I am Dr Sandeep Bhasin, an industry-leading and trained cosmetic surgeon who specialises in offering a wide range of cosmetic surgery solutions.
Nowadays, liposuction is the most frequently performed cosmetic surgeries for removing excess fat. Today, I will tell you everything about liposuction.
You may have many questions in your mind about this aesthetic surgery procedure. For example, what it is, how it is performed, what should be done and what should be not, what results you can expect from this procedure and more.
I will educate you completely on this procedure so that you can take an informed decision if you are planning for this procedure. Through this report, I will virtually walk you through this popular way of getting rid of excess fat.
So, let me start now.
What is Liposuction?
Liposuction is a procedure by which we surgically remove excess fat from your body. And this is done with the help of instruments and machines. This procedure is performed under local and general anesthesia.
What are the various types of liposuction?
It can be done by normal suction, by power assisted suction, by ultra assisted liposuction and Vaser assisted liposuction.
What are the methods involved in liposuction?
The methods can be dry, wet, super wet and tumescent liposuction.
Dry Liposuction is no longer used.
In Wet Liposuction, we put some fluid, remove the fluid with suction, but that is also no longer used.
What is being used now is super wet or tumescent. In super wet liposuction, we put 2 liters of fluid inside the fat, and then we remove two liters of fat.
In Tumescent Liposuction, we put 4 liters of fluid and then remove 2 to 3 liters of fat out. This is what the difference is between tumescent and super wet liposuction.
Which among them is the best technique for liposuction?
What we find now is that super wet liposuction is the best technique as chances of fluid overload is less as compared to tumescent liposuction that was done in the past.
In the past, people were given large amount of fluid to the body and the procedure was done under local anaesthesia.
So friends – my advice is if you are going for liposuction, do not go for tumescent liposuction as this procedure can be dangerous too.
If it is a big area, the chances of fluid over load are very high. Some clinics still follow this procedure. As long as the area is small, it is ok. But for large area, it is not recommended.
This is my first recommendation or advice to you. Super wet liposuction is safer than tumescent liposuction.
Now let me come to another very important point.
Many clinics started doing liposuction procedure in local anaesthesia and still many are doing. But now there is a caveat.
A very important point you should understand that the medicines used in local anaesthesia are xylocaine and lidocaine which are toxic to the body after a particular limit. It starts causing problems to nervous system, heart and it can also be dangerous to the entire body.
The maximum limit of using lidocaine is 35mg/kg according to the American Plastic Association.
Many times when we give local anaesthesia to bigger area, the limit of xylocaine and lidocaine can exceed.
What we do in our practice or clinic, we don’t do the procedure in local anaesthesia. We do liposuction in general anaesthesia. So, we don’t use xylocaine and lidocaine in that amount. We use them in low dose, such as 10 mg/kg or 15 mg/kg so that doses do not exceed and the chances of toxicity is minimised to a great extent.
So, my recommendation is if you are going for liposuction for bigger area, do not go for local anesthesia, and go for general anesthesia.
For you, it may sound interesting or cool that you are undergoing the procedure under local anaesthesia and going back home the same day. But if bigger area is involved, go for general anaesthesia.
Spinal anaesthesia is not good for many reasons, your blood pressure can drop, and many other things can happen. So, epidural spinal anaesthesia is not very good option to be used in liposuction. So, in liposuction, the best option is to go for general anaesthesia and reduce the doses of xylocaine.
Can excess of fat be removed by liposuction?
We come across many people who say – doctor, remove 20 liter or 15 liter fat in me…
Let me come to this point how much fat we can remove safely from your body through liposuction.
This is a very crucial question, and you have to take it very seriously. Liposuction has its own problems and complications. Don’t ignore that. 10% of your body weight can be removed in one session.
Suppose, your weight is 70kg, up to 6 to 7 liters of fluid can be removed. But according to safety norms of liposuction, we can remove 5 litre of fluid in one sitting. If we remove a very large amount of fat, say 15 liter or 20 liter is to be removed, chances of complications are going to increase a lot.
You will be required to prolong your stay in the hospital. Chances of blood transfusion, electrolytic imbalance can be there. A lot of such complications can happen.
