The liposuction surgery
Liposuction surgery takes one, two or even five hours, depending on the scope of the procedure (size and number of the treated areas, amount of fat being removed, the type of anesthesia and the technique used.) Before the liposuction the surgeon marks the area on the skin from which the fat should be removed. The marking should be performed in standing position as in lying position the locations of subcutaneous fat change and the anatomic relations may be distorted. Disinfection shall be applied on the marked place and its surroundings when in the operating theatre or surgery. The place is covered by sterile towels to prevent contamination of surgical tools and subsequent infection.
Depending on the liposuction technique used (except dry technique) the infiltration solution shall be infused in the marked area. Its content depends on the type of technique: with a local anesthetic for tumescent technique and without an anesthetic for wet techniques under general anesthesia. The solution is infused from an infusion bottle connected to a tube with a needle on the other end. The needle is punched into the hypodermis under the marked areas, usually through several punctures, to fill the whole area equally with the fluid. It is important to infuse the solution slowly to give the body time to adapt and in a sufficient amount to suck the fat totally. A pump is used to apply the solution. If the liposuction is performed under local anesthesia it is necessary to wait circa 40 to 60 minutes until the anesthetic takes effect.
Then the most important stage, the suction of fat, is performed. It takes usually 40 minutes. The surgeon makes an incision with scalpel, usually 2 or 3 incisions for one treated area. The liposuction cannula (narrow tube) shall be applied into the hypodermis through the incision (circa 3 - 6 mm) and the layer of fat shall be sucked. During the procedure the cannula moves from base to surface (up and down) to prevent any damage to the underlying muscle layer and upper skin cover. The movements must be gentle and even; it is an accurate job. During the liposuction it is possible to change cannulas with different diameters. The most difficult part is the suction of borderlines of the marked locality. The cannula is connected to a vacuum device and the dissolved lipo is sucked through a tube to the collecting container. The sucked fat is mixed with blood and has peach-like color. The surgeon continuously checks the appearance of the sucked fat and according to the color of fat evaluates the extent of bleeding. In the end the incisions are sutured and dressed with a sterile cover. At some clinics these minor wounds are not sutured but the rims are brought together by a steri-strip which is permeable for the rest of effluent tumescent solution and tissue liquid, and covered. The patient is immediately after the liposuction dressed in a compression garment which may be even tailored at the clinic. Its supply is included in the liposuction procedure. It prevents swellings and hematomas (blood clotts) and enhances the healing process. The liquid keeps leaking for 8 – 10 hours after the procedure is over or even longer and therefore the patients are provided with absorbent mats which may be changed when at home. Corrective procedures or repeated liposuction are not recommended within six months following the initial procedure.