Liposuction, also known as suction lipectomy, liposculpture, or microliposculpture, is a surgical technique that consists in extracting unsightly, unwanted fat deposits located in specific areas of the body, without hardly leaving any scars.
Liposuction is a procedure whereby fat deposits are extracted under vacuum pressure through a cannula inserted into the hypodermis, the layer of fat cells under the skin. To insert the cannula, an incision several millimetres long is made at a strategic point. Incisions always run parallel to natural skin folds. Others may also be concealed underneath natural body creases.
On a technical level, liposuction can be done in three ways: either with SAL/Suction Assisted Liposuction (traditional method), UAL/Ultrasound Assisted Liposuction or PAL/Power Assisted Liposuction. In all cases, fat cells can be removed from the outermost (closer to the skin's surface) or from the innermost (located deeper inside the hypodermis) layers of fat cells.
Liposuction performed closer to the skin allows for better skin redraping. However, more bruising will appear than with profound liposuction.
Ultrasound Assisted Liposuction consists in liquefying or emulsifying fat deposits by using a cannula that transmits ultrasound waves from its tip. Upon contact with these waves, fat cells are turned into oil. The liquefied fat will then be suctioned off under low pressure. Compared with SAL, UAL has been clinically proven to remove significantly larger amounts of fat, lower risks of skin irregularities. Some studies suggest a 30 to 50% reduction in blood loss compared to the conventional method.
In conclusion, liposuction may be done under local or general anaesthesia. The total duration of the procedure varies according to the quantity of fatty tissues to be removed and the areas of the body to be treated. Convalescence can take 4 to 14 days.
Fatty tissues, also called adipose tissues, form the deepest layer of the skin, or hypodermis.
The hypodermis is made up of millions of fat cells called adipocytes. These adipocytes cluster together to form little vesicles called fat globules which, in traditional liposuction, are visible to the naked eye as little gelatinous, yellowish globules.
The hypodermis contains blood and lymphatic capillaries, nerves and vertical elastic fibres that provide the skin with support (septa) (Figure 1).
Most authors of medical literature dealing with genetics found that each adult has a set number of fat cells that do not regenerate themselves. During weight gain, the fat cells do not multiply but rather increase in volume. Therefore, logically speaking, if we remove a certain amount of fat cells, we must necessarily get permanent results.
Still, some questions remain to be answered. Why does excess fat accumulate in specific areas of the body only? And why does excess fat not respond to dieting or physical exercise? A number of studies mention enzymatic deficiency as a plausible reason. However, the one thing we definitely know is that we now have the means to extract fat.
Lipodystrophy is the medical term for abnormal fatty tissue formation. In women, lipodystrophy is found on the lower body half, such as thighs, knees and hips.
It should be clearly understood that liposuction is not an alternative to a diet. It is designed to enhance silhouette and body shape. The ideal candidate will have a healthy weight with well-localised fatty excess, not likely to be eliminated via calorie-reduced diets or exercise.
The skin's capacity to shrink after liposuction varies from person to person. That is why the surgeon sometimes deems it necessary to limit fat extraction, so that excessive accumulation of loose skin will not occur.
On the other hand, it is quite normal to have some loose skin following the procedure. For the skin to hug the natural body contours once again, the patient must wear a compression garment between 2 to 4 weeks.
It is generally said that liposuction is not a solution for cellulite control. Still, liposuction is able to improve the condition, especially so, since fat lobules that produce the state of congestion are removed on a permanent basis. As well, a close post-liposuction follow-up helps patients establish a certain routine that keeps hypodermic congestion cellulite from coming back.
