Classic liposuction can be either so-called dry technique, when there is applied no liquid under the skin of treated area. Or liposuction under general anesthesia with the use of infiltration solution and liposuction cannula ran by vibration, ultrasound, radio-frequency or laser energy. It is possible to suck out larger amount of fat. The hospitalization takes 1-2 days, wearing of compression underwear for 8-12 weeks, sport activities after 4 weeks.
Looking for a new look? Consider liposuction surgery abroad. Read on to discover if liposuction surgery is a good option for you!
Liposuction is a procedure which removes localized fat deposits to shape one or more places on your body. Liposuction improves your body’s shape by intrusion and removal of subcutaneous fat using metal cannula connected to a vacuum device through a tube. It enables to suck the fat from the required areas. The suction cannula is inserted in the body through short incisions, maximum several centimeters in size, which are located in the natural skin folds to be as little visible as possible when healed up. Liposuction can help sculpt the body mainly in the abdomen, hips, buttocks, thighs, knees, upper arms, chin, cheeks and neck. Liposuction is suitable if you have fat deposits in so-called problematic parts of your body and exercise and diet do not help. It cannot be used to treat extreme overweight or obesity!
Prague has many attractive features for those considering liposuction abroad. Its location in Central Europe is easy to access; its mild climate is conducive to healing and its experienced clinics and liposuction surgeons ensure you’ll receive the best possible care. Liposuction Prague costs are often much more affordable than in the UK or with the NHS. For more information about getting to and around the Czech Republic, please visit our handy cosmetic surgery Prague info guide.
The liposuction techniques are divided into dry and wet (fluid is not or is used). According to the device used and cannula type liposuction can be divided into classical, power-assisted, ultrasound-assisted and laser. They all use the same principle where the intruded fat tissue is removed through a narrow tube – cannula. The cannula is inserted under the skin and using the vacuum it removes the excessive fat tissue. The methods of liposuction and anesthesia maybe combined in various ways. The final result depends on how much tissue is removed, how experienced the surgeon performing the procedure is and, of course, on the technique and anesthesia used.
Dry technique: The technique does not use any fluid injection – therefore the name Dry Technique. A higher suction must be used in this method which may lead to higher blood loss or tissue damage resulting in more significant unevenness. The method is considered as obsolete and is seldom used today.
Wet techniques: The fluid is injected under the skin. The wet techniques differ according to the amount of used fluid. The fluid is a mixture of saline solution (solution of sodium chloride), adrenaline (substance contracting blood vessels) and it may also contain an anesthetic. The technique facilitates the removal of fat, reduces blood loss and if an anesthetic is included it also provides anesthesia during and after the surgery. The injected fluid also helps to reduce bruising.
The volume of injected fluid is lower than the expected volume of removed fat. Usually 200 – 300 ml of the fluid for the treated area.
The volume of injected fluid approximately equals to the expected volume of removed fat. The technique is similar to the tumescent technique, except that a local anesthetic is not usually contained in the fluid or only in small amounts.
If the tumescent liposuction technique is used, large volumes of fluid are injected into the treated area through a 12cm-long needle which is tubed to a bag with the diluted solution. The fluid is infused slowly using a pump operated by a foot, which enables the surgeon to control the flow easily. The tumescent fluid contains a local anesthetic, usually lidocaine, to provide local anesthesia in the treated area. It enables to perform the procedure without the necessity of general anesthesia. The procedure performed under local anesthesia takes more time than liposuction under general anesthesia. It is necessary to wait for the effect of the local anesthetic and thus inject the fluid into each area just before the suction. The amount of the anesthetic and thereby the amount of the fluid is determined by the weight of the patient. The volume of fluid is usually 2-3 times higher than the volume of the sucked fat. It results in a solid swelling – tumescence, the skin in the treated area becomes white and cold. When the tumescent solution has been applied the suction of fat tissue can start. The liposuction is performed through a cannula tubed to a device which uses vacuum to suck. Different types of cannulas may be used with this technique. The biggest advantage is the possibility to position the patient as the procedure is performed under local anesthesia. The patient is conscious he/she can turn as needed, lift limbs or stand up. Some fat may be after a palpative and visual check removed when the patient stands.
Power assisted liposuction utilizes a so-called vibration cannula that gently vibrates in quick micro-movements within 0,5 – 1 mm back and forth. The cannula is connected to a special device which produces the necessary power. It carefully penetrates fibrous fat tissue – e. g. in buttocks or back. At the end of the procedure it helps to smooth irregularities in the sucked area and its borders to make the transition from sucked to non-sucked area even and smooth. It is used for example in repeated interventions in the tissue. Most clinics use the advanced Vacuson LP 60 equipment which includes the vibration cannula, a device for solution infiltration and a sucking device. Presently, most experts consider the combination of tumescent liposuction, which is due to the contain of an anesthetic in the infiltration solution performed under local anesthesia, and vibration cannula as most advanced as well as most effective and sparing method.
