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Liposuction

Liposuction is a surgical procedure intended to remove fat deposits and shape the body. The operation is also known as liposculpture or suction-assisted lipectomy.

Fat is removed from under the skin with the use of a vacuum-suction canula (a hollow pen-like instrument) or using an ultrasonic probe that emulfsies (breaks up into small pieces) the fat and then removes it with suction. People with localized fat may decide to have liposuction to remove fat from that area. Liposuction is a procedure for shaping the body and is not recommended for weight loss.

Liposuction may be performed on the abdomen, hips, thighs, calves, arms, buttocks, back, neck, or face. A liposuction procedure may include more than one site, for instance, the abdomen, back, and thighs all on the same day.

Liposuction is also used to reduce breast size in men with large breasts (gynecomastia) or to remove fat tumors (lipomas) but it is most commonly used for cosmetic body shaping.

Hospital Stay: Hospital Stay: 2 days
Duration: Duration: 2-3 hrs
Cost Estimate: Cost Estimate: 1700 USD - 6000 USD These are indicative prices in Indian Hospitals

The following are some of the uses for liposuction:

  • Cosmetic reasons, including fat bulges, or an abnormal chin line.
  • To improve sexual function by reducing abnormal fat deposits on the inner thighs, thus allowing easier access to the vagina.
  • Body shaping for people who are bothered by fatty bulges or irregularities that cannot be removed by diet and/or exercise.

Liposuction is generally not appropriate for these uses:

  • As a substitute for exercise and diet, or as a cure for general obesity. But it may be used to remove fat from isolated areas at different points in time.
  • As a treatment for cellulite (the uneven, dimpled appearance of skin over hips, thighs, and buttocks) or excess skin.
  • In certain areas of the body, such as the fat on the sides of the breasts, because the breast is a common site for cancer.

Many alternatives to liposuction exist, including a tummy tuck (abdominoplasty), removal of fatty tumors (lipomas), breast reduction (reduction mammaplasty), or a combination of plastic surgery approaches.

Types of Liposuction Procedures

  1. Tumescent liposuction (fluid injection) is the most common type of liposuction. It involves injecting a large amount of medicated solution into the areas before the fat is removed (sometimes, the solution may be up to three times the volume of fat to be removed). The fluid is a mixture of local anesthetic (lidocaine), a drug that contracts the blood vessels (epinephrine), and an intravenous (IV) salt solution. The lidocaine in the mixture helps to numb the area during and after surgery, and may be the only anesthesia needed for the procedure. The epinephrine in the solution helps reduce the loss of blood, the amount of bruising, and the amount of swelling from the surgery. The IV solution helps remove the fat more easily and it is suctioned out along with the fat. This type of liposuction generally takes longer than other types.
  2. The super-wet technique is similar to tumescent liposuction. The difference is that not as much fluid is used during the surgery–the amount of fluid injected is equal to the amount of fat to be removed. This technique takes less time; however, it often requires sedation with an IV or general anesthesia.
  3. Ultrasound-assisted liposuction (UAL) uses ultrasonic vibrations to liquefy fat cells. After the cells are liquefied, they can be vacuumed out. UAL can be done in two ways, external (above the surface of the skin with a special emitter) or internal (below the surface of the skin with a small, heated cannula). This technique may help remove fat from dense, fiber-filled (fibrous) areas of the body such as the upper back or enlarged male breast tissue. UAL is often used together with the tumescent technique, in follow-up (secondary) procedures, or for greater precision. In general, this procedure takes longer than the super-wet technique.
  4. Laser-assisted liposuction (LAL) uses laser energy to liquefy fat cells. After the cells are liquefied, they can be vacuumed out or allowed to drain out through small tubes. Because the cannula used during LAL is smaller than the ones used in traditional liposuction, surgeons prefer applying LAL for confined areas. These areas include the chin, jowls, and face. A possible advantage of LAL over other liposuction methods is that energy from the laser stimulates collagen production, which helps prevent skin sag after liposuction. Collagen is the fiber-like protein that helps maintain skin structure.
  • A liposuction machine and special instruments called cannulas are used for this surgery.
  • The surgical team prepares the areas of your body that will be treated.
  • You will receive either local or general anaesthesia.
  • Through a small skin incision, a suction tube with a sharp end is inserted into the fat pockets and swept through the area where fat is to be removed.
  • The dislodged fat is vacuumed away through the suction tube. A vacuum pump or a large syringe provides the suction action.
  • Several skin punctures may be needed to treat large areas. The surgeon may approach the areas to be treated from different directions to get the best contour.
  • After the fat is removed, small drainage tubes may be inserted into the defatted areas to remove blood and fluid that collects during the first few days after surgery.
  • If you lose a lot of fluid or blood during the surgery, you may need fluid replacement (intravenously). In very rare, cases, a blood transfusion is needed.
  • A compression garment will be placed on you. Wear it, as instructed by your surgeon.

Before the Procedure

Before your surgery, you will have a patient consultation. This will include a history, physical exam, and a psychological evaluation. Feel free to ask questions. Be sure you understand the answers to your questions. You must understand fully the pre-operative preparations, the liposuction procedure, and the post-operative care. Understand that liposuction may enhance your appearance and self-confidence, but it will probably not give you your ideal body.
Before the day of surgery, you may have blood drawn and be asked to provide a urine sample. This allows the health care provider to rule out potential complications. If you are not hospitalized, you will need a ride home after the surgery.

