Introduction

the largest increase in surgical procedures was in liposuction with an increase of more than 9% compared to the previous year. These data place this procedure in second place among body interventions, only surpassed by breast augmentation,

What is liposuction?

It is a surgical procedure that aims to eliminate fat deposits and improve the contour of the body. Liposuction can be performed on almost the entire body, for example, face and neck, arms, trunk, abdomen, buttocks, hips and thighs, knees, calves, and ankles. It is important to know that it is not a surgery to improve obesity, it is only performed to correct those areas of the body with localized fat that cannot be eliminated with either diet or exercise.

It is an invasive procedure but with very small 1-2 cm incisions located in areas where scars can be well hidden. It consists of the aspiration of fat and is normally carried out under local anesthesia and sedation. If the area to be treated is very large, the surgeon may perform it under general anesthesia.

The surgery can last between 1 to 4 hours, depending on the areas to be treated and the volume of fat that has to be removed and it can be ambulatory or with a postoperative night of hospitalization.

How do I know if I am a candidate?

Ideal patients to perform this intervention have a normal weight but have localized fat in some areas. Before performing this procedure, the surgeon will assess 3 aspects:

The amount of fat to remove
The location of the fat
The quality and sagging of the skin

It is also essential that patients have good health, psychological stability, and realistic expectations. It is also important to know that this procedure does not improve cellulite. “Liposuction is useful as long as the accumulations of fat are reasonably localized and occur in people who are not very obese because otherwise, the results would be very difficult to find,”

How do I choose a surgeon?

Choose a certified, qualified, and experienced surgeon who will provide you with security with their information, facilities, and equipment. Ask about their success rate and see photos of their work and results. It is highly recommended to investigate what they say about the surgeon on specialized portals as they will provide objective and disinterested information.

“Liposuctions are minimally invasive surgical techniques but they are not exempt from possible complications; the risks are lower if it is placed in the hands of qualified specialists and the interventions are carried out in clinics equipped with adequate infrastructures and good teams of anesthesiologists and the rest of the necessary professionals so that the results obtained are optimal, natural and safe “,

What is the first appointment with the surgeon like?

During the first visit, the surgeon will measure your body mass index, your weight, the firmness of the skin, and your general state of health. Usually, certain studies will be requested to corroborate the state of health such as electrocardiogram, and blood and urine tests, among others that the surgeon deems appropriate. The technique to being used, the areas to work and improve and the estimated amount of fat to be eliminated will be explained.

It is important that at this appointment you explain all the doubts you have about the procedure, postoperative care, or the recovery time. In addition, the surgeon will inform you about the anesthesia, admission to the hospital, and the price of the surgery.

Do not forget to tell him if you are a smoker or take any medicine or vitamin. It is also important to mention the number of previous pregnancies and if you plan to get pregnant again (if you are a woman) or any other relevant medical information. Feel free to ask anything, especially anything related to your expectations.

Tip: It is important to bring a companion, such as a family member or friend, on the day of surgery to accompany the patient out of the hospital and on the way home. This way you will be confident and supported if necessary.

In what parts of the body can it be performed?

This surgery can be practiced on different parts of the body and also on the face; being an intervention that eliminates fat deposits from any part of the body. The most common areas to perform liposuction are:

Double chin or double chin: it is a procedure highly demanded by both men and women.
Chest: Men who have a pronounced female-type chest can be treated as well. It is a situation called gynecomastia.
Arms: to eliminate excess fat, it is usually done in people with good skin tone to avoid sagging.
Abdomen and waist: mainly indicated to eliminate stubborn fat that is not so easily eliminated with diet or exercise.
Low back and flanks: one of the most requested points.
Mount of Venus: the fat deposited in that area of the pubis is difficult to eliminate with diet and exercise. It is an area that is increasingly in demand.
Fat under the buttocks (subgluteal banana): The area between the buttocks and the upper thigh, where women tend to accumulate fat.
Thigh and holsters: it is a mix of improving the outer contour of the legs and the internal area.
Knees: The inside of the knees is susceptible to stubborn fat accumulation.
Twins: with this procedure, a reduction of the twins is achieved.
Ankles: it can only be done when there is an accumulation of fat, not liquids.

How it is performed?

