Liposuction, also referred to as liposculpture or suction assisted lipectomy, is used to remove unwanted fat. 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 around the hips. Other areas for fat deposits include the neck, arms, tummy, loins, thighs, inner side of the knees and the ankles.

Fat cells are believed not to be regenerated in adult life. Removing them by liposuction will give a permanent change in contour and be independent of any changes in your body weight.

It is important to understand that liposuction is not a treatment for obesity. The amount of fat that can be removed from a localised area of the body is limited by what is considered safe (maximum of 3 litres) so it may not be possible to slim down an area as much as you might wish. Further treatments can be carried out in the same area after 6 months. Where the skin is inelastic and loose liposuction will tend to leave the skin more baggy and we can 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. Please also note that dimples and wrinkles of the skin, sometimes called cellulite will not be improved by liposuction.

The first thing to do is to talk to your GP who can refer you to Mr Meagher. By talking to your GP and Mr Meagher you are more likely to get the results you want from the surgery.

Before the operation

The most important thing to do is to talk with Mr Meagher so that there is a clear understanding of your desires and expectations, in light of any biological prerequisites. We want you to be well informed and have realistic expectations of the results.

Mr Meagher will describe the liposuction, the type of anaesthesia, the hospital, any additional surgery, the pros and cons, benefits, potential complications, possible risks and the costs of the procedure.

You will be asked to discuss your medical history, including information about any medical conditions, drug allergies, medical treatments you have received, previous surgeries and medications that you currently take. You will have to stop taking medication which alters blood viscosity, e.g. aspirin. As for all surgery, patients are requested to stop smoking at least 6 weeks prior to the operation.

Specific individual risks will also be explored especially those related to medical situations such as high blood pressure, a tendency to scar, smoking, medications and any deficiency in blood clotting. As well as assessing your general health, Mr Meagher will assess your mental and emotional attitudes toward the surgery.

Mr Meagher will examine the area where liposuction will take place, taking measurements and photographs for your medical record.

If you decide to proceed with the operation you will be required to confirm your understanding of all aspects of the surgery and agreement to proceed by signing a consent form.

During the operation

Your surgery will be performed in a major hospital under a local or general anaesthetic. It can take between 1 and 2 hours for the operation and, for your safety, the attending anaesthetist will use various monitors to check your heart, blood pressure, pulse and the amount of oxygen circulating in your blood.

It is usually performed as a day case although some cases of multiple site liposuction may require overnight stays. An epidural is an alternative for the lower part of the body, but a local anaesthetic alone is only suitable for small areas.

The liposuction technique involves inserting a cannula (narrow metal tube) through a small incision in the skin. The cannula 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.

Mr Meagher prefers to inject the area to be treated with solutions (wet or tumescent technique). Suction is usually applied with a powerful vacuum machine, but it is sometimes perfectly adequate to use a simple syringe for small areas. Ultrasound assisted lipectomy is another variation.

After the operation

You will need simple pain killers for a day or so after the operation and you will probably be asked to return 7 to 10 days after surgery to have the sutures removed. We recommend that you wear a snug pressure garment or corset around the treated area for 6 weeks after the operation to reduce bruising and swelling.

You can expect considerable bruising which will be uncomfortable and at times painful. The larger the area treated the greater the bruising will be and 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 12 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 liposuction operation for up to 6 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 to 2 centimetres long, at the site of insertion of the suction cannula. There is a small risk in some people that these scars may stay red for a while but they are usually located in less obvious areas.

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. Mr Meagher will advise you of the required time off work and what activities are permitted during the recovery period.

Potential complications

Although liposuction is one of the most commonly performed cosmetic plastic surgery procedures in the world, and the majority of these operations are successful, as with any surgery there are risks and potential complications. Mr Meagher will explain the possible risks, which are rare, but may include:

1. Pain: As with any surgical procedure, pain of varying intensity may occur following your liposuction. You will be prescribed some pain medicine to take in hospital and at home after your discharge, if you need it.

2. Infection: Infection does not happen very often and you will be given an antibiotic at the time of your surgery to prevent this. If you do develop an infection, see Mr Meagher as soon as possible. Most infections can be treated with an antibiotic but they can cause serious problems and increased scarring.

3. Haematomas: Haematomas are a solid swelling of clotted blood within the tissue and they can happen after any surgery. The risk of infection is higher if a large haematoma or seroma (a collection of watery fluid within the tissue) collects immediately after surgery. Haematomas after liposuction are uncommon.

4. Poor wound healing: Healing can take longer in cases of:

• Infection
• Bleeding
• Fluid accumulation, essentially if a tumescent technique is used
• Overly tight stitches
• Improper support during healing
• Pressure against the scar tissue

Wound healing may also take longer in patients who have diabetes, or other medical conditions, or who smoke.

Other potential issues

After surgery, some patients may experience dimpling, lumpiness, numbness, scarring, discoloration or sagging skin in the treated area. Follow-up surgery may be needed to correct these problems.

More serious complications include blood clots, excessive fluid loss leading to shock, pulmonary embolism due to dislodged fat or blood clot, fluid build-up in the lungs, and drug overdose.

Because of the very nature of cosmetic surgery, sometimes patients can be dissatisfied with the results.