Ultrasound-assisted liposuction uses a special cannula that produces ultrasonic energy. The energy bursts the walls of the fat cells and the fat is then liquefied. Ultrasound liposuction can be an effective tool for removing fat from fibrous body areas, such as the upper half of the back or enlarged male breasts. The advantage of ultrasound liposuction is the ability to penetrate the more fibrous tissues, e. g. fat tissues. It may be used in repeated liposuctions. Another advantage is a lower blood loss. There is a danger of skin burns unless the technique is performed correctly. The fat is removed in the same way as in other liposuction techniques. The combination of the tumescent method with ultrasound cannula is also a suitable however rare method due to the higher costs of the ultrasound device.
Under the term ultrasound liposuction we often encounter a non-invasive fat removal method where ultrasonic energy is applied to the fat tissue from outside the body. The fat cells are broken and purged by the natural metabolism of the body. Ultracontour and Ultrashape are devices using this advanced technology. The term non-invasive liposuction or E-UAL – external ultrasound-assisted liposuction may be rather misleading as it is not liposuction in the true sense of the word. No fat is sucked away.
Laser-assisted liposuction known also as ultrasound lipolysis uses a 1-2 mm wide cannula with a laser beam. With the forth and back movement of the cannula the energy is applied directly to fat cell, dissolves it and enables its removal. The laser beam also affects hypodermis, contracting collagen fibers. The liquefied fat tissue is not usually sucked in small localities. It is gradually absorbed during natural metabolism. In larger areas it is necessary to suck the fat tissue liquefied by laser. According to the laser type used we know SmartLipo and CoolLipo. Most clinics use a vibration cannula for the suction; it means they combine laser and power-assisted liposuction.
The liposuction cannula diameter is important in all liposuction technique. Wider cannulas suck more fat and save time and effort. However this type of cannulas leaves more empty space behind and therefore creates bigger irregularities on the skin surface. Presently, cannulas with smaller diameters are used more often as they are considered more delicate.
In out-patient liposuction under local anesthesia it is not advised to remove large amount of fat at a time but divide the procedure in several sessions. The suction of larger volume of fat, which also removes water, vitamins and other nutritious substances, can cause a state of collapse (shock). More extensive liposuctions (more than five litres of fat) should be performed by wet technique under general anesthesia. They require careful post-operative care including 1-2 days of hospitalization, replacement of lost liquids by infusions, pain relieving therapy.
Liposuction may be performed under local or general anesthesia or with tumescent technique.
Liposuction in small areas may be performed under local anesthesia, i. e. the treated area is filled with a solution of local anesthetic.
Tumescent technique uses a rather diluted solution of a local anesthetic. The anesthetic is absorbed from the tissue with contracted vessels (effect of adrenalin) to blood circulation slowly and the limits for the anesthetic contained in blood are not exceeded. There is another advantage as due to the slow absorption the local anesthetic operates in the target area on a long-term basis. The disadvantage is the toxic effect of lidocaine. With this technique you may feel discomfort when the fluid is being injected.
With a general anesthesia the patient sleeps through the entire procedure and all pain is eliminated. The pain is controlled only during the procedure; when the operation is over painkillers must be administered. The choice of analgesic depends on the scope of the procedure. It is necessary not to drink, eat and smoke for about six hours before general anesthesia. Note that general anesthesia is an interference with the organism and has some risks. Presently the liposuction under general anesthesia involves super wet or wet technique and the fluid usually does not contain an anesthetic.
Infiltration pump – is connected to a tube system. It is designed to infuse the infiltration fluid into hypodermis.
Suction device – is connected to the liposuction cannula through a tube system. It enables the suction of fat.
The suction device and infiltration pump may be included in one instrument (e. g. Vacuson LP 60 which produces also the energy for the vibration cannula).
Liposuction cannulas – have various diameters from 2 to 4 mm (sometimes 6 mm), various lengths, curvatures; the ends are either rounded or in the shape of a pointless chisel. Each type has its purpose.
There are also the aforementioned power-assisted cannulas, ultrasound cannulas, laser cannulas. Their equipment must include an ultrasound or laser device to produce the energy.
Containers for sucked fat – they are transparent to check the addition of blood and the amount of sucked fat, mainly to compare two sides.
During your initial consultation, your surgeon will explain the surgery in detail, discussing which liposuction techniques are most appropriate for you. You will together determine where your fat deposits lie and assess the condition of your skin. Be sure to discuss your expectations frankly with your surgeon. You should be realistic in your expectations. The surgeon should be equally frank with you, describing your alternatives and the risks and limitations of each liposuction technique. You should realize that general anesthesia is a significant risk and load for your organism, in particular in case of heart and vascular diseases. During the procedure unexpected complications occurred in some patients, e. g. heart failure due to the fluid overload, allergic reactions to the anesthetic or even death. It is necessary to consider especially following cases:
Your surgeon shall give you instructions to prepare for the surgery, including guidelines on eating and drinking, smoking, and taking or avoiding certain vitamins and medications. You may be asked not to use any medications containing acetylsalicylic acid (such as Acylpyrin, Aspirin, Alnagon, Mironal, etc.) They can increase bleeding during and after surgery. It is assumed that no illnesses (viral illness, cold, etc.) will have occurred at least three weeks before the planned operation. Report any illness to your doctor. If you smoke, plan to quit at least one to two weeks before your surgery and not to resume for at least two weeks after your surgery.
