effective, the skin loses its tone, adding the risk of not retracting well.
Can a lot of fat be removed?
It is rare to exceed 3 liters per procedure. But an experienced surgeon can go up to 5 liters in circumstances that allow it and are rather rare, for example in the trunk area, if the patient’s weight justifies it.
Can all the fat be removed?
Absolutely not. Fat plays a very important role, and removing it completely would lead to functional and aesthetic complications. Allow me to quote Dr. Pierre Fournier, one of the pioneers of liposuction: “It is not the fat that is removed, but the fat that remains that determines the success of liposuction.” It is unreasonable to remove all the fat, but leaving just the right amount is what distinguishes the talent of the liposculptor.
Can multiple areas be reshaped at once?
Yes, but the choice of sites requires experience and discernment on the part of the surgeon. One must also consider the person’s age, weight, health status, expectations, and the overall context. Additionally, there is a limit to the amount of medication needed for local anesthesia, as they become toxic if the permitted dosage is exceeded. Take the case of an average-weight person in good health. Often, three sites are treated during the same procedure: for example, the saddlebags, flanks, and inner thighs.
Does liposuction require hospitalization?
Absolutely not, this type of procedure can very well be done in an outpatient clinic called a CMS (specialized medical clinic). One will also be much safer from germs than in a hospital.
Is a special diet required after liposuction?
No. However, to optimize results, heal the surgical trauma well, and avoid complications, it is recommended to drink plenty of water and follow a balanced diet: lots of fruits and vegetables, as well as proteins, fish, poultry, of course without exaggeration, as even good things become bad when overdone.
Can one go in the sun?
It is preferable to avoid it as long as there are bruises, for a period of about two weeks. This is to avoid any possibility of pigmentation spots.
Can one undergo multiple liposuctions?
Of course, if there are many areas to be treated. For example, the trunk, then the thighs, then the arms and calves, the buttocks, and so on. I have already performed up to four liposuctions on the same person, over time.
Should liposuction be done before or after pregnancies?
Most consult after their pregnancy, but there is no objection to doing it before, quite the contrary, the skin and muscles will only be of better quality and the results even more improved, especially if the patient tends to gain excessive weight during her pregnancies.
Does liposuction make cellulite disappear?
A frequently asked question. Even if we cannot guarantee the disappearance of cellulite, we can predict that the skin surface will almost certainly improve, as the tissues being less tense, they will give less hold to the orange peel appearance.
Is it beneficial for an obese person?
Liposuction is not a treatment for generalized obesity, but rather for localized obesity, called adiposity. It is not intended to make one lose weight, but rather to slim the body’s curves. However, people suffering from moderate obesity can greatly benefit from it. It is worth noting that liposuction is sometimes the starting point for significant weight loss in some obese individuals with very little effort. This is referred to as the “starter” effect. Among the benefits for the obese, it can be said that liposuction brings improvement in respiratory comfort, sleep, and undoubtedly a tremendous boost of hope. It has also been said to regulate insulin, lower plasma lipids and cholesterol, and increase basal metabolism, but additional evidence would be needed to confirm this.
Does the removed fat come back?
No, because the fat cells are also removed, and fat cannot “settle” if there are no fat cells to receive it. Thus, no one will ever gain weight on their forehead, because there are no fat cells there. However, it should be added that the few fat cells that must be left to achieve an aesthetic result can swell after liposuction, but never to the point of reforming the adiposity that was removed. To be more precise, if your adiposity was 5 cm thick, and ½ cm was left, it is possible, in case of weight gain, to end up with 1 cm, which is far from the previous 5 cm.
In that case, why does one regain weight after a weight loss program?
Because a diet empties fat cells but does not eliminate a single one. The fat cell (adipocyte) is genetically programmed to fill with fat, that is its only purpose, its only reason for being in life. This is why, according to statistics, obese individuals regain weight in 95% of cases. If it is simply emptied, the fat cell becomes, so to speak, “destabilized,” which is why, to overcome it, it must be amputated, and that is what liposuction does: an amputation of fatty tissue.
How does the skin react after liposuction?
Much better than after a weight loss program. Indeed, the liposuction cannula irritates the subcutaneous tissues, the dermis more precisely, and this provokes an important healing reaction that retracts the skin, we speak of bio-stimulation. It must be remembered that it is the fat that makes the skin sag and not the other way around. Once the fat is removed, the skin only wants to rise. Of course, in extreme cases, where the elastic tissue is destroyed, the skin will not be able to rise. Apart from these rare cases where the patient is carefully warned, the skin will have a completely normal appearance.