It is generally carried out under local anesthesia and sedation, but it will also depend on the areas to be treated. “When you require general anesthesia, you will have to perform a preoperative study with analytics and ECG as well as a consultation with the anesthesia specialist.

During the operation, the surgeon makes an incision and inserts the cannula of about 5 mm to first infiltrate an anesthetic and vasoconstrictor solution, and then the liposuction cannulas with which to suction the excess fat. At the same time, the patient is monitored by an anesthetist, who supplies the necessary drugs and fluids.

“Currently we are looking for superficial planes to get the skin to adapt better, only in the areas necessary to correct the alteration of the silhouette. The incisions are very small and are located in discrete areas and can be easily concealed ”conclude from

It is an outpatient surgery but may also require an overnight stay in the hospital, at the discretion of the patient and the surgeon.

What are the different types?

There are different types and variations of this surgery, each one focuses on offering a better result and covering a need of the patient or the surgeon.

Tumescent liposuction: a liquid that is a mixture of anesthesia (lidocaine and local anesthetic), epinephrine (constricts the blood vessels), and liquid is injected with the help of the cannulas, which helps to swell and harden the fat areas, and with this, You can extract more gently and minimizing bleeding.
Power-Assisted Liposuction (PAL): Also known as vibroliposuction, a special cannula is used that vibrates short and fast to help destroy fat cells so they can be suctioned and removed from the body. Thanks to the PAL technique, the intervention can be done in a shorter time.
Ultrasonic liposuction (UAL), VASER liposuction, lipo selection, or HD Lipo: with the help of ultrasound applied with special cannulas, the fat deposits dissolve when hitting the sound waves and facilitate the removal of fat through the cannulas suction. It especially helps to eliminate fat from dense and fibrous areas, such as the back.
Laser Liposuction (LAL), SmartLipo, ProLipo Plus – A laser is used to liquefy and dissolve the fat before it is removed.
Dispersion or water jet liposuction (Water Jet liposuction), Aqualipo, BodyJet: with the help of a jet of water that is fired in a fan shape, the deposited fat is released. With this technique, the fat is aspirated the same as with the other techniques and at the same time the water previously introduced is aspirated, it is not destroyed or dissolved, it is eliminated along with the water.
Radiofrequency assisted liposuction (RFAL), Bodytite: Using a bipolar radiofrequency device, the fat is heated to melt it so that it can then be sucked in more and better. It has the added benefit that by heating the tissues from within, it provides extra retraction of the skin in the treated area.

What treatments are used in liposuction without surgery?

Some treatments promise fat removal results but are not invasive, they are known as liposuction without surgery, here are the most common treatments listed. Faced with these options, patients should have realistic expectations. They will not achieve the same result as liposuction with surgery that will always be more effective, although these therapeutic options should not be ruled out for this reason:

Cavitation, Ultra-cavitation: thanks to the ultrasounds of this equipment, fat is dissolved to be able to eliminate it naturally, through urine, sweat when exercising, etc. It is also a treatment that helps eliminate cellulite. The session lasts between 45 min and 1 hour.
UltraShape: it is approved by the FDA to reduce fat in the abdominal area, it does not produce bruises, and the results are visible after two weeks. It is an outpatient treatment and the session lasts about 45 minutes.
HIFU high-intensity focused ultrasound: it is a non-invasive ultrasound-based treatment, it eliminates the fat that is between the skin and the muscle, and you can return to normal activities after the session.
Cryolipolysis: This treatment eliminates localized fat and cellulite thanks to its system of freezing fat and crystallizing it and does not eliminate the surrounding tissues, the fat is eliminated through urine and sweat. The temperature it reaches is -5ºC to -10ºC. It takes 10-20 sessions to see results.
Ultrasonic hydrolipoclasia: it is a treatment that allows the elimination of up to 4 cm of fat, it is a technique that combines cavitation with an injection of physiological saline in the area to be treated and the extraction of fat with a cannula, after the session you must use a girdle to shape the body and have the expected results.

Other treatments are not exactly considered liposuction without surgery, but that help to shape the body and eliminate fat from targeted areas of the body, for example, lipo laser ALL, mechanical lymphatic drains, reducing massages, radiofrequency (such as the BodyTite technique), intralipotherapy (infiltrations of a lipolytic agent combined with the application of ultrasound waves), Sculpsure, Dermalyx, Aqualyx, CoolLipo, VelaSmooth, VelaShape, etc.