Liposuction surgery takes one, two or even five hours, depending on the scope of the procedure (size and number of the treated areas, amount of fat being removed, the type of anesthesia and the technique used.) Before the surgery the surgeon marks the area on the skin from which the fat should be removed. The marking should be performed in standing position as in lying position the locations of subcutaneous fat change and the anatomic relations may be distorted. Disinfection shall be applied on the marked place and its surroundings when in the operating theatre or surgery. The place is covered by sterile towels to prevent contamination of surgical tools and subsequent infection.
Depending on the liposuction technique used (except dry technique) the infiltration solution shall be infused in the marked area. Its content depends on the type of technique: with a local anesthetic for tumescent technique and without an anesthetic for wet techniques under general anesthesia. The solution is infused from an infusion bottle connected to a tube with a needle on the other end. The needle is punched into the hypodermis under the marked areas, usually through several punctures, to fill the whole area equally with the fluid. It is important to infuse the solution slowly to give the body time to adapt and in a sufficient amount to suck the fat totally. A pump is used to apply the solution. If the procedure is performed under local anesthesia it is necessary to wait circa 40 to 60 minutes until the anesthetic takes effect.
Then the most important stage, the suction of fat, is performed. It takes usually 40 minutes. The surgeon makes an incision with scalpel, usually 2 or 3 incisions for one treated area. The liposuction cannula (narrow tube) shall be applied into the hypodermis through the incision (circa 3- 6 mm) and the layer of fat shall be sucked. During the procedure the cannula moves from base to surface (up and down) to prevent any damage to the underlying muscle layer and upper skin cover. The movements must be gentle and even; it is an accurate job. During the liposuction it is possible to change cannulas with different diameters. The most difficult part is the suction of borderlines of the marked locality. The cannula is connected to a vacuum device and the fat is sucked through a tube to the collecting container. The sucked fat is mixed with blood and has peach-like color. The surgeon continuously checks the appearance of the sucked fat and according to the color of fat evaluates the extent of bleeding. In the end the incisions are sutured and dressed with a sterile cover. At some clinics these minor wounds are not sutured but the rims are brought together by a steri-strip which is permeable for the rest of effluent tumescent solution and tissue liquid, and covered. The patient is immediately after the liposuction dressed in a compression garment which may be even tailored at the clinic. Its supply is included in the liposuction procedure. It prevents swellings and hematomas (blood clotts) and enhances the healing process. The liquid keeps leaking for 8 – 10 hours after the procedure is over or even longer and therefore the patients are provided with absorbent mats which may be changed when at home. Corrective procedures or repeated liposuction are not recommended within six months following the initial procedure.
To be a good candidate for liposuction, you must have realistic expectations about what the procedure can do for you. The best candidates for liposuction are normal weight people with firm, elastic skin who have pockets of excess fat in certain areas. You should be physically healthy and psychologically stable. Your age is not a major consideration; however, older patients may have diminished skin elasticity (around 40 years of age) and may not achieve the same results as a younger patient with tighter skin. The procedure then combines with plastic surgery which removes the excessive skin.
Not all areas are suitable for liposuction. There are so-called prohibited areas which include the lower part of buttocks. Some areas are not explicitly prohibited but the liposuction is not recommended due to the anatomic localization, e. g. back. Other unsuitable areas are those with excess skin or even an overhang.
Liposuction is a high-risk procedure for people with health disorders as diabetes mellitus, heart or lung diseases, blood circulation insufficiency (in particular in case of general anesthesia) or for those who have recently undergone an operation near the area to be treated.
Some infiltration solution and tissular fluid shall outflow from the incisions after the operation. It is fluid which was not sucked and has not been absorbed by the organism yet. The fluid may be colored by blood – there is no need to worry. The outflow stops after approx. 10 hours. At some clinics a small drainage tube (so-called drain) may be inserted beneath the skin for a couple of days to prevent fluid build-up. To control swelling and to enhance your skin condition you will be fitted with a close compression garment. The garment cannot be taken off during first 24 hours after the operation. Than it can be taken off for 1-2 hours every day and perhaps washed. Most types of compression garment have a hole to enable toilet. The garment is worn for a period recommended by the surgeon; it depends on the practice at a clinic. Usually the period of 2 to 3 weeks (even at night) is recommended. The question of massages, so-called “rolling”, is rather discussed. Some surgeons advise not to roll and let the sucked areas quietly heal. Others recommend rolling – roll the sucked areas 3 times a day with a pastry rolling pin. You can go to work and do common activities after 2 or 3 days after the procedure performed by tumescent technique. Driving is not recommended immediately after the procedure; get somebody to drive you home. Sports are not recommended for 2 weeks. Wounds are covered by steri-strips for approx. 5-6 days and then the cover may be removed. The use of painkillers depends on every individual. Usually, it is not necessary or 1-2 tablets of Ibuprofen are sufficient. Tummy is a specific locality where rather strong sensitive nerves to innervate the tummy skin get out of rectus abdominis muscles. Note that during the liposuction under local anesthesia not only the fat but also the local anesthetic is sucked away, which means that the patient may feel pain of different intensity towards the end of the liposuction. Moreover in the tummy liposuction the cannula pulls these nerves which cannot be numbed as they run through the muscles and the pain may be really very unpleasant. The liposuction under general anesthesia is followed by a 1-2 day hospitalization and it is advised to wear the compression garment for 8 to 12 weeks. Sports should be avoided for 4 weeks. The period of wearing the compression garment depends in case of all liposuction techniques on skin conditions, amount of sucked fat, size of treated area and recommendation of the surgeon or clinic.
