Liposculpture
	Principles and indications
	Surgery
	After surgery
	Conclusion

Principles and indications

Liposculpture (or liposuction) came into being in the early 1980s completely revolutionising body shaping surgery. It has changed enormously since the 1990s, especially with the appearance of ultrasound.

The operating principle is simple: using small incisions, 3 mm long and therefore virtually invisible, a probe is inserted under the skin and the fat is liquefied (using ultrasound to break up the fat cells) and then fine tubes called cannulas suction out the fatty emulsion.

The standard operation is now codified:

• Small diameter cannulas (2 to 4 mm) are used,
• A 5-mm layer of superficial fat must be left under the skin to avoid an uneven surface.
• Several incisions are made for insertion of the cannulas in order to make the "sculpture" more regular and harmonious (using the principle of crossed planes).

The result depends on the skin's ability to retract. It is obvious that the more firm and toned the skin, the greater its retractability. Liposculpture is possible at any age, depending only on the quality of the skin.

Many different areas may be treated with liposculpture:

• Face: double chin, jowls, cheeks, etc.
• Body: abdomen, knees, hips, buttocks, waist ankles, gynecomastia (abnormal breast development in men), etc.

Surgery

Local anaesthesia of the neuroleptic analgesia type (light sedation), spinal or general anaesthesia may be used for small areas of liposculpture while spinal anaesthesia or general anaesthesia may be used for larger areas.

The type of anaesthesia depends on the number of zones to be treated and the volume of fat to be removed. A consultation with the anaesthetist is imperative prior to the operation: this is when the anaesthetist decides on the type of anaesthesia after discussion with the patient.

The operation lasts between 30 minutes and two hours, depending on the number of zones to be treated and the volume of fat to be removed. At the end of the operation, a special compression panty girdle is placed over the area: this does away with the need for a dressing. The girdle helps the skin to retract and reduces postoperative swelling. This is an outpatient procedure and only a few hours are spent in the clinic; you enter in the morning and usually leave at around 6.00 pm the same day.

After surgery

As there is generally little pain after the operation, you must move around the following day to avoid complications such as phlebitis. Antibiotics and mild painkillers are systematically prescribed.

You may remove the panty girdle the day after surgery, wash it with soap and water and take a shower. This garment must be worn day and night for two weeks, and then only during the day for a further two weeks.

Since very little bleeding occurs, there will be only a few bruises, but the result of the surgery will be partially concealed by postoperative swelling.

Swelling lasts around three months, but begins to go down very quickly and one month after the operation you will already see 50% of the result, and after a period of six to eight weeks 90% will be visible. The final appearance may be seen during the third month.

You must avoid the sun for four weeks, while you are wearing the panty girdle. Sport is prohibited for one month, but is advised after this period because the muscles will provide deep massage and help to get rid of the swelling more quickly.

NB. Lymphatic drainage sessions are recommended after surgery, as they help with the resorption of the swelling.

The final question asked by all liposuction patients is: "Will the fat come back?"
The answer is that liposculpture is not a weight loss procedure; it only modifies the figure by reducing local problems. To ensure that the results last, you are strongly advised not to gain too much weight.

Conclusion

This procedure gives excellent results in reshaping the figure, sometimes in its entirety.

It can also serve as a psychological starter for patients who are sometimes grossly overweight and for whom dieting no longer works.

For these patients, the rapid removal or three or four litres of fat acts as a trigger and they often lose weight much more easily during the months following liposuction.