What is it?
Liposuction is a minimally invasive cosmetic surgery procedure that permanently removes fat from various areas of your body through suction. This procedure allows localized and stubborn fat which are resistant to exercise and diet to be effectively removed, improving your overall body contours, proportions and definition. Common areas include the abdomen, thighs, arms and under the chin.
How is the Surgery done?
Generally, liposuction is performed under sedation or general anaesthesia. Except small areas of liposuction for fat grafting, this can be performed under local anaesthesia. The incisions are all less than 1cm, placed thoughtfully in well-hidden areas so that ultimately the scar is barely visible.
A concocted tumescent fluid will be injected into the targeted areas to reduce bleeding and to provide post-operative pain relief. Thin cannulaes will be used to extract/suction the fat out. Various types of modalities and machines can be used at this stage to improve the efficacy of fat removal.
Following this, you will be dressed in post-operative compression garment.
Where are the incisions placed?
All the incisions are placed in well-hidden areas and are less than 1cm to ensure that scars are barely visible.
Breast – IMF / areolar (same for male and female)
Back – bra line / midline
Flank – can be reached from lower abdomen / flanks itself
Abdomen – umbilicus / lower abdomen
Arms – above elbow at the back
Thighs – inner groin / mid thigh
Calves – mid calf
Will I need anaesthesia?
Depending on the amount of fat removed and the type of liposuction technique performed, your liposuction surgery can take place under local anaesthesia, sedation or general anaesthesia.
For liposuction from a small area under the chin or <100mls of fat harvested (from the abdomen or thighs) for the purpose of fat grafting, it can be performed under local anaesthesia.
Larger volume liposuction or the use of mechanical or ultrasounic assisted liposuction, sedation or general anaesthesia is commonly used.
Is liposuction painful?
For the first few days, you will experience some discomfort and soreness. It feels like having gone through 2 hours of spin class straight! You may sometimes also experience fullness as a result of the swelling. The areas that have undergone liposuction may feel even feel temporarily numb.
To help reduce post-operative swelling, bruising and discomfort, oral analgesia will be provided and compression garment will be worn.
Are there any limitations for liposuction?
Liposuction surgery may not be the ideal solution for everyone. Firstly, liposuction is not a substitute for weight loss. It may be part of your weight loss journey, either at the beginning to motivate you to kickstart the process or towards the end when there are still resistant pockets of fat bulges despite regular exercises and diet control.
Who is not a candidate for liposuction surgery?
Smoking will increase the risk of complications and it is best to stop smoking before and after the procedure. Certain underlying medical conditions may also increase the risk of liposuction and will need to be optimized prior to the surgery.
BMI of >30
Individuals with BMI of more than 30 or if there is excessive amounts of loose skin and adiposities, liposuction may not be the procedure of choice as it may not provide optimal results.
Extensive stretch marks and poor skin elasticity
Liposuction surgery may not yield satisfactory results for individuals with extensive stretch marks and poor skin elasticity as these issues are not likely to improve after the procedure. Abdominoplasty may be a more suitable option.
What should I do about the loose skin after liposuction?
People with good skin quality and elasticity will undergo natural contraction and tightening of the skin during the recovery period once the swelling have subsided.
Additional skin tightening procedures can be performed at the same time as liposuction if there is excessive loose skin or if you desire a more taut and toned appearance. This tightening is achieved using radiofrequency assisted lipolysis machine called Facetite or Bodytite which heats up the tissues from deep within the skin to a temperature of 69°C. This heat will cause contraction of the skin, resulting in a tightening effect.
Simultaneously, radiofrequency microneedling of the skin is performed using a machine called Morpheus8. The microneedles are set at various depths to heat the entire layer of the skin. The deepest layer can penetrate 7mm into the skin. This provides additional tightening effect.
If the amount of loose skin remaining is still bothersome to you, abdominoplasty maybe a more suitable procedure for you.
Frequently Asked Questions about Liposuction
Liposuction performed by trained plastic surgeons is a very safe procedure, but it does have the potential for some risk and complications to occur. The risk does increase if multiple areas of the body are being treated concurrently or if the overall lipoaspirate volume is huge.