Shortly after the operation under general anesthesia you should start to exercise lower limbs, eventually stand up and make a short walk. It is a prevention of thromboembolic complications. The swellings and hematomas are individual, you are likely to feel stiffness, pain, burning or your sensitivity may be temporarily diminished. Your surgeon may also use antibiotics to prevent infection. It is not usual at every clinic. It is also suitable to use products for better healing as e. g. Wobenzym. The larger part of post-operative swelling disappears within 7 – 10 days. The stitches, provided the incisions are sutured, are usually removed within the week after surgery. Most of the burning and swelling usually disappears within 3 weeks. Healing is a long-term process and the recovery depends on your physical condition.
Don’t expect to look great right after liposuction surgery. New liposuction technique are more gentle than the old ones, despite, you shall experience some pain or itching for several weeks. The final result is apparent after 2 – 3 months, exceptionally after six months. At some clinics you will be checked regularly during the recovery to judge if you need any correction or you suffer from any complication. Some surgeons do not monitor you and you come only in case of complications. If you have bruises, sunbathing is not recommended. Sunbathing is also not advised for 3-6 months until the scars fade. During this period the scars may be covered by plasters or cream with a high sun protection factor.
As with any other surgery, complication may occur even after liposuction. Although it is not very often your surgeon should inform you on the risks. Complications may occur if your body has for example a reduced healing ability. Problems with recovery may occur if you do not observe surgeon’s instructions or you take unnecessary risk, for example when visiting solarium or doing sports. The skin may very rarely show:
Liposuction is a safe method of aesthetic surgery; however, you should follow all instructions of your surgeon and inform him/her on your health state. If the surgery is performed with precision by an experienced surgeon, the complications are minimal and the result is satisfactory. The liposuction of more than one area during one session is more complicated; eventually a combination of liposuction with other surgical interventions. It is performed rarely and mostly under general anesthesia.
Liposuction is always an aesthetic surgery paid by the client. The health insurance does not cover it as there is no health indication. The client cannot go on sickness leave and must plan holidays instead.
You will see a noticeable difference in the shape of your body usually a week after the surgery. However, improvement will become even more apparent after about four to six weeks, when most of the swelling has subsided. If your expectations are realistic, you will probably be very pleased with the results of your liposuction surgery. You may find that you are more comfortable in a wide variety of clothes and more at ease with your body. By eating a healthy diet and getting regular exercise, you can help to maintain your new shape.
Some people have problems related to excessive fat deposits in specific areas of the body, including the hips, abdomen and buttocks. This unwanted fat under the skin can be removed by means of a vacuum suction cannula, using a surgical procedure called liposuction.
In case of tumescent liposuction a large amount of infiltration fluid is injected into the target area through a needle tubed to a container with the solution. Tumescent liposuction is usually performed in patients who require just a local anesthesia. This intervention takes more time than conventional liposuction (it runs for three hours in maximum, mostly two hours only). As the injected fluid contains a certain amount of anesthetics (lidocain usually) besides saline solution and adrenaline (to contract vessels), further anesthesia is not necessary. The anesthetic drug contained in the infiltrative solution has an anesthetic effect; however, it also has a lipophil effect and therefore causes surface destruction of the fat cells that are freely sucked by thin (2 mm) cannulas. Usually, 2-3 times more liquid than the volume of the sucked fat is used.
The technique received its name for the swollen state of the fatty subcutaneous tissue (tumescence in English). This edema that is obviously temporary makes using of thin, round cannulas possible. However, if the tissue were not infiltrated, the cannulas would have to be double or triple the diameter. Before the suction it is necessary to wait for about 40 minutes for the anesthetic effect. Then the fat is sucked by liposuction cannulas. The advantages of tumescent liposuction include local anesthesia, application of large amounts of fluid, lidocain lipophil effect, positioning of patient during the procedure and final suction completed in standing position. The procedure takes longer time than the conventional liposuction and it is not recommended to suck several large areas or whole body in one session. Tumescent technique together with a vibration cannula is considered the most effective and the gentlest liposuction method. It is a combination of tumescent and power-assisted liposuction.
SmartLipo or laser lipolysis is a method used in removal of undesirable fat deposits. It shapes your body. The laser beam promotes the breaking up of the fat cells that are eliminated in a natural manner from the body. Without large bleeding, without pain and incapacity for work.
