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Liposculpture is a process of removing large areas of unwanted fat from the body and at the same time sculpting the body shape into a more desirable form. The other term , liposuction, is an older name for a similar process. The main difference is that liposculpture generally uses smaller instruments for more fine-tuning results. Thus, liposculpture is for body contouring rather than for whole-sale fat debulking and weight reduction.
The ideal patient is not too far from their ideal body weight, but has a fatty bulge somewhere which does not shift sufficiently with the normal exercise and dietary routine. Thus, this procedure is not a weight- reducing process. If a patient is overweight, they may still be suitable for treatment if they have genuinely exhausted other normal diet and exercise programmes.
Cellulite is an entirely different subject. A person can be fat but have no cellulite and vice versa. Occasionally, there is some cellulite improvement, but it is not a reliable outcome.
Liposculpture is performed in a day-theatre or in a hospital. There are various options for local anaesthetic only, twilight anaesthetic or even general anaesthetic. Dr. Sacks uses the tumescent and twilight anaesthetic combination and it can be done as a day- only procedure. For his country patients, he prefers an overnight stay in hospital.
There are some advantages of the tumescent/twilight technique over general anaesthetic:
- Less risk than the general anaesthetic. There is no airways risk as the patient is controlling it themselves. Less heart risk for similar reasons. Less drug usage.
- Less morbidity (complications). The only part anaesthetised is the skin and fat. The important underlying structures retain full sensitivity and the patient will react if these areas are challenged. This reduces the risk of internal injury.
- Less post- operative discomfort and quicker recovery.
- Less chance of needing a secondary procedure to remove an unwanted or missed area of fat. There is more mobility of the patient to check results. The fatty deposits often look entirely different in the lying position as compared to the standing position. It is possible to stand the patient at the end of the procedure and check.
- Less cost
The disadvantage is that the general anaesthetic technique has no inter-operative pain and has the presence (in most cases) of a specialist anaesthetist.
Post- surgery, the patient must wear a compression garment for 4 weeks. There is reduced activity such as physical work, sport or exercises for 2 to 4 weeks (more depending on the type of work, sport or physical activity). It is uncommon to have serious health issues with this type of treatment, but lesser side effects such as swelling, haematoma, seromas are more common.
Patients with much larger collections of fat may require more than 1 treatment or may need to be referred to a plastic surgeon. Often these patients will also need tummy tuck or other skin removal. Skin issues post operatively are more common in the areas of the lower abdomen and upper arms.
The most common areas for liposculpture include upper and lower abdomen, the hips, upper thighs, inner thighs, knees, man boobs, chin.