Is it necessary to apply compression dressings?
Yes, a compression garment is worn for about a month. It must be worn constantly for the first 72 hours; then, during the day only. Liposuction traumatizes the subcutaneous tissues which must heal. It is well known: a wound that is not held hurts and heals poorly. This means that light compression provides comfort, analgesia, and faster healing.
Is healing fast?
It depends on the extent and site of the liposuction. If it was done on the abdomen, the edema (swelling) can persist for two to three months. Elsewhere, for example on the hips or saddlebags, the benefits are visible two weeks after the procedure.
Does the treated person have to stop working?
If the job is not physical, for example office work, and the operation takes place on a Friday, one can sometimes return to work the following Monday. If the job requires physical effort, or if it is a major procedure, such as the trunk, a week of rest may be necessary.
What about scars?
The incisions are so small (4 mm) that they are practically invisible after a few months. Moreover, when possible, they are made in hidden places, such as the pubic hair, navel, or under the buttock fold.
Is the result permanent?
It depends on the experience of the liposculptor. If he leaves a lot of fat for fear of removing too much, this fat becomes “seed for weight gain.” If he leaves only the minimum necessary for a perfect result, the adiposity cannot return. This does not mean, however, that one cannot correct or improve a liposuction whose result is imperfect. Obviously, having removed too much will be much more difficult to correct than the opposite.
Who can perform this type of procedure?
Dr. Giorgio Fischer, the inventor of liposuction, whom I have met, declared: “Liposculpture does not belong to any surgical specialty. It is a new concept of body contouring surgery, which uses instruments that we do not use in surgery.” In this perspective, Dr. Pierre Fournier of Paris, a surgeon and one of the pioneers of liposuction, wonders if it does not belong to a new specialist: the “liposculptor.”
The liposculptor can be any recognized physician who has the required training and, above all, sculpting talents. If your choice falls on a liposculptor who has performed hundreds of procedures, even thousands, it will be much more reassuring. About fifteen years ago, I spent a few days in the United States with a renowned aesthetic surgeon, who had even worked for three years in Brazil with the very famous Dr. Yvo Pitanguy, surgeon to the stars and crowned heads. This American surgeon confided in me in a moment of intimacy: “In liposuction, I am constantly improving, and I blush today when I look at my results from two years ago!” Hence the importance of choosing a liposculptor who performs many, many, many procedures. The adage: “Practice makes perfect” is also true in this practice.
Should he have a lot of experience?
Obviously, there is a beginning to everything, especially since liposuction is not really taught, it is rather learned through practice. To be a virtuoso, a pianist must have talent, of course, but above all, practice. It is the same in the case of a liposculptor surgeon, even if he watched a surgeon work for a year, it would be like watching a pianist play for a year, what would he have learned exactly? Would you hire him as a musician for your wedding? Only practice will make him able to predict the result of each gesture he has made. Moreover, he will have seen countless cases and will be better able to advise his patients according to their age, skin quality, realistic expectations, sites to be treated, etc.
Can one take baths after liposuction?
No, showers only for the first week. Hot baths can increase swelling and could promote infection, as long as the incisions are not well closed.
Will there be bruising?
This reaction depends on each person. Those who bruise easily in everyday life will bruise more easily. For others, it depends on the extent of the liposuction. Bruises last about ten days. Thanks to the small cannulas, no stitches are needed to close the incisions. Thus, the fluid responsible for bruising can flow outside, which is a definite advantage.
Are there touch-ups?
In aesthetic surgery, perfection cannot always be achieved in one go. In this case, a slight touch-up will correct either a slight asymmetry, a small oversight, or healing that did not go exactly as planned. Touch-ups are still very rare, I would say 2 to 3% of procedures. The word touch-up is poorly chosen, it should rather be called refinement, final touch.
What kind of complications can occur?
They are very rare on the part of an experienced liposculptor.
