Tumescent liposuction is one of the most commonly performed cosmetic surgical procedures in Australia. Tumescent liposuction is the advanced technique of permanently removing excess fat deposits in areas that are resistant to diet and exercise.Resistant fat deposits may be a genetically inherited problem, so do not blame yourself for their presence.

The tumescent technique utilizes large volumes of natural saline solution, containing local anaesthetic, which is dispersed into the fatty tissue. The injected area then becomes locally anaethetised.

With the tumescent technique, liposuction patients do not need a general sedation commonly referred to as "twilight" sedation In fact, many patients receive only minor sedation to help them relax and then remain completely conscious and comfortable during the liposuction process.

After liposuction surgery, all patients get up and walk out of the cosmetic surgery day centre without any assistance. Most patients are usually back to their regular routine in a couple of days.

Post operative surgical discomfort ranges from minor to moderate but generally only requires paracetamol with codeine to minimise the pain experienced which is often described as being similar to an extreme work out at the gym. Liposuction is also called liposculpture as the cosmetic surgeon artistically sculpts and contours the body into a new shape.

The ideal candidate for liposuction is fit, healthy, has good skin tone and discrete pockets of fat requiring sculpting and reshaping of the figure. The most popular areas for liposuction for woman include the lower abdomen, upper abdomen, inner and outer thighs, hips, waist, buttocks, inner knees and arms and chin.

For men the most popular areas for liposuction include the abdomen, waist and neck.

Will liposuction stop me from gaining weight?

By the end of our adolescence, most people have produced a fixed number of fat cells, which will be with them for their remaining years.After this, if a person gains weight, then the pre-existing fat cells grow larger, rather than the body producing more fat cells.

Many patients find that liposuction results in a psychological boost that gives them renewed confidence and more incentive to lose weight, in some patients weight loss seems easier post liposuction.

Following liposuction, the areas treated will have less fat cells. If a person begins to gain weight, the fat will distribute into the remaining fat cells throughout the body. This usually results in weight gain which is more evenly distributed rather than fat being excessively deposited in previous problem areas.

An often welcomed side effect, is that women notice with weight gain, that the fat goes to their breasts. It is advisable to see two opinions and make sure your doctor is suitably qualified and experienced.

Will liposuction stop me from gaining weight?

By the end of our adolescence, most people have produced a fixed number of fat cells, which will be with them for their remaining years. If, after the procedure, a person gains weight then the pre-existing fat cells grow larger, rather than the body producing more fat cells. Following liposuction, the areas treated will have less fat cells. If a person begins to gain weight, the fat will distribute into the remaining fat cells throughout the body. This usually results in weight gain which is more evenly distributed rather than fat being excessively deposited in previous problem areas.
Many patients find that liposuction results in a psychological boost that gives them renewed confidence and more incentive to lose weight, in some patients weight loss seems easier post liposuction. An often welcomed side effect is that women notice with weight gain, that the fat goes to their breasts.

Who can benefit from Liposuction and liposculpture?

The best candidates for Liposuction should have firm elastic skin, be in good health and have tried to eliminate bulges through diet, exercise and weight loss. Liposuction is not suitable for people who are simply overweight. It is a body reshaping procedure not a weight loss procedure. By the time we reach the end of adolescence our body has created a certain number of fat cells and the actual number of these does not generally increase from then on.

Through a combination of genetics and hormones both women and men tend to have areas where these fat cells are deposited more thickly than other areas. These spots include the thighs and buttocks in women and the stomach and love handles in men. It is liposuction's ability to permanently thin the layer of fat in these areas that makes it such a useful treatment. If we later put on weight this tends to be distributed evenly to all the fat cells in the body. While the treated area may grow to some extent it will never reach its former size because the layer of fat cells in that area is permanently thinned.

What is the difference between Tumescent Liposuction and SmartLipo, Vaser Liposuction, powered liposuction, CoolLipo, LipoLite etc?

