Liposuction (Liposculpture)

Suction-assisted liposuction is performed under general anaesthetic (when you are full unconscious) as a day case or one night stay, dependent upon the quantity of fat removed.

Liposuction involves the use of a cannula (a thin, hollow tube) to manually loosen and remove fat, creating a better shape within the body area being treated.

The cannula is inserted through tiny incisions in the skin and suction is applied to remove fat from the body. It takes between 1 to 3 hours to perform the surgery, depending on the size of the treatment area. The 4 mm incisions are closed with a small dissolvable stitch and covered by a waterproof dressing.

It is common to leak a significant amount of blood-stained fluid from the incisions over the first 24 hours. This is normal and nothing to worry about. In order to perform liposuction, I inject several litres of fluid with adrenaline and tranexamic acid to stop bleeding, as well as local anaesthetic into the areas. Most of this is removed by the liposuction but there will be some excess fluid, which leaks out from the incisions. It can look like a lot of blood but in fact it is mainly fluid with a small amount of blood in it.

You will need to wear compression garments to help shape the area for 4 weeks following your surgery.

Liposuction procedures can be carried out under local (when you are awake, but the area is numb) or more commonly, general anaesthetic (when you are fully unconscious). The choice depends upon your preference, combined with the size of the area(s) to be treated and the amount of fat to be removed. If only a small amount of fat is removed, a local anaesthetic may be all that is needed.

The area from where the fat is removed is bruised and tender but will settle after a couple of weeks. You may need to take regular painkillers for up to 2 weeks after surgery to improve any discomfort.

Often, you only need to be in hospital for a few hours. An overnight stay maybe necessary if a large amount of fat is removed (or liposuction is combined with another procedure).

Having cosmetic surgery should be a very positive experience. Complications are infrequent and usually minor. However, all surgery is not without risk, and it is important that you are aware of possible complications. All the risks will be discussed in detail at your consultation. However, if you have further questions or concerns, do not hesitate to discuss them. Decisions about this surgery should never be rushed.

Risks with this surgery can be divided into those specific to the surgery and those that relate to the anaesthesia.

General Anaesthetic risks: An anaesthetic is very safe, however, should a complication arise, the relevant medical expertise is immediately available to deal with this.

The risks increase if you have certain medical problems, which will be discussed at length during the consultation. The risks include:

• Unintended intraoperative awareness, which is very rare.
• Dizziness and nausea.
• Sore throat.
• Damage to teeth or mouth.
• Nerve injury due to body positioning.
• Allergic reaction or anaphylaxis.
• Malignant hyperthermia, which is a rare life-threatening condition.

The anaesthetist will go through these risks, and others, in more detail prior to your surgery.

Scars:  The scars are very small (less then 5mm) and they should be barely perceptible. However, some people heal with thickened scars, which makes them more noticeable.

Bruising and swelling:  This is very common, and bruising may take a few of weeks to settle.

Infection: This is rare but may require a course of antibiotics.

Contour irregularities: It is possible to have indentations or laxity of the skin following this procedure. Massaging the area(s) should resolve this but occasional further surgery may be required to correct this.

Wound healing problems: Blisters or skin necrosis can occur following liposuction. This is rare and should settle with dressings. However, significant skin necrosis may need a small split skin graft.

Altered sensation: Numbness, pins and needles or a burning sensation often occur as your nerves recover. These symptoms should resolve over a period of up to 6 months.

Further liposuction: This may be necessary to give the desired result. Only a certain amount of fat is removed at one operation (4 to 5 litres). To take more than 4 litres of fat at one session can put you at risk of fluid shifts and blood loss. If you desire more liposuction then a second procedure gives the flexibility to add this.

Damage to internal structures: Liposuction is performed in the superficial layer of fat underneath the skin. As the cannulas are blunt, they are very unlikely to damage any important structures. However, if there is a hernia or weakness of the abdomen, then damage may be possible; this is very unlikely.

Deep Vein Thrombosis/Pulmonary Embolism (DVT/PE): Following any surgical procedure it is possible to develop a blood clot in your legs, which could potentially break off and travel to your lungs. If the blood clot is large enough, it could prove fatal.

The overall risk for cosmetic surgery is less than 1%, but to reduce any risks of a DVT/PE, you will be provided with special stockings to wear in bed together with a blood thinning injection, if you are not mobile or have previously had a DVT or PE.

All the risks outlined above will be discussed in detail at your consultation with me. However, if you have further questions or concerns, please do not hesitate to ask.

Decisions about cosmetic surgery should never be rushed.

At the end of the procedure, compression garments will be applied to the area(s) to help the skin conform to the new shape and reduce the swelling. These garments are available from the hospital, who will measure you to ensure the correct size is purchased by you.

If you are feeling well after the operation, you will be able to go home. You will not be able to drive yourself home from hospital and, ideally, you should have someone to stay with you for a few days to assist you after your procedure. If you have any concerns during this period, do contact the clinic for advice.

After the operation, you are advised to wear your compression garment for 4 weeks.

Before you are discharged from Hospital you will be given a follow up appointment to see the nurse after one week post-operatively.

I normally see you in clinic between 2 and 3 weeks following your procedure, depending on the surgery.

You should take things easy for the first week and most patients return to work by 1 week. You can drive from as soon as you are comfortable, which is normally between 1 to 2 weeks. Most patients return to the gym at 2 weeks, and I recommend you wear your compression garments for 4 weeks.

Scar Advice
Once the dressings are removed, I recommend that you massage the incisions using small circular motions at least twice a day for 5 minutes. You can use any moisturising cream of your choice and apply firm pressure until it blanches.

The scars would also benefit from Silicone scar gel (ScarAway® or Kelo-Cote®) twice a day, which will soften and fade the scars as well as applying sunblock for 12 months to provide sun protection.

The ScarAway® can be purchased from Healthcare Pharmacy at Governors Square in Grand Cayman.

For self-funding patients, surgical fees are a combination of the hospital costs, the surgeon and anaesthetic fees and any consumables. I do not charge an additional fee for post-op appointments. The fee is based on the surgical time rather than procedure. This means that the costs are calculated fairly, and complex patients may have higher costs than routine patients. You will be given a quotation for surgery within 48 hours of your consultation.

Liposuction - Nicotine and Surgery

Liposuction - Pre-Op Instructions

Liposuction - Post-Op Instructions