Liposuction (liposuction) is a surgical procedure in aesthetic surgical medicine in which the subcutaneous fatty tissue (subcutaneous fatty tissue) is removed or suctioned by vacuum with the help of an aspiration cannula. Liposuction in the abdominal area (belly) allows for quick and effective removal of troublesome fat deposits. Often, these cannot be combated through exercise or a targeted change in diet, and women in particular suffer from the unaesthetic shape of their bodies. Liposuction on the abdomen can be combined with abdominoplasty, which is also a surgical procedure that allows tightening of the abdominal region by removing excess skin and fat.
Indications (areas of application)
- Unaesthetic fat pads in the abdominal area.
- Stage 3 lipedema (lipedema extends from the hips to the ankles; health insurance coverage).
Contraindications
Absolute contraindications
- Known allergy to anesthetics or local anesthetics of tumescent anesthesia.
Relative contraindications
- Known tendency to seizures (epilepsy).
- Taking anticoagulants (anticoagulant medications).
- Too high expectations of the patient for the outcome of the operation.
- Severe heart disease
- Severe lung disease
- Svere liver damage
- Severe kidney damage
- Tendency to thrombosis (thrombophilia)
Before surgery
Before surgery, an intensive medical history discussion should be conducted that includes the patient’s medical history and motivation for the procedure. The procedure, any side effects, and the consequences of the surgery should be discussed in detail. Note: The requirements of the explanation are stricter than usual, since courts in the field of aesthetic surgery demand a “relentless” explanation. Furthermore, you should be examined for hip asymmetry. One study indicates that most patients have a crooked hip, which can significantly affect the surgical outcome and patient satisfaction. You should not take acetylsalicylic acid (ASA), sleeping pills or alcohol for a period of seven to ten days before an abdominoplasty. Both acetylsalicylic acid and other painkillers delay blood clotting and can lead to unwanted bleeding.Smokers should severely limit their nicotine consumption as early as four weeks before the procedure to avoid jeopardizing wound healing.
The surgical procedure
Before the actual surgery, there is the planning of the procedure, which includes the individual recording of the findings and the education of the patient. During this process, the surgeon carefully draws the surgical area on the standing patient and determines the access points for the aspiration cannula. The procedure is performed with the help of so-called tumescent local anesthesia (TLA): In a first step, one and a half to several liters of a mixture of sterile, isotonic water, sodium bicarbonate, a local anesthetic (drug for local anesthesia) and often also some cortisone are infused into the subcutaneous fat tissue. After a 30-minute waiting period, the infused fluid has distributed itself evenly in the fatty tissue. This forms a kind of emulsion of fat cells and tumescent solution, which makes the actual liposuction much easier. After the tumescent anesthesia has been allowed to take effect for 30 to 40 minutes, the surgeon uses a scalpel to make small incisions through which he can insert the suction cannulas. The subcutaneous fatty tissue is now suctioned from different angles in an overlapping, fanning motion. Often, the belly button is also a suitable access region, as the surgical scar can be hidden very well here. As already mentioned, liposuction on the abdomen can be combined with skin resection in the suprapubic area (just above the pubic region).
After the operation
After surgery, a tight support girdle must be worn continuously for the period of ten days to stabilize the surgical result during healing. During the first few days, the patient may experience a sensation similar to muscle soreness. Sporting activities should initially be avoided for a few weeks in order not to negatively influence the surgical result. The small scars of the incisions fade with time and the final result can be admired after six to nine months.
Possible complications
- Allergic reactions – e.g., to the anesthetic.
- Hematomas (bruises)
- Keloids – increased scarring
- Edema (swelling)
- Pain, feeling of tension
- Sensory disturbances in the surgical area
- Thrombosis – vascular disease in which a blood clot (thrombus) forms in a vessel.
- Wound healing disorders due to circulatory problems.
- Wound infections
Benefit
Abdominal liposuction is the most requested procedure in the field of liposuction. It can help patients achieve a new, slimmer and more toned body shape. However, because it is an invasive procedure, the need for the surgery must be weighed against the risks.