After the Procedure

Liposuction may or may not require a hospital stay, depending on the location and extent of surgery. Liposuction can be done in an office-based facility, in a surgery center on an outpatient basis, or in a hospital. After the surgery, bandages and a compression garment are applied to keep pressure on the area and stop any bleeding, as well as to help maintain shape. Bandages are kept in place for at least 2 weeks. You will need the compression garment for several weeks.
You will likely have swelling, bruising, numbness, and pain, but it can be managed with medications. The stitches will be removed in 5 to 10 days. Antibiotics may be prescribed to prevent infection.
You may feel sensations such as numbness or tingling, as well as pain, for weeks after the surgery. Walk as soon as possible after surgery to help prevent blood clots from forming in your legs. Avoid more strenuous exercise for about a month after the surgery.
You will start to feel better after about 1 or 2 weeks following liposuction surgery. You may return to work within a few days of the surgery. Bruising and swelling usually go away within three weeks; however, you may still have some swelling several months later.
Your surgeon may call you from time to time to check on your health and to monitor your healing. A follow-up visit with the surgeon will be required.

Risks and recovery

After the operation, the treated area will be bandaged and stitched, and you may need to wear elastic compression clothing to reduce swelling. You may need to stay overnight in hospital if general anesthetic is used.
It usually takes about two weeks to make a full recovery, but it can take up to six months to see noticeable results, as the treated area may take time to settle down.
Like all types of surgery, liposuction carries a number of risks. These include bruising, infection, scarring, irregularities and numbness.

Outlook (Prognosis)

Most patients are satisfied with the result of the surgery. Your new body shape will begin to emerge in the first couple of weeks. Improvement will be more visible 4 to 6 weeks after surgery. By exercising regularly and eating a healthy diet, you can help maintain your new shape.

Liposuction, also known as liposculpture or suction assisted lipectomy, is a technique to remove unwanted fat deposits. The unsightly distribution of body fat is usually due to an inborn tendency to deposit fat in one particular area of the body, most commonly the hips. Other areas include; the neck, arms, tummy, loins, thighs, inner side of the knees and the ankles. The growth of a benign fat tumour (lipoma) can also be a disfigurement, and in men fatty swellings can develop under the nipples to look like breasts (gynaecomastia).

If you have a localised area of fat it is possible to reduce its bulk by an operation called Liposuction. A narrow metal tube is inserted through a small incision in the nearby skin. It is attached to a strong vacuum pump which is drawn back and forth within the area of excess fat. The process removes tunnels of fat leaving the small blood vessels and nerves intact. The skin will then retract.
There are some minor variants in the techniques. Some surgeons inject the area to be treated with solutions (wet or tumescent technique) others do not. Suction is usually applied with a powerful vacuum machine, but it is some-times perfectly adequate to use a simple syringe for small areas. Ultrasound assisted lipectomy is another variant.

You can expect considerable bruising which will be uncomfortable and at times painful.. Some people bruise more easily than others. The discoloration of this bruising will usually last for about a month, but the lumpiness and swelling of deep bruising can take up to six months to disappear, particularly when the abdomen or ankles have been treated.
As swelling can take a long time to settle you may not see the full benefit of the operation for up to six months. If you have a tendency to be anaemic, or if you were to have a large area treated, you may need to take iron tablets for a month. You can expect some numbness in the treated skin which lasts for several months.
You will have small scars 1.0 to 2.0 centimetres long at the sight of insertion of the suction cannulae. There is a small risk in some people that these scars may stay red for a while but they are usually sighted in less obvious areas.
If you are having treatment to your legs you may find that your ankles are swollen for a few weeks and if your ankles themselves have been treated, they may stay swollen for a few months.

Fat cells are thought not to be regenerated in adult life. Liposuction permanently removes fat cells and can alter body shape, although the results may not last if you put on weight after the procedure. Liposuction results are generally long lasting as long as you maintain your weight. If you gain weight after liposuction, your fat distribution may change. By exercising regularly and eating a healthy diet, you can help maintain your new shape.

It is important for you to understand that liposuction is not a treatment for obesity. The amount of fat that can be removed from a localized area is limited by what is safe (maximum of 3 liters) and a natural limitation when no further fat can be removed. Therefore it may not be possible to slim down an area as much as you might like. Further treatments may be carried out in the same area after six months. In certain situations the skin is inelastic and loose. Liposuction in these areas will then tend to leave the skin looser and it may be recommended that a skin excision be carried out to correct this, either at the same time as the liposuction, or as a second procedure. This is most likely in the abdomen, after pregnancy or weight loss, the buttocks or the neck. Dimples and wrinkles of the skin, sometimes called cellulite will not be improved by liposuction.

The procedure is normally carried out under general anaesthesia as a day case. You may wish to stay the night if you have had many areas treated. An epidural is an alternative for the lower part of the body, but a local anesthetic alone is only suitable for small areas as it is uncomfortable to administer and does not work particularly well.
You are likely to need simple pain killers for a day or so after the operation and you will probably be asked to return a week after surgery to have sutures removed. A snug pressure garment or corset is usually advised around the lower part of the body. This is used to reduce bruising but can be taken off to wash, quickly dried and put back on. You can take this opportunity to bathe yourself. The corset is usually worn for two to three weeks.
You will only need to take a few days off work if a small area is treated, but larger areas may necessitate 7 to 10 days off work. You may be somewhat anaemic and need to take iron. You are welcome to sunbathe but remember that discoloration of bruising will last about a month and you will not achieve your best appearance for three to six months.

The large majority of patients who have this operation done by an experienced surgeon run into no problems at all. Heavy bruising can happen particularly in patients who have a tendency to bleed or have been taking aspirin or anti-inflammatory drugs. Serious infection is very rare, but there is sometimes inflammation in the areas that have been treated with perhaps some oozing from the incisions. It normally settles with a course of antibiotics.

You should avoid aspirin and anti-inflammatory drugs for 2 weeks before the operation. You should take iron if you are anemic. Occasionally your surgeon will advise you to stop taking the contraceptive pill if the liposuction is going to be extensive, perhaps involving skin excision.

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