A very small cannula (tube) approximately 1.0 mm to 2.0 mm in diameter containing a laser fiber is inserted into the skin. The cannula is moved back and forth delivering the laser’s energy directly to the subcutaneous fat cells, causing them to rupture and easily drain away. The laser energy also interacts with the dermis, resulting in collagen shrinkage.
Liquid fat tissue is left usually without suction in case of very tiny parts. It is gradually absorbed due to natural metabolism. In case of larger treated areas it is necessary to gently suck the fat tissue dissolved through laser. Most of the modern clinics world-wide use technique of vibration liposuction.
Due to the cannula’s small size, Smartlipo is a minimally invasive procedure and can be performed under local anesthesia. The laser causes small blood vessels to coagulate immediately on contact, resulting in less bleeding, swelling and bruising – and a quicker recovery time than conventional liposuction.
Worries about the safety of the laser should be quelled – the laser can easily differentiate between fat cells and other tissues including nerves, blood vessels, and connective tissues. The places of laser beam insertion into the subcutis are not sewn, they are only treated with plaster. They almost disappear step by step.
If you have areas of fat that will not respond to diet and exercise, then you’re a candidate for Laserlipolysis. Ideal candidates are in good health, of normal body weight and have realistic expectations for the results.
SmartLipo is ideal for treating following areas : tummy, chin, arms, male breasts, inner and outer thights, buttocks, decolletage, knees, hips, ankles and areas of loose and flabby skin. The procedure may improve the body’s shape and may improve cellulite to a certain degrese.
For most patients, typically only one treatment is required. The session may last from 45 minutes to one hour for each area treated.
After the treatment you will need to wear a compression garment for several days to several weeks, depending on the body area being treated.In small treatments such as double chin it is possible to leave the treated areas without compression underwear. Rest is recommended after the procedure and activity may be resumed gradually. Refrain from hot tubs or strenuous exercise for 2 weeks. Most people go back to work after two days.
Yes, adults do not create new fat cells. When a person gains weight, the fat cells expand. The Smartlipo procedure permanently removes the fat cells. Should you gain weight, most fat will be deposited in areas where the procedure was not performed.
Results can be seen as soon as a week with continued improvement over several months.
Some people have problems related to excessive fat deposits in specific areas of the body, including the hips, abdomen and buttocks. This unwanted fat under the skin can be removed by means of a vacuum suction cannula, using a surgical procedure called liposuction.
Ultrasound-assisted liposuction (UAL) uses a special suction cannula producing ultrasound energy. This energy affects the walls of fat cells and liquefies the fat. Ultrasound liposuction can be an effective tool for removing fat from fibrous body areas, such as the upper half of the back, male buttocks, abnormally large male breasts, scarred areas, as well as in older patients. The advantages of ultrasound liposuction include lower blood loss and the ability to penetrate tissues with larger content of ligament. Unless the technique is performed correctly there is a risk of skin burns, however not very often. The fat suction is identical with other liposuction methods. Ultrasound suction cannula can be successfully combined with tumescent technique. The ultrasound-assisted liposuction is not much used due to the high costs of ultrasound device and the surgery.
The term ultrasound liposuction is often incorrectly used for external ultrasound-assisted liposuction (E-UAL) in which the fat cells are disturbed by ultrasound through skin and washed out of the body by natural metabolism. The skin is not damaged and no fat is sucked through a cannula. This technique of fat removal and body contouring is used by Ultracontour and Ultrashape devices.
Some people have problems related to excessive fat deposits in specific areas of the body, including the hips, abdomen and buttocks. This unwanted fat under the skin can be removed by means of a vacuum suction cannula, using a surgical procedure called liposuction.
Power assisted liposuction utilizes a surgical device with a liposuction cannula that oscillates in quick micro-movements back and forth. The device has proven to be especially gentle to fatty tissues with higher percentage of ligament, e.g. on buttocks or back. This kind of liposuction is used for repeated intervention in tissue remodeling; it can smooth the final irregularities in the sucked area and in the border areas between sucked and unsucked parts of the body. Vacuson LP 60, the advanced and most often used equipment, consists of a vibration cannula, infiltration and suction device. Presently, the tumescent technique using a vibration cannula is considered the gentlest and the most efficient method, i.e. tumescent liposuction together with power-assisted liposuction.
Leading cosmetic surgery provider The Hospital Group have seen an immense growth in the number of men striving to achieve a supple body shape, with the number of liposuction operations growing largely during the last year. The procedure, which contours parts of the body by removing fat, has rocketed in popularity by 117% since August 2009.
Last year, soccer ace Ronaldo was reported to have undergone liposuction to remove fat from his stomach and in line with this revelation, The Hospital Group have seen a massive increase in men wanting fast, dramatic results to achieve a trim and toned body shape.
Previously British men were keen to slim line their chests and avoid the Simon Cowell man boobs look. However surgeons have recorded a fall in demand for the gynaecomastia operation this year. Now men want to lose those love handles and get a washboard stomach instead.
Medical Director of Aesthetic Surgery at The Hospital Group, Mario Russo, said cosmetic surgery procedures are no longer such a taboo with men and that increasing pressure in the job market could be one of the reasons why men want to banish flabby tummies during 2010.