Is it an alternative to diet?

This surgery is not a substitute for weight loss. It is simply useful to remove localized accumulations of fat that are not eliminated by diet or exercise. As we have already mentioned, it is not a treatment to eliminate cellulite either. “Although the intervened areas can be improved, it is not possible to eliminate that annoying orange peel only with this procedure.

Therefore, it should not be considered as an alternative or substitute treatment for diet. Rather, post-operative surgeons will recommend making changes in eating habits and exercising to improve and maintain the results of the surgery.

Is it painful?

It is not usual to feel pain after this surgery, what is normal is to feel some discomfort that the doctor to prevent or mitigate, will prescribe analgesics and anti-inflammatories.

Normally, after two or three days you stop feeling the discomfort and the recovery will begin. The effect of anesthesia is normal for about 24 hours. From 72 hours or later, the sensitivity and discomfort will decrease. After two weeks, you can resume normal activities without any problem.

“Like any surgical intervention of these dimensions, the patient will be sedated during the procedure and therefore comfort is assured. In the postoperative period, some small discomfort may be found in the areas treated due to the movement that was made with the cannula. After the first 48 hours, the pain will gradually disappear, although the first few days you may notice a slight discomfort as if you had soreness ”.

How is the postoperative?

The results can begin to be appreciated after the surgery, although it must be considered that there are bruises and swelling that will go away with the passage of weeks. The most obvious results can be seen after two weeks. It is normal for some swelling to last a few months, the final results can be seen 6 months after the intervention and changes will be seen for up to a year.

Recovery time can range from 2 days to a week, depending on the amount of fat removed. It is recommended to walk slowly and avoid exercise and heavy activities for at least the first month.

It is important to use the post-operative girdle, which is placed in the operating room at the end of the surgery. The girdle should be used between 4 and 8 weeks (depending on what the doctor indicates). During the first three weeks, it is recommended to use it all day (24 hours), from the fourth, only during the night. “In addition to the girdle, we recommend following the diet guidelines that we offer to our patients to minimize fluid retention”.

Some surgeons recommend postoperative treatments to aid in recoveries such as manual lymphatic drainage, radiofrequency, ultrasound, or massage. Another thing to avoid exposure to the sun is to avoid marks and always use sunscreen of at least 30 SPF. Do not consume aspirin or vitamin E as they affect clotting. Tobacco and alcohol must be completely stopped and salt consumption moderate to avoid fluid retention.

It is essential to follow the instructions indicated by the surgeon after the procedure to have good results and guarantee your safety.

How are the postoperative massages?

Some surgeons recommend starting with lymphatic drainage or some other manual massage about two weeks before surgery to prepare the body. The most recommended are the sessions after the intervention, these are important above all, for patients with circulation problems and/or fluid retention.

Postoperative massages can be started the day after the intervention. During the first five days, they should be done over the girdle. The start of treatment may vary, it will depend on the recommendation of your surgeon.

The benefits of postoperative massages are :

Help disappear edema
Drain the remains of medicines, anesthesia, and serum from the surgery
Benefit the regeneration of vessels and capillaries
Eliminate annoyances
Reduce postoperative time
Improve skin and its appearance
Accelerate the recovery and retraction of the skin
Mitigate and eliminate fibrosis

A minimum of 10 sessions are required with a frequency of 2 times a week. The postoperative treatment should not be painful, you should feel an improvement from the first session.

What results to expect?

The final results are seen months later, once the body has been deflated and the bruises removed. It is normal not to lose drastic weight, as it is not a surgery designed for this. It is an intervention to shape the body by eliminating fat deposits and thus improving the body contour considerably.

The scars are minimal thanks to the new techniques and technologies used. scars are 5mm or less. It is important to follow the surgeon’s recommendations to aid healing.

“The results of the liposuction are not immediate, we will have to wait about three weeks for recovery. After this, the decreases in the measurements will begin to be seen, but the definitive results will be noticed in the third month ”.

How long do the results last?

After this operation, fat can reappear if you don’t take care of your eating habits and practice sports; although the treated parts will be less affected by weight gain and fat accumulation. This is why it is important to take care of your diet, as well as exercise constantly, and stay active throughout the day. “Light tasks and walks are always recommended after any procedure, always consult with the surgeon if you have doubts, especially if it is a sport with high impact or risk”.

