Liposuction (lipoaspiration) is a surgical intervention, which involves removal of accumulation of fat in the problem area, which cannot be removed by dieting or vigorous sports. These are the so-called “fat traps” that develop locally due to genetic characteristics. Most surgeons perform the procedure under local anaesthesia, minimizing its duration and the likelihood of complications.

Types of liposuction:
Classic. Adipose tissue pretreated with Klein’s solution is removed with the help of a cannula. The most common yet traumatizing method.
● Ultrasound or infrasound. An ultrasound or infrasound wave from the tip of the cannula is quickly split and removed by vacuum. Advantage: minimal invasiveness, stimulates skin contraction. Typically used for double chins.
● Laser. The laser beam breaks down fatty cells, which are subsequently excreted naturally.
● Water. Fat is destroyed with water jets.
● Vibration. Fatty cells are destroyed with vibration. Advantages: simplicity and low invasiveness.

Which areas can be treated?
Lipoaspiration is carried out on the following areas:
● lower third of the abdomen;
● waist (“love handles” on the waist);
● the inner surface of the hands;
● area up to the line of costal arches;
● area of the anterior abdominal wall;
● “saddlebags” (upper thigh);
● the inner surface of the leg;
● area above the knees;
● double chin;
● neck;
● back (“widow’s peak”);
● in men – chest and abdomen.

How is the cost of liposuction measured?
One of the first questions to as a doctor during your appointment: “How much does liposuction cost?” It depends on the cost of a single working area. Typically, the size of a working area is estimated by the size of the palm. For example, the front of the abdomen can be 1–4 working areas, the waist (“love handles”) — 2 areas (left and right), saddlebags — 2 areas (left and right).
The full price of the procedure depends on the number of working areas, liposuction method, involvement of additional plastic surgeries. Only a surgeon can give the most accurate cost of procedure upon consultation with the patient.

How is the surgery done
In classical surgery, the problem area is anaesthetized, Klein solution is injected to reduce blood vessels, manage pain, and break down adipose tissue. In 30 minutes, a cannula is inserted through a 10 mm incision, which removes fat. After the procedure, cosmetic sutures are applied.

Indications
Fat removal surgery is recommended in clients unable to remove body fat through diets or exercise. Often, a genetic predisposition “gives” fatty deposits in the lower abdomen even to the owners of a gaunt figure and active people. Also, often weight is gained on the inner surface of the arms, the upper back in former athletes, when the muscles are replaced with adipose tissue as they age.

Important to know: plastic surgeon Pavel Denishchuk warns his patients that it is dangerous to lose 10 kg in a day using lipoaspiration, and it is impossible to get a slender figure for a massively overweight person. For such patients, the doctor recommends reducing the amount of adipose tissue with the help of diets and sports to start the transformation process. And then liposuction can be used correct problem areas.

Contraindications
Liposuction of the abdomen, chin, knees, and other areas will not be performed against the background of the following conditions:
● diabetes mellitus;
● blood coagulation disorders;
● thrombophlebitis or varicose veins in the area where fat should be removed;
● neoplasms in the problem area;
● stomach ulcer;
● arterial hypertension;
● renal failure;
● pregnancy.
Liposuction is not performed in patients under 18 years of age.

What results can be achieved due to the procedure?
Lipoaspiration helps to:
● remove deposition of adipose tissue in any part of the body;
● make skin more toned, achieve a slender body;
● the second chin is removed, as well as larger folds on the face, neck.

Possible complications
● Asymmetry. After liposuction of the thighs and abdomen, wearing compression underwear is mandatory. If the patient violates this recommendation, then swelling develops rapidly and asymmetry occurs.
● Bleeding. In one liposuction procedure, it is safe to remove up to 3 litres of adipose tissue. If the client would like to remove more tissue, then there is a high chance of bleeding.
● Fatty thromboembolism of the lungs. Another complication that occurs with a single large-volume removal of adipose tissue. Plastic surgeon Pavel Denishchuk advises patients who wish to get rid of a large accumulation of fat to divide lipoaspiration into several stages.
● Damage to the internal organs with the cannula. The problem occurs with aggressive liposuction performed by a beginner doctor. To avoid such problems, it is better to choose an experienced surgeon.
● Postoperative haematoma. It occurs in 0.8 % of cases. Most often, haematomae are encountered by patients with problem vessels or smokers who have not avoided the habit for 2 weeks before the surgery;
● Necrosis of the operated area. This complication accounts for 0.2 % of cases. It occurs due to circulatory disorders in the area of procedure, a doctor’s error, general weakness of the body, or violations of recommendations for recovery.

Preparation for surgery
In Kyiv, plastic surgeon Pavel Denishchuk would like to remind that before removal of fat smoking patients shall avoid smoking for at least 2 weeks. Nicotine has a negative effect on blood coagulation, increases vascular fragility and significantly increases the likelihood of complications (haematomae, necrosis, bleeding).
A week before the procedure, the patient shall undergo blood and urine tests, a consultation with a doctor and a surgeon, an ECG. When there are no contraindications, then the day of the procedure is scheduled.
On the day of liposuction, before going to the surgery room, the surgeon applies a special marking on the patient’s body, indicating the edges of the areas where fat will be removed. This is necessary so that Pavel Denishchuk knows exactly where to perform liposuction when the client is already on the operating table.

What is the rehabilitation process like
After liposuction, the patient is recommended to wear corrective underwear for 1–1.5 months. This is necessary to prevent skin sagging and proper distribution of remaining adipose tissue. Underwear shall not be removed even at night.
A month after liposuction, patients are allowed to go in for sports. Saunas, bath houses, tanning parlours shall be avoided for at least 2 months.

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