He said: “We are seeing an increasing number of men who don’t have the time to achieve such amazing body results by just hitting the gym. This, combined with increasingly tough workplace environments means men want to be looking and feeling their best, so they can perform at their best.
“Lots of celebrities are turning to cosmetic surgery to fix imperfections, with amazing results and men are no longer scared to strive for the same body shape.
“Liposuction and liposculpture provides the perfect way for men to feel good about their bodies again.”
The Hospital Group offers a number of cosmetic surgery procedures to restore body confidence, including rhinoplasty (nose job) abdominoplasty (tummy tuck) teeth whitening and bariatric procedures, as well as rejuvenating non-surgical treatments such as dermal fillers and chemical peels to turn back the clock.
Liposuction is today the most used way of body shaping. It is based on removal of undesired fat cells of dermis in a certain location. In last fifteen years the range of used liposuction methods has greatly increased. It is caused by new devices and instruments for these procedures and also by confirmation of processes for their usage. It is often very difficult for potential clients of these procedures to orientate in offered techniques and it is even harder to choose one of them. The aim of following text is not professional medical description of shaping procedures but the effort to provide a list of different techniques to a broader public with a step into the history.
General term, which contains all modern invasive and non-invasive methods serving to body shaping. One of the most used invasive techniques is liposuction.
The word comes from Greek lipos-fat and suctio-to suck. It describes permanent removal of undesired fat tissue in certain locations.
The word comes from Latin tumescere – to swell. It describes the look of subcutaneous tissue of treated area, which is filled with larger amount of special solution with a mixture of anesthetics and adrenaline.
It is considered to be a French Dujarrier in 1921. There was used a gynecological curette under pressure, the sucked area were knees and calves and the experiment ended with leg amputation caused by damage of large vessels.
Performed in 1974. Italian Fischer broke and sucked fat tissue in dermis with the help of small rotation scalpel deposited in a cannula.
It was shown by French lllouz in 1978. At the same time he worked with a technique of subcutaneous tunneling of fat tissue from more approaches and their crossing. This system has been used until now with various changes and improvements although it was applied on modern liposuction techniques.
Method used for body shaping before the origin of tumescent liposuction. There was “dry” and “wet” type. The first method was performed under general anesthesia without filling the subcutaneous fat layer with a solution with the need of patient’s hospitalization. Relatively thick cannula sucked fat tissue under high under pressure. This method had many complications (blood losses, ungentleness, fat and blood embolism, odds and asymmetries) and it has not been used anymore. The second (wet) method of this technique uses filling of fat tissue with a mixture of local anesthetics and adrenaline, which reduces the possibility of bleeding and simplifies the suction. Other risks remain though, therefore it has been used only limited for extremely strong individuals or as a part of other procedures under general anesthesia (e.g. abdominoplasty).
Tumescent liposuction (filling of fat tissue with anesthetics only locally without the need of general anesthesia)
Since 1984 and 1985 Peter Fodor and then American Klein introduced “super wet” technique. It is characteristic with large volumes of added mixture, great concentration of anesthetics in this solution, epinephrine (adrenaline) and minerals that change inner atmosphere of treated area. This method enables to suck fat tissue with thin cannulas (from 1 mm to 3mm mean) symmetrically and practically with no blood loss. Recommended values of different ingredients of a mixture were definitely set in 1990 and the instructions have been used with small changes until now. Method with the greatest number of treated patients is now in literature marked as “classic tumescent” or “conventional tumescent”. In the range of modern shaping liposuction techniques it presents “golden standard” today.
It was performed probably in 1993 for the first time. There serves again cannula as a performing device, which is inserted subcutaneously. It transmits ultrasound waves into fat tissue, the cells break due to formed energy and they are sucked out at the same time. At the beginning the technique caused high percentage of damaged skin and muscle membranes and large swellings. Till 2000 it went through many technical improvements, although even today the opinions on the safety of its usage have not been unified.
First efforts for construction of cannulas that also vibrate with great frequency, break and release fat cells and suck the fat at the same time can be found in 1994. The source of vibrations are gracile pneumatic or electromotoric systems. Significant technical perfection were achieved in 2002 (Flynn) and today is liposuction with the help of these cannulas relatively valuable and appreciated method. To its advantages belong gentleness, reduced operating time and reduction of surgeon’s fatigue.
Using laser for dissolving fat was described in 1992 (Apfelberg). First larger studies were described in 1999 to 2004 and they concerned laserlipolysis of chin. At present NdYAG laser is used practically on all body parts with subcutaneous fat excesses. It is based on dissolving of fat cells and suction of formed lysate by gentle classic or vibration cannula. In case of very small parts it is possible to leave these parts without suction and presume to remove the dissolved fat by natural metabolism. The gentleness of the technique and the possibility of laser stimulation of subcutaneous collagen and therefore also reaching of perfect skin lift ranges this method among most perspective.
