Liposuction

Published by Bupa’s Health Information Team, May 2011.

This factsheet is for people who are having liposuction, or who would like information about it.

Liposuction is an operation to remove unwanted body fat to change the shape of the body.

You will meet the surgeon carrying out your procedure to discuss your care. It may differ from what is described here as it will be designed to meet your individual needs.

About liposuction

Liposuction, also known as lipoplasty or liposculpture, is an operation that sucks excess fat out from under your skin. It can remove small amounts of fat that you haven’t been able to shift with diet and exercise. Liposuction is not a treatment for weight control or obesity, and it can’t remove cellulite or stretch marks.

Liposuction can be done on your abdomen (tummy), hips, buttocks, neck, arms, thighs, knees and ankles.

There is a limit to the amount of fat that can be safely removed from any area of your body, so it may not be possible to reduce an area as much as you would like. Your body won’t replace the fat cells, so you should have a long-lasting change in your body shape, especially if you exercise, eat a healthy diet and maintain a healthy weight after liposuction. However, putting on weight can cause the remaining fat cells to change.

Getting advice about liposuction

It’s important not to rush into the decision to have cosmetic surgery. Discuss your options with your GP, who may be able to recommend a reputable surgeon or advise you on how to choose a hospital to be treated in.

Before choosing to have liposuction, discuss with your surgeon what you hope to gain from the operation and the result you can realistically expect.

What are the alternatives to liposuction?

If you want to lose fat from your abdomen, an alternative may be a tummy tuck (abdominoplasty), where excess fat and skin are removed from the abdomen. However, a tummy tuck is also not a treatment for obesity.

Many creams, diet supplements and beauty treatments claim to reduce stubborn areas of fat or even cellulite. However, there is no scientific evidence that they work.

Preparing for liposuction

Your surgeon will explain how to prepare for your operation. For example, if you smoke, you will be asked to stop, as smoking increases your risk of getting a chest and wound infection, which can slow your recovery.

Liposuction is usually carried out under general anaesthesia, which means you will be asleep during the procedure. If you’re having a general anaesthetic, you will be asked to follow fasting instructions. This means not eating or drinking, typically for about six hours beforehand. However, it’s important to follow your surgeon’s advice.

You can have an epidural for surgery and pain relief if you’re only having your lower body treated. If you’re having a small area treated, liposuction may be carried out under local anaesthesia. This completely blocks pain from the area that is being treated and you will stay awake during the procedure. You may also be given a sedative to help you relax during the procedure.

At the hospital, your nurse may check your heart rate and blood pressure, and test your urine.

Your surgeon will discuss with you what will happen before, during and after your procedure, and any pain you might have. This is your opportunity to understand what will happen, and you can help yourself by preparing questions to ask about the risks, benefits and any alternatives to the procedure. This will help you to be informed, so you can give your consent for the procedure to go ahead, which you may be asked to do so by signing a consent form.

You and your surgeon will discuss the areas you want treated. He or she will then mark the treatment area on your body. Photographs may be taken, so that the results of the liposuction can be compared with your original appearance.

Liposuction is often done as a day case procedure, but you may need to stay in hospital overnight if you’re having large areas treated. You may be asked to wear compression stockings to help prevent blood clots forming in the veins in your legs. You may need to have an injection of an anticlotting medicine called heparin as well as, or instead of, wearing compression stockings.

What happens during liposuction?

There are several different techniques and your surgeon will explain the options available to you.

Depending on how much fat you’re having removed and the technique your surgeon is using, the operation usually takes between one and three hours.

Wet liposuction

Your surgeon will inject a mixture of salty water, local anaesthetic and adrenaline into the fatty area being treated. This helps to reduce bleeding, bruising and swelling and make it easier to remove the fat.

Your surgeon will make a cut in your skin and insert a thin metal tube. This is attached to a vacuum pump or a syringe. The tube is moved vigorously inside the fatty tissue to break it up. The fat and fluid is then sucked out. If you’re having large areas treated, your surgeon may need to make more than one cut in the area to be treated to reach all the fatty deposits.

