Schnheitschirurgie

Liposuction

Synonyms

Liposuction, liposuction
English: liposuction

Definition / introduction

Liposuction is one of the most common surgical operations that affect the aesthetics of the body. In the meantime, body regions can be specifically shaped as a result.
The background to such an intervention can be the elimination of the consequences of an illness (e.g. lipedema, which is often referred to as "saddlebags" in colloquial language) or simply achieving a desired figure. The fat deposits, which could not be removed even through exercise or diet, are usually removed permanently.

Epidemiology / statistics

Of the circa 270,000 cosmetic surgeriesthat are carried out annually in Germany are roughly omitted 33,000 interventions on the Liposuction.

Causes of Liposuction

The Liposuction has many causes, but only serves aesthetic purposes. So it is not suitable for overweight therapy. It can only be seen as an additional measure. The fat is taken out of the body areas where despite Lose weight (e.g. diet) and physical activity, no fat reduction is possible.
In addition, there are many diseases whose unsightly side effects are caused by a Liposuction can be corrected. This includes, for example, all forms of fat distribution disorders or an enlarged man's breast (Pseudogynecomastia / gynecomastia).
See also: Endurance sports and fat burning and Double chin exercises.

Symptoms

There are many reasons why liposuction is performed. In addition to the aesthetic aspects, health problems can also play a role here:

Lipedema

Symptoms and consequences
- Heaviness in legs
- swollen legs when standing and sitting for long periods of time
- Cellulite (Orange peel)
- Hardening of the subcutaneous tissue, pain to touch
- Tendency to bruise affected parts of the body
- Difficulty walking
useful information
- Even for years without symptoms, lymph congestion can occur in the increased fat tissue over time (the cause of this is the compression of the fine lymph vessels with the result of increased Water retention)
- Fat tissue increases in the thigh and hip area, on the inside of the knee joints and lower legs
- Typical for the appearance is the recess in the ankle region and the Feetso that sometimes the fatty tissue overlaps the ankle region

Pseudogynecomastia

Symptoms and consequences
- Enlargement of the male breast without the involvement of breast tissue
- increased storage of adipose tissue in the case of existing obesity
useful information
- In rare cases you can also Tumors (for example fibromas and Lipomas) causal for the Breast augmentation be. Here, however, the enlargement often only occurs on one side

diagnosis

The patients who opt for liposuction for beautification are carefully examined beforehand. It is important here whether there are previous illnesses that could lead to complications during the operation. In addition, the places where the fat is to be sucked off are examined more closely. The fat volume to be removed is also determined beforehand.

Treatment of lipedema by liposuction
The diagnosis of lipedema can be made by the external appearance and palpation of the affected body areas. There are also several clinical findings that suggest this condition:

irregular distribution of the fatty tissue, leaving out the foot area
Pain on touch or finger pressure
bruises

Lipedema is also divided into stages:

The surface of the skin is smooth and the fatty tissue is fine-knotted (stage I)
The surface of the skin is uneven (orange peel) and the fatty tissue is nodular (stage II)
The fatty tissue is divided into large lobes. In addition to the legs, arms and hands are also affected (stage III)

Treatment of pseudogynecomastia / gynecomastia with Liposuction
These two conditions, both of which are manifested by enlargement of one or both breasts, only occur in men. Pseudogynecomastia and gynecomastia differ primarily in one feature:
It is called pseudogynecomastia when no mammary gland tissue is increased. This means that the cause of the enlargement here is, for example, the storage of fat due to obesity.
On the other hand, one speaks of gynecomastia when the breast tissue is increased.
The diagnosis, which is made by palpating the chest, decides on the further treatment method.

therapy

Different therapy methods

Tumescence technique

Operation procedure:
- Liquid saline solution is injected into the affected parts of the body in conjunction with a local anesthetic (or e.g. adrenaline, enzymes) in order to better dissolve the fat cells and to reduce bleeding during the operation
- A suction tube is used to enter the pretreated fatty tissue through one or more skin incisions (no larger than a few millimeters) and a part of it is sucked out
- The later body shape is modeled here
Useful information:
- Most common method used
- If fat is removed from several places or a larger area is suctioned off, the operation is carried out under anesthesia
- The incision during the operation is such that later no scars can be seen or they disappear into skin folds

Ultrasound-assisted liposuction or ultrasound-assisted aspiration lipectomy

Operation procedure:
- With a special instrument, ultrasound is applied to the fatty tissue, causing the cells to burst
- The liquid fat is sucked out
Useful information:
- This technique is based on the original method
- Advantageous for fat cells in areas with a large proportion of connective tissue (e.g. in the back area or the man's chest in pseudogynecomastia)
- Favorable for the second liposuction procedure if fat cells have formed again after the first procedure (e.g. in diseases such as lipedema)
- More time consuming than the tumescent technique

Liposuction with vibration technology or Power-assisted liposuction

Operation procedure:
- Use of cannulas that vibrate at a high frequency
- Fat cells are destroyed in the process
- and at the same time sucking off fat
Useful information:
- This method is now used more and more frequently
- Advantageous for fat cells in areas with a large proportion of connective tissue
- Removed fatty tissue (autologous fat) can partially be injected back into other parts of the body (e.g. face)

Most of the excess fluid that leaks from the incisions in the first few days after the operation consists of the remaining saline solution. The liquid can be removed through cannulas.
If a larger area has been worked on, drainage is often created to drain off wound fluid, blood or the excess saline solution. A compression bandage is often placed on the patient to prevent excessive tissue swelling, pain and shapelessness.

If the skin is still tight, it will contract again after the operation. The operated parts of the body are then shaped.

This is more difficult in patients with excessively stretched skin. Additional measures such as a tummy tuck may have to be carried out here.

Read about this too Adipose tissue necrosis

rehabilitation

In the first few days after the Liposuction will give the patient a Compression bandage created. This should absorb the remaining fluid (wound fluid, blood or the excess saline solution). There are also special ones Compression bodicethat have a positive effect on the healing process. The compression connects the detached layers with the sub-tissue. Through this process, a optimal healing takes place and promotes the growing together. However, these bodices must be worn for 24 hours for up to six weeks. The compression girdles support the body shape and have a decisive influence on the end result.

Whether an inpatient (major procedure) or an outpatient stay (minor operation) is recommended for the patient depends on the volume to be removed. During the inpatient procedure at Liposuction the patient remains in the clinic for several days. This also ensures optimal care, which in turn ensures a good healing process.

After this Liposuction should all activities are reduced to a minimum until further notice. Sports activities are possible again after about four to five weeks.

The redness of the scar goes back little by little until it finally almost fades away. The final result of the operation can only be seen after a few months.