Epidemiology

In Germany, 250,000 people have their fat suctioned every year, in the USA it is about 750,000. Men now account for 20% of the population. Liposuction is one of the most frequently performed aesthetic surgical procedures, about every fifth operation removes fat. It is often performed in combination with other cosmetic surgery procedures, such as skin tightening, to optimize the cosmetic result.

Procedure

Fat removal surgery can be performed both on an outpatient and inpatient basis. This depends on the extent of the operation. For smaller operations a local anaesthetic can be used.

In this case the patient is put into a sedated state, i.e. he is given a tablet or an injection before the operation, whereupon he falls into a state in which he is responsive but relaxed and insensitive to pain. After the operation he can leave the clinic after a resting period. If a major operation is performed on several sites, the operation is usually performed under general anesthesia.

The anaesthetist (the anaesthetist) is present during the entire operation and monitors the anaesthesia. In the case of liposuction of the legs or hips, spinal anaesthesia can be used instead of general anaesthesia. In this procedure, a local anesthetic is injected in the area of the spine, which blocks the sensitivity and motor functions of the lower half of the body.

During the operation itself, the fat cells are sucked out through small skin incisions about 0.5 – 1 cm long on the previously marked areas. The incisions are made in places where the remaining scars are not too obvious. To ensure that the result is symmetrical, the surgeon makes sure that the same amount of fat is removed from each side by collecting and measuring the amount of fat that has been suctioned.The amount of subcutaneous fat tissue removed varies greatly depending on the condition, but more than 5 liters are not removed in one session.

After the incisions are sutured, bandages, support stockings or similar are put on to compress the tissue of the affected areas. This serves to prevent excessive bleeding with subsequent bruising. The period during which the compression garment should be worn can vary from a few days to several weeks.

The duration of the procedure can be 20 minutes or up to three hours. Liposuction of the thighs or hips takes about 1-1.5 hours on average. After the procedure, an infusion can be made, since water is also withdrawn together with the fat cells. This serves to compensate for the loss of fluid. Since there is an increased leakage of fluid from the tissue after the operation, the dressing must be changed regularly at the beginning.