Hematoma or seroma: it is an effusion of blood or fluid that produces a slight elevation of the skin. The treatment consists of removing this fluid with a syringe. It leaves no trace;
Bruising or swelling of the operated areas: it is temporary and without consequences;
Pain, itching, or discomfort. These symptoms are normal after any surgical procedure and are very bearable. They disappear quickly and respond well to painkillers;
Marbling persists on the skin: in general, it can be removed with pulsed light (IPL) or with a laser;
Sensitivity disorders in the operated areas: sensitive points are rare, can last a few months, and always end up disappearing;
Infection is very rare, as the xylocaine used to infiltrate the tissues to freeze them has a germicidal action. Moreover, an antibiotic is always given as a preventive measure;
Not enough fat may have been removed, some may have been forgotten: it is very easy to go back to finish the job, but one must wait six months;
Removing too much fat is more complicated, as it must be reinjected: this complication is rather rare for an experienced surgeon;
Embolisms are very rare and occur during enormous liposuctions that should therefore be avoided. Mobilizing quickly and staying well hydrated after the procedure helps prevent this complication;
Fat embolisms are also very rare: they could occur when another surgery is performed at the same time, such as lipectomy, which is best avoided;
One could also perforate a deep organ, but this occurs almost exclusively under general anesthesia.
In summary, liposuction compared to any other aesthetic surgery has few postoperative complications; statistical data speak of 68 cases per thousand, which is less than 1%. Of course, these statistics apply only to tumescent outpatient liposuction (with local anesthesia), as I have practiced for several decades.
What kind of pain follows liposuction?
First of all, the local anesthesia acting for about twelve hours, it is only in the evening that a feeling of discomfort may appear. Some patients compare it to a sunburn, others say there is a feeling of having overexerted oneself, of being sore. Others, however, say that after only two days, they feel very well without taking their painkillers. The question of pain is very rarely raised, and the prescribed painkillers are very effective. I have noted that the more the patient ardently desired this liposuction, the less it hurt afterward. It is not uncommon to have a feeling of numbness in the liposculpted areas. This always resolves after a few weeks.
When can one resume exercise?
One can take walks the next day. After a week, one can stretch and lift light weights. Aerobics can gradually resume after two weeks. Of course, it all depends on the extent of the liposuction. It is enough to listen to one’s body and act accordingly. Significant efforts should be avoided during the first four weeks.
What about sexual activities?
There are no restrictions in this regard. Possibly, you will not feel like it the first few days, but then your body will tell you. You are the only master of it.
Are results seen quickly?
It depends on the areas. A result is often spectacular immediately after liposuction, but then it is possible that the edema (swelling) masks this result for a few weeks. As mentioned above, the abdomen takes the longest to heal, remaining hard for at least two months. For example, after two weeks, it is possible to go on vacation by the sea.
Can one drink and smoke after liposuction?
Alcohol is prohibited one week before and three days after liposuction. After these three days and for the first week, one drink daily should not cause any harm. As for tobacco, it delays healing, as it is well known to interfere with blood circulation. So, the less you smoke, the faster you heal… If it is impossible to stop completely, it would be wise not to exceed five cigarettes per day, the two weeks before and after the procedure. If a fat graft is needed, smoking prevents the new fat from coming back to life, not a drop will remain…
What happens if one gains weight after liposuction?
The liposuctioned areas can never regain their previous volume, as the fat cells have been removed and cannot return. Indeed, fat cells do not grow back in adulthood, like teeth. For the rest of the body, the weight will be distributed as if there had been no liposuction, no more and no less.
What is the cost of liposuction?
Surprisingly affordable, considering the benefits it brings. Often, it is the same price as a weight loss program, while statistics will tell you that only one in twenty patients will keep their new weight, whereas with liposuction, the result remains. I would say that currently, in Quebec, the cost of liposuction, according to the criteria mentioned above, can vary from $2,500 to $5,000. Some clinics charge $7,000 to $10,000 for the same procedure, taking into account the cost of general anesthesia. But you know my point of view on the matter!
Can a failed liposuction be repaired?
It is very rare that one cannot repair or at least improve a poorly performed liposuction. It is obviously much easier to repair bumps than holes, as to fill a gap, fat must be reinjected, so it must be found, harvested in a sterile manner. Let us note in passing that this fat can be frozen for 2 years. Since 40% of the “implanted” fat will come back to life, it may sometimes be necessary to reinject it a second or third time.
What to choose between lipectomy and liposuction?
Klein states that in 95% of cases, even with sagging skin, liposuction is preferable to lipectomy. Here are 2 examples where liposuction was fortunately chosen.