So, large volume that is called mega liposuccion is something which should be taken up with a lot of precautions and care, because if the complication happen, then it is very difficult to handle.
The situation gets difficult for both the patient and the doctor.
So, the volume of fat we remove in one sitting should be less than 5 liters or not more than that for safety reasons in my view. This is about the volume of liposuction that we do.
Fluid management and discharge
Normally, when we do liposuction in our set up, we never allow the patient to go back home the same day.
I know 80% of the centers send the patient same day but my advice is to keep them overnight. We give them sufficient fluids, intravenous fluids and hydrate them well. We observe them for 24 hours.
The reason is we give them xylocaine and the side effects of xylocaine may not happen immediately but can happen after few hours.
Secondly when we remove a lot of fat, there can be dizziness, difficulty in walking and the patient may feel pain and discomfort. For that reason, we do not advise patients to go back home the same day but after 24 hours when they are comfortable and okay. Then only we discharge them. This is something important practice that we follow in our setup.
Another thing that is important for patient and we practice in our centre is we ask the patient to move as soon as possible after the surgery. The reason is if they do not walk or move after this surgery or any other surgery, the chances of venous thrombosis increases. Either, we give them the medications to prevent thrombosis or we ask them to move as soon as possible.
If they move soon after the surgery, the chances of this thrombosis would be minimized. If the chances of thrombosis is high risk, then we make sure we give them injections like the blood thinners.
Liposuction is an inch loss procedure
Another thing I would like to tell you here that when a patient comes to us for liposuction, we do a proper counseling and tell them clearly that it is not a weight loss procedure but an inch loss procedure.
It is an inch-loss procedure. What you can expect after liposuction is an inch loss and not a weight loss. That is something that we tell them very clearly. And if they really want weight loss, we have a very special protocol which we follow after liposuction.
We give them high protein low carbohydrate diet which they have to follow. We ask them to take some supplements which can increase their metabolic rate and after 3 to 4 weeks, we ask them to do some exercise that are called high intensity workouts and weight training that can help them in weight loss.
My patients who have undergone liposuction, who have followed high protein diet, who have done high intensity exercise and taken supplements, we have seen, average in about two months, they lose 15 kg to 20 kg, sometimes 10 kg, which is a very good weight loss.
And this does not happen normally with liposuction alone. But when combining with these programs which we give them, there is a good weight loss that they can expect.
So, if you are motivated, you can lose weight, this is, what my thinking is.
Which all tests are done in liposuction?
When we take any patient for liposuction, we do a very thorough examination, we don’t take it lightly. We do all your blood tests, ECG, cardiac check-up, ultrasound, high resolution ultrasound or MRI to rule out any hernia.
Things to keep in mind:
Friends, if there is a hernia and it is missed by any chance, I am telling you liposuction can be very dangerous.
So, it is something which has to be done. We are very meticulous about that before liposuction. We go for high resolution ultrasound of abdomen to rule out any missed hernia.
If it is there, we refuse the patient for liposuction. We ask them to get hernia treated first.
Another thing is we always look for bleeding time and clotting time and all other factors. If there is any bleeding disorder and you undergo liposuction, your bleeding will not stop.
That can be very fatal. We always look for your bleeding profiles before taking you for liposuction procedure.
These are protocols we follow in our clinic.
Another very important thing is, after liposuction, we always get ultrasound done and we also look into your blood profile to see that you are comfortable with no accidental injuries in liposuction.
Now, understand, liposuction is a blind surgery, a blind procedure, complications can or may happen.
We are very careful before we do liposuction, when we do liposuction and after liposuction.
It should not be ignored something, what we tell people. Don’t take liposuction very lightly.
Clinics may have a good team, have good doctors. In Spite of all that, things do happen. So, be careful on that regard.
Another thing we tell people is that you know we are using vaser liposuction quite a lot. The advantage with laser liposuction is skin tightening and it gives a better body contouring. And my advice is not to go for tummy tuck and try to avoid tummy tuck. Because the wound healing time in tummy tuck procedure takes normally much longer time and liposuction is much less invasive.
Hopefully, I have cleared all your doubts or confusion that you had about liposuction procedure. And also I am confident that I have educated you well about this procedure. If you want to gather more information about it or have any questions in mind, please do contact me. I will assist you in the best possible manner.