Liposuction is a type of cosmetic surgery used to remove unwanted body fat. The operation is also known as liposculpture or suction-assisted lipectomy.
Liposuction is carried out on areas of the body where deposits of fat tend to collect, such as the buttocks, hips, thighs and tummy. The procedure is generally used to improve appearance rather than treat health conditions.
Liposuction permanently removes fat cells and can alter body shape, although the results may not last if you put on weight after the procedure.
Liposuction is not a treatment for obesity, and it will not remove cellulite or stretch marks.
Conditions that can be treated with liposuction include lymphoedema (where fluid accumulates in body tissue) and gynaecomastia (where fatty swellings develop under a man's nipples).
Having any kind of cosmetic surgery, including liposuction, is a major decision. It can be expensive, time consuming and the results can't be guaranteed.
It's important to ask yourself why you want to have cosmetic surgery. It's a good idea to discuss your plans and other possible options with your GP before going ahead with treatment. Liposuction is usually only recommended if you have tried changing your lifestyle but this has not helped.
If you decide to have liposuction, be absolutely sure about your reasons for wanting to have it.
Choosing a surgeon
If you decide to have liposuction, it's important that the surgeon and other healthcare professionals carrying out the procedure are fully qualified and experienced.
You should discuss the procedure in detail with your surgeon. Ask as many questions as you need to so that you're fully aware of what the procedure involves, how it will be carried out, what the results will be and whether there will be any after effects.
How liposuction is performed
Before having a liposuction operation, your surgeon should discuss the procedure with you to decide which technique they will use to prepare the area where fat is to be removed.
Possible preparation techniques include injecting the area with a solution containing anaesthetic and medication, and breaking up the fat cells using high-frequency vibrations.
Once the area is prepared, a small cut is made. A suction tube attached to a specialised vacuum machine is then inserted. Several cuts may be made if there is a large area being treated.
Liposuction is usually carried out under general anaesthetic, although local anaesthetic or epidural anaesthetic in some cases.
Risks and recovery
After the operation, the treated area will be bandaged and stitched, and you may need to wear elastic compression clothing to reduce swelling. If general anaesthetic is used you may need to stay overnight in hospital.
It usually takes about two weeks to make a full recovery, but it can take up to six months to see noticeable results, as the treated area may take time to settle down.
Like all types of surgery, liposuction carries a number of risks. These include bruising, infection, scarring and numbness.
As liposuction is usually used to improve your appearance rather than your health, it is not normally available. It may be available if used as part of reconstructive surgery or to treat certain conditions such as lymphoedema.
To receive cosmetic surgery, you will normally need a referral from your GP. You will have to have a consultation with a plastic surgeon and an assessment by a psychiatrist or psychologist. They will decide whether there is enough social, psychological or physical benefit to justify surgery.
Things to consider about cosmetic surgery, plus questions to ask your surgeon, what to expect, and the risks of surgery
Why liposuction is used
Liposuction is generally considered a type of cosmetic surgery because it is most often carried out to improve a person's appearance, rather than their health.
Liposuction can be used to remove small areas of fat that are hard to lose through exercise and a healthy diet. It works best in people who are a normal weight and in areas where the skin is tight.
Areas commonly treated with liposuction include:
Liposuction is not an alternative to losing weight, and it is not a treatment for obesity. It is also not an effective method for removing cellulite or stretch marks.
Many people find they can lose weight, tone up and reduce fatty areas with a combination of healthy eating and exercise. Liposuction is only recommended if you have tried changing your lifestyle but it has not helped.
Before choosing to have liposuction, discuss other options with your GP. Think carefully about why you think liposuction may benefit you.
Treating health conditions
Liposuction is occasionally used as part of the treatment of certain conditions, including the ones outlined below.
Lymphoedema is a condition where fluid (lymph fluid from the lymphatic system) accumulates in body tissue rather than being drained away. This causes swelling, numbness, discomfort and sometimes infection. It is most common in the arms and legs.
The most common form of chronic lymphoedema in the UK is in women who have had treatment for breast cancer, such as removal of the lymph nodes or radiotherapy to the lymph nodes in the armpit. This causes the arms to swell.
Liposuction can be used to reduce the pain, discomfort and swelling of lymphoedema, but is only advised for the most severe cases. People who have this procedure may have to wear a compression bandage permanently.
Sometimes, men can develop enlarged breasts due to fatty swellings under their nipples. This condition is called gynaecomastia, and it can be caused by a hormone imbalance or some types of medication. Liposuction can be used to remove these swellings.
This is a condition where fat is gained in one area of the body and lost from another. It is a side effect of some medicines used to treat HIV (antiretrovirals).
The redistribution of fat may cause obvious physical changes, which people with the condition can find extremely upsetting. Liposuction may be used as part of the treatment to improve the appearance of someone with the condition.
Lipoedema is the abnormal build-up of fat cells in the legs, thighs and buttocks. It occurs almost exclusively in women. It is not known what causes lipoedema, but there is a family history of the condition in up to 50% of cases.
Liposuction appears to be the only effective treatment for the lipoedema, as most of the treatments normally used for tissue swelling - such as diuretics (tablets that get rid of excess fluid) - are generally unhelpful for the condition.
Extreme weight loss
Liposuction may also be used after extreme weight loss.
This might be as a result of a controlled dieting programme or weight loss surgery, such as a gastric band or bypass surgery. In this case, more surgical procedures may be needed to remove excess skin or correct any scarring or other abnormalities. Liposuction may be used as part of this process.