Some of the risk and complications include:
- Seroma accumulation
- Excessive bleeding
- Infection that develops within the fatty tissue
- Irregular skin contours and indentations
- Numbness and changes in skin sensation
- Scarring which can be hypertrophic / keloidal / hypopigmented or hyperpigmented
- Injury to deeper structures like abdominal organs, lungs, nerves and blood vessels
- Persistent swelling in the legs
- Deep vein thrombosis or pulmonary embolism
- Fat embolism
- Thermal burns or other heat injury when using ultrasound assisted liposuction (VASER)
- Allergic reaction to drugs
Discomfort and soreness will be experienced in the first few days. These are easily managed with oral analgesia. The swelling and bruising will be managed with anti-swelling medications as well as postoperative compression garments worn immediately after liposuction.
Postoperative compression garment:
- Up till 2 weeks: to be worn continuously
- 2-4 weeks: can be worn at night
- Ideally, if you can wear the garment for 4-6weeks duration, the compression results will be better
- Swelling is generally worst during days 2-5, but it will start settling from then onwards
- Swelling will mostly settle after 4-6 weeks
- Bruising will settle by about 3 weeks
- Final contour and shape will be apparent after 3-4 months
Depending on the extent of your liposuction procedure, generally 3-7 days is ideal. For limited areas liposuction, you can even return to work the next day.
It is ideal to avoid strenuous exercises and swimming for the first 2 weeks following liposuction.
If you experience any these symptoms, you should contact your surgeon immediately:
- A temperature of over 38°C or develop chills and rigors
- Excessive or increasing pain over the areas of liposuction
- Worsening redness around the incision areas
- Heavy bleeding from the incision areas
- Pain over the calves or breathlessness
As the surgery is generally done under sedation or general anaesthesia, you will need to be fasted for 8 hours prior to surgery. You should also stop smoking at least 2 weeks before and 2 weeks after the surgery. Certain medications may need to be stopped prior to surgery like blood thinners. Avoid medication that can cause bleeding – Traditional Chinese medicine, certain supplements, check with your surgeon about blood thinners like aspirin/Plavix.
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Liposuction can be a standalone procedure, but it is often used in conjunction with other body-contouring surgeries.
These procedures include:
- As part of mummy makeover
- Fat grafting to the breast
- Fat grafting to the buttocks
- Fat grafting to other parts of the body like dorsum of the hand and nanofat to the face
- Together with abdominoplasty, brachioplasty and thigh-plasty to further improve the results
Yes, if you reaccumulate fats over similar areas years down the road, liposuction can be performed again to remove the fats.
Based on MOH guidelines on liposuction:
- <100mls can be performed in liposuction accredited clinic procedure rooms
- Above 100mls to <2L needs to be performed in at least an ambulatory day surgery centre. It can also be performed in a hospital.
- >2L of lipo-aspirate will need to be performed in a hospital for safety reasons.
- We are not allowed to aspirate over 5L in each session to reduce any potential complications.
Liposuction can be as a kickstart to your exercise and diet regime. It can also be during the journey to remove stubborn areas of fat that are resistant to exercise or dieting. However, after liposuction it is important to continue to keep up with your exercise and diet regime.
To maintain the results of liposuction, you can start exercising about 6 weeks after liposuction. Do start with lighter forms of exercises first, before moving on as long as there is no discomfort.
Liposuction surgery in Singapore costs between $3000-$6000 per area, depending on the thickness of adiposity present and the overall volume of the area of concern.
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For patients who are not prepared to undergo liposuction or prefers a non-surgical approach, there are some options to consider.
CoolSculpting which works by freezing the fat, cools the targeted areas of fat until they crystalize and burst. Your body then breaks down these particles and removes them. Multiple sessions are often required, so cost-effectiveness needs to be taken into account. There are also reports of paradoxical adipose hyperplasia which causes an overgrowth of the fat tissue.
EmSculpt works by using radiofrequency and high-intensity electromagnetic energies to generate heat which causes the fat cells to be permanently damaged while stimulating the muscles concurrently. Your body then breaks down these damaged fat particles and removes them. Once again, multiple sessions are required.