Once your surgeon has removed the required amount of fat, the metal tube is taken out and the cuts may be closed with stitches.

Variations of the wet technique are called super-wet liposuction and tumescent liposuction. Both of these techniques inject a larger amount of fluid into the fatty area.

Dry liposuction

Your surgeon uses a metal tube with suction, without fluid injection, to remove the fat.

Dry liposuction can cause more bleeding and bruising than wet liposuction, so it’s not often used.

Ultrasound liposuction

If the fat is very dense, for example on a man’s torso or if there is a lot of fat, ultrasound can be used to break up the fat before it’s removed.

What to expect afterwards

Afterwards, the treated area is firmly strapped with bandages. You will usually be fitted with an elasticated support garment. This will help to reduce swelling and improve your body shape.

If you had a general anaesthetic, you may need to rest until the effects of the anaesthetic have passed. You will need to arrange for someone to drive you home. Try to have a friend or relative stay with you for the first 24 hours.

General anaesthesia temporarily affects your co-ordination and reasoning skills, so you must not drive, drink alcohol, operate machinery or sign legal documents for 24 hours afterwards. If you’re in any doubt about driving, contact your motor insurer so that you’re aware of their recommendations, and always follow your surgeon’s advice.

If you had a local anaesthetic, it may take several hours before the feeling comes back into the treated area. Take special care not to bump or knock the area. You will usually be able to go home when you feel ready.

You may need pain relief to help with any discomfort as the anaesthesia wears off.

Before you go home, your nurse will advise you about caring for your stitches, hygiene and bathing. You will usually be given a date for a follow-up appointment.

Recovering from liposuction

It usually takes about two weeks to make a full recovery from liposuction, but this varies between individuals, the type of liposuction you had and the area treated. It’s important to follow your surgeon’s advice.

If you need pain relief, you can take over-the-counter painkillers such as paracetamol or ibuprofen. Always read the patient information leaflet that comes with the medicine and if you have any questions, ask your pharmacist for advice.

You will usually need to wear your elasticated garments or bandages for about three weeks after your operation. Don’t do strenuous exercise for up to four weeks, but walking and gentle exercises are encouraged. If you had treatment on a large area, it may take you longer to recover and you may need to take up to 10 days off work.

If you had dissolvable stitches, the amount of time they will take to disappear depends on the type of stitches you have. However, for this procedure, they should disappear in about two weeks. If non-dissolvable stitches are used, these are usually removed about a week after liposuction.

It’s possible that you still won’t be happy with your appearance after the operation. It may be several months before you see changes to your body shape as the swelling can take time to settle down. If you have skin with good elasticity, it’s more likely to shrink down to fit your new body shape.

What are the risks?

As with every procedure, there are some risks associated with liposuction. We have not included the chance of these happening as they are specific to you and differ for every person. Ask your surgeon to explain how these risks apply to you.

Side-effects

Side-effects of liposuction may include:

• considerable bruising – this can be painful and can sometimes take more than a month to clear
• swelling – this may not completely settle for up to six months
• scars – typically 1 to 2 cm long
• numbness – this may last for several months
• swollen ankles
• raised, bumpy veins (thrombophlebitis) around the inside of your knee and inner part of your upper thigh if these areas are treated – this is not the same as deep vein thrombosis (DVT) and should settle after a few weeks

Complications

Complications are when problems occur during or after the procedure.

The possible complications of any operation include an unexpected reaction to the anaesthetic, excessive bleeding or developing a blood clot, usually in a vein in the leg (DVT).

Other complications to liposuction may include: 

• lumpy, uneven results, that may need another operation
• fat getting into the blood vessel and travelling to your lungs – this can cause a blockage, called a pulmonary embolism, which can be fatal
• build-up of fluid in your lungs (pulmonary oedema) as a result of fluid injected into your body
• damage to your internal organs – this may require further surgery to repair

For answers to frequently asked questions on this topic, see Common questions.

For sources and links to further information, see Resources.