How liposuction is performed
Before having liposuction, your surgeon should discuss the procedure with you to make sure you are happy with the kind of anaesthetic needed and the techniques involved.
You will also be asked to have general health tests to check you are fit to undergo surgery.
Avoid aspirin and anti-inflammatory drugs for two weeks before surgery. For women having an extensive operation, a surgeon may advise you to stop taking the contraceptive pill as well. If you are anaemic, taking an iron supplement may be recommended. If you smoke, you may be advised to stop during the weeks leading up to the operation.
Before your operation can be carried out, you will be asked to sign a consent form. This is to confirm that you understand the risks, benefits and possible alternatives to the operation.
The treatment area will be marked on your body with a pen. You may be asked to allow a photograph of the area to be taken so the results of the operation can be compared to how you looked before surgery.
Most liposuction operations take between one and four hours and are performed under general anaesthetic. For treatments on the lower body, an epidural anaesthetic may be used. This numbs the lower part of the body while you are awake.
A local anaesthetic (where only one area of the body is numbed and you are awake) is only suitable when liposuction is performed on very small areas of the body.
The surgeon will start by preparing the area where the fat is to be removed. This usually involves injecting the area with a mixture of anaesthetic, salt solution and a medication called epinephrine. This is done to reduce blood loss, bruising and swelling.
In some cases, preparation may also involve breaking down the fat cells in the treatment area so they are easier to remove. This can be done using high-frequency vibrations, a weak laser pulse or a high-pressure water jet.
The surgeon will then make a small cut in the skin of the area to be treated. If it's a large area, several cuts may have to be made.
A tube called a microcannula, which is attached to a specialist vacuum machine, is then inserted into the cut. The tube is passed back and forth within the treatment area to loosen the fat and suck it out.
When the fat has been sucked out, the surgeon drains any excess fluid and blood using small drainage tubes. This may have to be done several times after the procedure.
Recovering after liposuction
How quickly you recover from liposuction depends on the type of liposuction you have, how large the treated area is and which kind of anaesthetic is used.
After the operation
Liposuction is sometimes carried out as a day procedure, which means you don't need to stay in hospital overnight. However, an overnight stay may be recommended if general anaesthetic is used. Following a general anaesthetic, you will not be able to drive yourself home and will need a friend or relative with you at home for the first 24 hours.
If the treatment area is small, local anaesthetic may be used and this should be a day procedure. If only your lower body is treated you may be able to have an epidural anaesthetic instead. It usually takes a couple of hours to recover from an epidural anaesthetic, so you will often be able to go home on the day you have the procedure.
You may have to take antibiotics straight after the procedure to reduce the risk of infection. Most people also take mild painkillers (analgesics) to ease the pain and swelling afterwards. If you have a history of anaemia, you may need to take iron tablets.
After the procedure you will be fitted with an elasticated support corset or bandages for the treated area. This helps to reduce swelling and bruising, and it should be worn for several weeks after the operation. It can be taken off to be cleaned and for you to shower. Your surgeon will advise you about how long you need to wear it for.
You will also be given advice on caring for your stitches. You should be given a follow-up appointment to have your stitches removed, which will usually be after about a week.
Bruising and numbness
There will be considerable bruising to the area treated. The bruising will be worse when a larger area has been treated. Deep bruising and swelling may last for up to six months.
There may also be some numbness in the area, which should go away in six to eight weeks. To relieve any pain from bruising or swelling you can use painkillers such as paracetamol or ibuprofen.
Getting back to normal
It usually takes about two weeks to fully recover from liposuction, but if a small area was treated you should be able to return to work within a few days. If a large area was treated you may need up to 10 days off work to recover.
You should avoid strenuous activity for up to four weeks, although walking and general movement should not be a problem in most cases.
If you notice any problems during your recovery, such as signs of a possible infection (for example, increasing swelling, redness or pain), contact your GP or surgeon for advice.
The results of the procedure are not always noticeable until the swelling has gone down. It can take up to six months for the area to settle completely. During this time you might notice some changes and subtle differences to the area.
The final results of liposuction are generally long-lasting if you maintain a healthy weight.
Risks of liposuction
As with all surgical procedures, liposuction has possible side effects and a risk of complications.
However, liposuction is generally a safe procedure and it is rare for serious problems to develop.
Side effects of liposuction can include:
bad bruising, especially in patients who have a tendency to bleed or who have been taking aspirin or anti-inflammatory drugs
swelling, which may not settle for up to six months
inflammation of the treated areas
fluid coming from the cuts (incisions)
scars where the incisions were made
thrombophlebitis (an inflammation of the veins), which is common inside the knee and on the inside of the upper thigh when these areas are treated
swollen ankles, if the legs or ankles are treated
Any major operation runs the risk of infection and excessive bleeding. Antibiotics may be needed to help prevent infection.
Other complications that may occur due to liposuction include:
lumpy and uneven results after the fat has been removed
bleeding under the skin - known as haematoma
numbness in the treated area that may last for months
changes in skin colour and a loss of normal feeling in the area treated if the treatment area is prepared using a technique involving high-frequency vibrations
thrombosis - the clotting of blood within a blood vessel, which can obstruct or stop the flow of blood
a build-up of fluid in the lungs - known as pulmonary oedema, which can occur as a result of the fluid injected into the body
pulmonary embolism - a potentially fatal blockage in the lungs caused by a blood clot
damage to the internal organs during the procedure