Exercise and proper nutrition are the best allies after this operation. This procedure does not guarantee that there may be weight gain in the future. In addition, we remember that it is not a treatment to lose weight, but to shape the body, so you have to follow a balanced diet and stay active.

At first, it may seem difficult and a big effort, especially if it involves a change in your routine. Seeing your new body will also be a great incentive to want to keep it that way for as long as possible.

How is the healing?

The procedure generates small incisions, the size of cannulas, so the scars are small (3 mm to 5 mm). At first, it is normal for them to be slightly red or pink and over time they will become whiter and less visible.

Not all people heal in the same way, that is why it is important to speak with the surgeon and follow all the recommendations that are specially designed for your skin.

“If scars remain, they would be so small that they are easily concealed, they will be like small wasp stings in the treated region. In addition, they are usually done on areas of the body covered by hair or in natural folds (such as the groin or the inframammary fold), so they will be hidden ”.

The basic advice of surgeons is: to avoid taking coagulants, not smoke or consume alcohol, protect scars from the sun and use certain creams that help in the healing and healing process.

What happens to the skin after liposuction?

“How can I improve the appearance of sagging skin?” Is the primary concern of patients undergoing a liposuction procedure. Fortunately, there are nowadays new cutting-edge technology platforms that combat this flaccidity in a very effective way. One of them is the plasma technology known as Renuvion J-Plasma, which is always performed in the operating room once all the fat that we are interested in sucking has been removed.

The technological alternative to the J-Plasma is the Bodytite bipolar radiofrequency system, which is used in the same way as the Renuvion J-Plasma but also allows the possibility of doing some treatments on the face. Both systems are based on applying very intense heat to the deep layers of the skin, but from within using the same incisions that had been previously made in liposuction. The heat makes the skin retract and tighten, thus minimizing postoperative sagging.

What are the side effects?

When performed by an experienced and certified surgeon, complications or side effects are minimal and very rare. It also has a very high success rate and that is why it is one of the most performed surgeries in the world. Although being an operation, it is not risk-free. “Our biggest fear after liposuction is that the skin does not respond adequately (does not retract in the desired way) and has a tendency to sag,” says Dr. Ibrahim Fakih.

Possible side effects are infection, bleeding, bruising, seromas, skin tenderness, scarring, adverse reaction to anesthesia, and unsatisfactory results that may require additional intervention.

Frequent questions

Are the results permanent? “Not. This is an operation that involves the removal of lipid layers, but not the change of habits. For the results to be permanent in the patient, they must follow a rigorous low-fat diet. If you do not follow the instructions of a nutritionist, you will most likely return to the previous stage. However, depending on the types of fat accommodation, some results may remain with greater or lesser probability ”
What happens if I gain weight? “It extracts fat cells from a certain area, they do not reappear but if you gain weight again, those that persist can increase in size. It is important to emphasize that it is not a treatment to lose weight or to eliminate cellulite or stretch marks. What should be clear is that by maintaining a healthy lifestyle and regular physical exercise, the results are permanent. ”
Should I wear a girdle? It is very important and necessary to wear the girdle after the intervention, as it will help to fix the skin and prevent shearing or displacement of the skin that we have advanced during the intervention and that we have left much more taut and fixed to obtain a more abdomen. aesthetic “
What about the fat that has been removed? “The fat that is extracted can be discarded or reused as filler material in areas that require volume increase (breast, buttocks, facial)”
Does it help to improve cellulite? “Even though the intervened areas can be improved, it is not possible to eliminate that annoying orange peel only with this surgery. For this, there are different alternatives that your doctor will explain in detail and that will depend on the type of cellulite, the location, and extent of it “
Is it a painful surgery? It is a minimally invasive procedure, which logically requires an analgesic, or sometimes an anti-inflammatory, in the postoperative period. The period with discomfort does not usually exceed 3-5 days “
Does fibrosis go away with time? “No, if you don’t attack fibrosis, it won’t go away over time. What some treatments can eliminate it or improve it in a high percentage”
Can I have this surgery if I am overweight? “It is a body reshaping technique, not a slimming technique. Ideally, you should normalize the weight as much as possible. Of course, each case is different, so it must be assessed individually”