Tumescent liposuction is the medical procedure of removing fat under local anesthesia. All other titles are company’s trademarked names of devices/instruments (lasers, ultrasound devices, vibratory devices) that aid in the removal of fat under local anesthesia. They are all used as part of the tumescent technique, not in lieu of it.

How long do the effects of the liposuction last?

The effects are usually permanent however if you put weight on later, the fat cells can return in that area, although the fat tends to accumulate in other areas first. Many patients find that liposuction is a psychological boost that gives them more incentive to lose weight and in some patients, weight loss seems easier, post liposuction.

Does liposuction produce permanent results?

After liposuction the body's new shape is more or less permanent. If a patient does gain a moderate amount of weight after liposuction, then the figure will simply be a larger version of the new body shape. Fat cells that are removed by liposuction do not grow back. As long as the patient does not gain excessive amounts of weight, the new, more pleasing silhouette is permanent. With advancing age, the body will produce the usual changes in the shape of the body associated with the aging process. If a person gains weight after liposuction, they will not accumulate as much fat in the treated areas as would have happened if liposuction had not been done. The myth of fat moving around after liposuction is still merely a myth.

Does the fat come back in other spots after liposuction?

If a patient does not gain weight after liposuction, then fat does not accumulate in other areas of the body. However, if a patient gains a significant amount of weight, say more than (5 kg), after liposuction, and then the fat must go somewhere. In fact, the fat accumulates in every area of the body in proportion to the amount of fat cells in each area. Areas where fat cells have been removed by liposuction will accumulate relatively little fat, while areas not treated by liposuction will collect relatively more fat. For example, if a woman gains weight after liposuction of her hips, outer thighs, and abdomen, then most of the fat will be deposited elsewhere such as the woman's breasts, face, back and legs.

When will I see results?

While you will see some results straightaway, you will not see the full result of your treatment until all swelling has settled down. This usually improves over the first few weeks. After 10 days you will have a good idea of the effect of the procedure, after 6 weeks you will about 85% of the result is apparent, and at 6 months full affect of the procedure is clear.

What can I do to ensure I get the best results?

The compression garment is vital as it alleviates pain by splinting affect and also prevents swelling. It is important that you continue to wear the compression garment for the period prescribed by your doctor as it also aids the body in recovery and ensures skins contracts evenly. From the second day following you surgery it is advised that you do some low impact exercise (such as walking) for 30 minutes a day to encourage blood circulation. There are also some massage techniques that can assist which Dr Feldman will discuss with you. You can return to non-strenuous work within two days but should not attempt more strenuous activity for the first fortnight.

How will I feel after the treatment?

Most patients feel very little discomfort immediately following the operation, but may be drowsy from medications used to relax patients during the procedure. It is important someone drive you home and you should rest for the first evening. You may experience some discomfort and stiffness in the first week following the procedure (a little like having done a strenuous gym workout) but this will gradually disappear. The swelling, tenderness and bruising (if any) of the treated area will generally disappear within 2 weeks or so. Most patients tolerate the discomfort without the need for painkillers (i.e. Panadol) but you may take these if you wish.

When can I resume work?

You can resume work within a few days Most patients get back to work within one to two days. You should not resume heavy exercise for two weeks.

Where is the surgery performed?

The surgery is performed at an accredited day hospital facility.

What sort of post-operative follow-up is there?

Patients are reviewed the week following surgery or sooner for any reason, then 4 weeks post operatively.

How much pain should I expect and will I need to take any medications?

The first 48 hours are generally the most painful but this varies for each patient. Some patients find they do not require any pain medication at all while others use prescription strength pain medication The compression garment is vital as it alleviates pain by splinting affect and also prevents swelling.

What types of medications will I be given during the procedure?

Prior to the procedure you will be given a relaxant tablet orally, as well as intravenous antibiotics. If required a short acting powerful analgesic will be administered during the procedure at your request.