The principle of this method is twin cannula, where there is a jet of water under great pressure in the inner cannula together with small dosages of local anesthetics. This water beam is precisely defined for fat tissue that it does not cut, but it breaks the fat cells and frees them from the cellular membranes. Such released fat is at the same time sucked by outer cannula. The beginning of water jet technique in other surgical branches started in 1995 “water scalpel), the usage of liposuction procedures began around 2004 and first larger numbers of such performed liposuctions were described in 2006 (Hernuss-Vienna). Longer experiences and evaluation on larger number of patients is still missing and even though this liposuction method is known for more that 4 years, it has not been much used by plastic and aesthetic surgeons.
Body shaping via liposuction techniques is at present one of the most performed procedures in the field of aesthetic surgery. It is caused also by no medical risks and possibility of out-patient performance only under local anesthesia (tumescence). Its still increasing number is also caused by stricter assessment of aesthetic appearance of an individual. Regarding life style of temporary population still more women and men can be expected to undergo one of the shaping procedures. They should choose clinics that specialize on these procedures, have many years of experience, own complete needed equipment and that are able to professionally treat all requested parts by a client.
This is a message particularly for women who are going to have liposuction in a typically problematic part of their body; and who also are starting to notice signs of ageing appearing in their face, or, they are interested in repairing some congenital disproportions in facial fat tissue. This message is also for those who suffer from the results of a poorly performed liposuction and have unnatural depressions in the treated areas as a result of “over-suction.”
Lipofilling – the removed fat tissue is applied to the target area as a filler. It brings about the same effect as with the use of other fillers like for example, Colagen, Restylane and others. However, the use of fat as a filler is inherent to the body and has no complications. The disadvantage, as with some other fillers, is that the fat will be absorbed and lipofilling must be repeated.
Lipografting – fat transplantation is a more demanding procedure compared to lipofilling. The fat tissue removal method, the preparation of tissue for grafting and the performance of the transplant is different. It is true that swelling and sometimes bruising last longer after the lipografting operation, however the effect is permanent or, at least, long-term (several years).
With growing age the partial atrophy of subcutaneous fat tissue occurs, accompanied by depression resulting from gravitation. It results in depressed temporal areas, circles under the eyes, depressions in the cheek-bone area and in cheeks, depressed nasolabial folds and typical depressions on both sides of chin.
The aforementioned signs are usually indications for cosmetic surgeries including lower eyelid surgery, medial lifting and a facelift. These surgeries, however, have better results when more significant signs of ageing occur, particularly loose skin and deep wrinkles in the area of the neck, chin or mouth. Beginning changes, mainly in the area of the lower eyelids, cheeks and nasolabial folds and particularly those in younger people (35 – 45 years of age) may be solved effectively and with no scars using lipografting (respectively temporarily with lipofilling). In some cases lipografting may substitute for a lower eyelid surgery (blepharoplasty), formerly often performed and not very wisely chosen, in place of a transition of lower eyelids in the cheek-bone area.
At this age women often undertake liposuction and it may be an advantage to combine both procedures.
Some of the abovementioned signs do not have to be the result of ageing and often occur in young people with a congenital disposition. Usually, it includes upper eyelids visibly sunk under the upper edge of the eye socket, circles under the eyes, sunken cheeks or sharp nasolabial folds. In these cases lipografting is the best solution. Lipografting can also effectively enlarge thin lips.
3) Unnatural depression on any part of the body caused by an “over-suction” during liposuction or as a result of an injury or operation.
A limited lack of fat tissue may also occur congenitally.
It may be concluded that lipofilling and lipografting can be performed independently but it is an advantage to combine these procedures with planned tumescent liposuction. The area treated by liposuction can be used for the extraction of fat. Tumescent liposuction is completed in the usual way while the extracted fat is prepared for transplant. Lipografting can also be combined with some facial cosmetic surgeries. The innovative rejuvenation facial operations not only remove and tighten tissues, but also are a suitable and gentle filling.
There have been, and undoubtedly will be, many articles written on this theme. Here, we hope to give you an overview of liposuction, provide some facts and dispel some myths.
Liposuction is not a method for losing weight. A preferable definition for this body surgery would be body contouring. Liposuction is more suitable for normal weight people who only need smaller, localized areas of excess fat removed.
Another condition for a successful liposuction is good skin elasticity. As our elasticity is reduced as we get older, the optimal age limit to perform liposuction is around 35-40 years. The decision to have liposuction above or below this age range is personal.
There are areas that are not recommended for liposuction. We call them forbidden areas; for example the lower half of the buttocks. Some areas are not strictly forbidden, although they are not recommended for liposuction. This is because of where they are located on the body, i.e. your back. Areas that are also not recommended for liposuction are places where there is an excess of skin.
Wearing bandage underwear after liposuction is natural. How long this will be required depends on the localization of the surgery, the amount of fat removed and skin quality. General information about liposuction abroad can be found here.
There are several types of liposuction techniques depending on the instruments used. Today, there are a wide range of devices available; including liposuction cannulas of various shapes, lengths and diameters.
Each method has its advantages and disadvantages. The newest modern technique is not always the best solution. The results of liposuction always depends on the surgeon’s skills and experiences with the specific liposuction technique. Click here to learn more from liposuction Prague doctors.
Liposuction is performed through either a so-called dry or wet (tumescent) method.
