Liposuction (liposuction) is a surgical procedure in aesthetic surgical medicine, in which the subcutaneous fat tissue (subcutaneous fat tissue) is removed or suctioned by vacuum with the help of an aspiration cannula. Liposuction in the thigh area is used to reshape an unsightly thigh contour caused by fat deposits on both the outer and inner thighs. On the inner thighs, a combined procedure of thigh lift and liposuction is recommended due to the frequent presence of excess skin. Another problem area is the so-called “banana region”, which is the horizontal fat bulge below the buttock fold. Liposuction of this area is usually combined with removal of the so-called breech deformities: These fat deposits on the outer sides often cannot be influenced by physical training and dietary changes, so that usually only surgery leads to the desired result. The usually female patients suffer from this blemish and are often impaired in their body image or self-confidence.
Indications (areas of application)
- Breech deformities
- Fat deposits on the thighs that can not be addressed by physical training or dietary changes.
- Stage 3 lipedema (lipedema extends from the hips to the ankles; health insurance benefit: see below).
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
- Severe 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 not take acetylsalicylic acid (ASA), sleeping pills or alcohol for about fourteen days before the operation. Both acetylsalicylic acid and other pain relievers delay blood clotting and can cause 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 operation, the patient is questioned in detail as part of the medical history and informed about risks and complications. The surgical area is carefully marked out on the standing patient. Liposuction in the thigh region can be combined with procedures in the abdominal region, buttock region, and knee region. The anesthesia (anesthetic) of choice is the 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 subcutis (subcutaneous fat tissue). After a 30-minute waiting period, the infused fluid is evenly distributed in the fatty tissue. A kind of emulsion of fat cells and tumescent solution is formed, which makes the actual liposuction much easier. The patient is in a lateral position during the operation, and the procedure takes several hours depending on the individual findings.
After the operation
After the operation, a bandage is applied, which consists of an elastic bandage, among other things. An elastic support girdle must be worn continuously for approximately 3 weeks. This is for stability and the shape of the surgical result. Physical stress as well as direct sunlight on the surgical scars should be avoided for the next 1 to 2 months. Redness of the scars may persist for several months.
Possible complications
- Allergic reactions – e.g., to the anesthetic.
- Tearing open the edges of the wound
- Dysformities in the suction area
- Post-bleeding
- Hematomas (bruises)
- Keloids – increased scarring
- Edema (swelling)
- Pain, feeling of tension
- Sensory disturbances
- Thrombosis – vascular disease in which a blood clot (thrombus) forms in a vessel.
- Wound healing disorders due to circulatory problems.
- Wound infections
Benefit
Thigh liposuction is an effective procedure to remove troublesome fat deposits and restore a beautiful thigh contour. Especially the breech deformities can be successfully controlled by this surgery. Note on the legal basis for the recognition of liposuction as a therapeutic measure by the statutory health insurance (SHI): since January 2020, the service is covered by the SHI for stage 3 b lipedema. In addition, proof of successful conservative therapy over 6 months must be provided. The same applies to patients with obesity grade II (BMI: 35-39.9).