Will there be scars from the procedure be and how noticeable will they be?

Incisions performed during liposuction are only 3-4 millimetres long and usually heal rapidly. After several months the scars are not noticeable.

Do I need to abide by any special diet, both pre-operatively and post-operatively?

You should follow your usual diet prior to the operation. For the 10 days prior to the surgeries you should not take any anti inflammatories or aspirin, no alcohol 24 hours prior to surgery.

What are the risks of liposuction?

Like any plastic surgery or any general surgery, liposuction carries some risks. Although liposuction complications are quite rare, they can include infection which is very uncommon. It is thought that the tumescent fluid is also antibacterial. Make sure your liposuction is only performed in a registered sterile theatre. The are other significant and fatal risks of liposuction, although they are very rare. This will be discussed at the time of the consultation.

Is an anesthesiologist necessary with Dr Frank’s technique?

An anesthesiologist should be present only when a patient is given general anesthesia. Dr. Feldman performs the procedure only with "conscious sedation"; therefore, no anesthesiologist is needed.

Does liposuction always remove cellulite?

Liposuction improves the silhouette of the body, but does not necessarily eliminate the pre-existing subtle "puckering" of the skin that is often referred to as "cellulite." Liposuction does reduce the degree of cellulite to a minor degree but it is unlikely to produce a significant improvement or to completely eliminate cellulite.

What are the advantages of a tummy tuck (compared to liposuction)?

The only patients for whom a tummy tuck is superior to abdominal liposuction are the relatively few women having extreme degrees of lower abdominal skin laxity, unusually extensive stretch marks, or severely stretched abdominal muscles (as a result of pregnancy). A tummy tuck surgically removes skin with severe stretch-marks (striae-distensae). Liposuction does not remove stretch marks. A tummy tuck can produce a flatter abdominal wall by tightening the abdominal muscles. Some loose abdominal skin does not mean that a tummy tuck is necessary. After liposuction, abdominal skin often contracts to a surprising degree so that an excision is not necessary.

What are the disadvantages of a tummy tuck?

Tummy tucks are often associated with ugly scars producing a deformed appearance of the pubic and lower abdominal areas. Although the lower abdominal area is usually covered when a bathing suit is worn, the scars are quite apparent without clothes. The removal of a large segment of lower abdominal skin requires that the belly-button be repositioned and surgically reconstructed. A surgically altered belly button often does not have a natural appearance. Tummy tucks are far more dangerous than abdominal liposuction. Tummy tuck surgery has a much higher risk of surgical complications such as blood clots in the lung (pulmonary embolism) compared to liposuction. In most cases, liposuction alone, without a tummy tuck, produces excellent cosmetic results and avoids the risks and additional expenses associated with a tummy tuck.

Is the cost of a tummy tuck greater than liposuction?

Tummy tucks are approximately 2-3 times as expensive as liposuction of the abdomen. The recovery time required before a person can return to work after a tummy tuck is typically two to four weeks longer than after liposuction of the abdomen.

How can one minimize the risk of complications associated with a tummy tuck?

When a tummy tuck is indicated, some surgeons believe it is safer to first do a liposuction and then, several months later, do the tummy tuck. Often the patient is so pleased with the initial liposuction that she no longer sees a need for a tummy tuck. Second, if the results of the liposuction are not sufficient, then dividing liposuction and tummy tuck into two separate relatively minor surgical procedures is usually much safer than one major surgery.

What about mesotherapy?

Mesotherapy involves a series of injections of various chemicals that supposedly melt fat. Treatments are painful, traumatic, bruising, and can leave very uneven and lumpy results. There is no true control of any contours. To date, mesotherapy is still a non FDA approved and terribly unregulated and unstandardized technique that is marketed for fat reduction. There are no studies that show its true efficacy and there are studies that suggest significant risk. To change one’s body contour, the accepted standard of care still is still liposuction. The cost is no different in the long term and the risks of mesotherapy can be much greater.