If a local anesthetic is added to the solution, the surgery may be performed as an out-patient procedure, without general anesthesia. It is always necessary to balance the dosage of a local anesthetic to prevent intoxication of the organism. Another risk during a large liposuction is a collapse due to the loss of a large amount of liquids. We therefore cautiously recommend performing liposuction as an out-patient procedure or to separate large liposuctions into several out-patient sessions
In larger liposuctions, when we expect large amounts of fat to be removed, when we plan to suck in many places, or a combination of both, we recommend performing the procedure under general anesthesia using the wet technique. It is very simple to watch the patient’s reaction, to replace the loss of liquids with infusions and to moderate pain. A one day stay in hospital with approximately 2-4 days at home is sufficient after the surgery.
Liposuction in a specific area of the abdomen is a more difficult procedure. This is where there are relatively strong and sensitive nerves coming from the rectus abdominis muscle. It is essential to be aware that during liposuction under local anesthesia we do not suck only fat but also the local anesthetic. The patient can therefore feel strong or uncomfortable pain at the end of the surgery. Moreover, we pull on the above mentioned nerves through the cannula. These cannot be numbed, so the pain might be really very uncomfortable.
From experiences that I have gained through years of performing liposuctions, I would like to touch on the topic of so-called “inflation” of removed fat. Many clients like the fact that several hundred milliliters or even a few liters of fat were removed. In reality, these numbers don’t matter, it’s the final effect that is the most important. Click here to see before and after photos of liposuction Prague.
Also one of the oldest rules in plastic surgery is still valid today; less often means more. It is better to remove the fat twice, than to suck too much the first time. Areas of the body with an insufficient amount of subcutaneous fat are almost always incapable of liposuction or only partially and imperfectly correctible.
Many clients like knowing that during liposuction under local anesthesia they are allowed to stand up. The surgeon and the patient can see where it is necessary to continue with liposuction and where it is not and if everything is symmetric. Such imagery is very effective. Liposuction can also be evaluated by touching, when we examine the amount of the fat layer between two fingers. Through such a method, we can set symmetry and also we don’t have to be afraid of a patient collapsing. Not every patient is able to keep their blood circulating on a sufficient level to maintain their blood pressure.
Finally, I recommend all potential liposuction patients seek out and trust only experienced, certified plastic surgeons. The consultation can help you in your decision making process, as can visits to several different offices. Liposuction may not be right for you, but another type of procedure may be recommended during the consultation.
Almost all women have fat pads which represent power margin, which was necessary in the past to complete pregnancy successfully in case of lack of food. This power margin differs from normal fat, it is the last to be degraded though a diet and the first to appear when the woman puts on some weight. These fat deposits have even women who are relatively slim and have normal weigh. Therefore it is sometimes difficult to get rid of this fat by a diet.
The usage of modern liposuction methods enables modeling of almost all parts of human body. Fat suction does not remove all fat but reduces it and models treated areas to achieve a harmonic shape.
Aim of liposuction is not and can not be weight reduction! It is always necessary to combine liposuction with a careful diet.
There are different methods of liposuction with some advantages and disadvantages – tumescent liposuction has a wide range of advantages compared to other treatments – it is decent and does not require general anesthesia. There is a precise modeling of the treated area and severe complications occur only in tenths per mille. Post-operational recovery is short, it is necessary to wear elastic underwear only for one or two weeks.
Liposuction is not an indispensable surgery, that is why it is very important to minimize all possible risks connected with this operation. Your surgeon has to be informed about your state of health, previous illnesses, way of life (smoking, alcohol) and eventually about current illnesses.
It is necessary to discontinue all medicaments which can cause increased bleeding ten days before the operation – ex. Aspirin, Godamed, Plavix etc. High dosis of vitamin E can cause increased bleeding as well. Some laboratory tests must be done before the treatment – blood count, Quick, PTT.
It is allowed to have breakfast or lunch before the surgery. Drinking alcohol and smoking is not appropriate! We recommend to wear loose clothes (ex. training suit, jogging trousers, spare pair of socks). First night should be spent on the clinic. During this time, tumescent fluid flows out of small punches caused by the sounds. These punches are not sutured, they heal very fast.
First 2-3 days after surgery, we recommend sufficient intake of fluids (2-3 l/day) and only a light physical activity (walks, light activities at home) and normal food. It is necessary to wear elastic underwear 24 hours per day for at least 7-10 days!
If it gets dirty by the tumescent fluid, it can be cleaned by washing. When it is being washed and dried, the patient should minimize physical activities. It is therefore better to buy second piece of elastic underwear.
Post-operational pains are minimal. They can be soothed by Paracetamol. Beginning with the third day it is possible to massage the skin with baby oil, Free oil etc. In case of hematoma (bruises), apply hirudoid creme or gel. Normal physical activity is possible as soon as you do not feel any pain more while exercising.
The final result of liposuction can be expected after 3-4 months.
Complications connected with liposuciton are minimal and mostly only light.
To the most common belong –
If any of these complications appear, be sure to contact your surgeon. Do the same in case of raised temperature, long-lasting discharge of tumescent fluid or blood, strong pain or other peculiarities which trouble you.