Liposuction

With liposuctions for men and women, the surgeon can remove fat deposits, that normally are caused by hormonal or genetic reasons and that cannot be lost by sports or diets. The fat removed in a liposuction normally does not reappear, so that with a good nutrition and sports an enduring forming of the figure can be achieved. A liposuction should not be seen as a dietetic measure for weight loss, but as a method to correct the shape of your body.

Basic preconditions:
	You are over 18 years old, in good physical and psychological condition and have a realistic idea.
	You are not pregnant and not nursing your baby.
	You should not have heavy fluctuations in your weight.

Preparations:
	About 4 weeks before the surgery, you should reduce smoking. Moreover alcohol should be avoided.
	On the day of the surgery you should not have your menstruation.
	About 2 weeks before the surgery you should not take anticoagulants (Aspirin, acetylsalicylic acid containing drugs).
	Not later than 3 weeks before the surgery the birth control pill must be discontinued.

Surgery preparations and examinations:
	For the surgery you need a blood count and an ECG. Your GP can provide both. Please bring the findings with you (it should not be older than two weeks).
	If you are over 40 you need a complete blood count and an ECG.

Length of the surgery:

Usually the surgery takes 1-3 hours. The time depends on the volume of fat removed and on the number of areas of the liposuction. The treatment is conducted during a stationary stay of 1-2 days in hospital.

Liposuctions can be done in the following areas:
	Upper abdomen and hypogastrium,
	Hip and waist,
	Right and left buttocks,
	Tight and shank,
	Knee,
	Male breast,
	Upper arm,
	Back,
	Double chin.

Course of action and techniques:

ABefore the surgery you will be informed during a detailed counselling talk on how the surgery is done, possible complications, risks, and alternatives. Maybe you want to write done your questions on the surgery. The surgery will be conducted under general anaesthesia. With liposuctions of a smaller scale (under 1000ml) it is possible to use regional anaesthesia. Before the anaesthesia you will be advised by an anaesthetist about the risks, complications and possible alternatives to a narcosis. The anaesthetist will be present during the surgery. A general anaesthesia means stress for the body. During narcoses risks or complications can occur, depending on previous diseases and your general state of health.

The tumescent liposuction technique

Before the surgery fat deposits are marked on the skin while you are standing. At the marked areas a mixture of saline solution, vasoconstrictive substances, and a local anaesthetic is injected. This technique facilitates the suction as the fat layer gets considerably lager and thus, among other things, blood loss can be significantly reduced.

Then, small incisions at inconspicuous positions are made, through which a long edgeless cannula is inserted. The cannula is connected through a hose to a vacuum pump. Thus fat deposits can be removed by moving the cannula softly back and forth. During the surgery the removed fat is collected, so that the surgeon can make sure that at both sides the same volume is seduced.

After the liposuction the incisions are closed with a self-dissolving suture. With this technique there is only a very small risk of injuring nerves or large vessels.

Perceptions and possible complications:

Within the first 24 hours the wound often dissociates liquid (mostly a rest of the injected saline solution). Swellings can remain 3-6 months and longer (i. e. in the neck). At the area of the joints swellings occur particularly often.

As the reactions of the tissue can never be predicted exactly, one has to anticipate possible irregularities of the skin. These, however, subside normally within several months.

Like after every surgery secondary bleeding cannot be excluded. For this reason you should avoid taking acetylsalicylic acid containing drugs (Aspirin). Despite antiseptic measures inflammations can occur, thus as a preventive measure you get antibiotics.

After a surgery there can occur blood clots in the main veins (thrombosis), these can be carried further and thus block a blood vessel (embolism). As prevention it can be considered to take anticoagulant drugs (i. e. injections of heparin), however these cause an increased bleeding tendency and in very rare cases grave dysfunctions of blood coagulation.

EEven when the wound healing is normal, scars can initially become red or harden. After a while they will fade, they become inconspicuous. You will be informed on further risks and possible side-effects in a comprehensive handout.

After the surgery:

Right after the surgery you get compression clothing which you have to wear 6-8 weeks day and night. Then, you must wear it for another 2-3 weeks (depending on the volume of fat seduced) only at night. Through this compression clothing it can be prevented that the generated antra fill with lymph and thus create larger scars. The compression clothing supports healing and the aesthetic form of the seduced area remains.

After the surgery you have to count with different types of pain (like when you have aching muscles), haematoma, and swellings. This can again be alleviated by the compression clothing, thus it subsides usually after 2-3 weeks. Please only take those drugs that you get from the clinic or from another doctor.

Disorders in the sensitivity of the skin (feeling of numbness) at the areas affected normally ease after some time. Usually you stay the first night after the surgery in hospital. The next day you have a thorough follow-up examination before you go home. To make it easier for you, you should have an accompanying person with you, as you should not drive yourself the way home. Make sure that you have enough breaks in which you should move (risk of thrombosis).

After a few days you can take up easy activities again. However, you should do no sports for about 6-8 weeks, sunbaths, solarium and sauna only after 8-10 weeks. After about 4 days you can take showers again (afterwards you should blow-dry the corsage), after 10 days you can take showers without the corsage. From this time on, you can take off the compression clothing for half an hour a day.

Make sure that you drink enough after the liposuction, in order to balance the loss of liquid during the surgery. With a well-balanced nutrition and some sports you can easily keep the shape of your body. Support your body by eating enough connective tissue-enhancing vitamins. To improve the elasticity of your skin you should apply body lotion, massage, take cold showers, and do peelings.


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