(piano music)
In this video, we're going to be talking about liposuction.
And hopefully give you some insights in the procedure.
This will help you prepare for your
first consultation with one of our doctors.
And help you think of some questions that you might
want to ask about your situation.
So what is liposuction and what is it used for?
Liposuction is a procedure that is used
to remove stubborn areas of fat from the body.
Now, we're all genetically predisposed
to a certain body shape.
Most of the time, unless you're a supermodel,
we have certain areas of fat which are
out of proportion to the rest of us.
So, for example, some people may
have an outer thigh which is bulging.
Or a little pot belly which they can never get rid of.
No matter what weight you are.
The purpose of liposuction is really to bring these areas
back into balance with the rest of the body.
So what we're doing here is fighting
against what you've been given genetically.
Which may not necessarily be ideal.
And shaping the body in a way that
exercise or weight loss simply can't.
One of the most common questions
I get asked about liposuction is, is it permanent?
When fat cells are removed from the body,
they are unable to regenerate in that area.
You might, for example, have a certain
number of fat cells in the outer thigh.
Now, with liposuction you might remove
a proportion of these fat cells.
These remaining fat cells are able to increase in size.
But not to the same size had you not had liposuction.
So I've seen people who have had
liposuction more than 10 years ago,
and they've still maintained that shape.
So what I'm saying is that if you lose weight
or gain weight, you'll still have that same body shape.
It will just be either a bigger or smaller version of it.
We aim to shape the female population
into an ideal hourglass shape.
So wide at the shoulders.
Narrowing at the waist.
Coming out at the pelvis a little bit.
And then coming down, narrowing at the legs again.
This is not naturally a common body shape that is seen.
It is however the ideal body shape.
And in studies, shown to be the most
attractive body shape for a female.
For males, we tend to aim for straighter lines.
And a V shape from the shoulders down to the hips or waist.
This is the ideal body shape for a man.
Common areas that we treat for men include
the abdomen, chest, and hips.
And also the chin area.
It's also interesting to note that
despite the fact that sometimes
liters of fat can be removed from the body
with liposuction, it's not a procedure
that is intended for weight loss.
It really is to balance the proportions of the body.
You may lose a small amount of weight with liposuction.
However, fat tends to be really light.
And the density of fat is quite low.
So, I think of it almost like fairy floss.
And if you think of fat and water together,
fat always floats to the top.
So one liter of fat, usually doesn't
weigh anywhere near a kilogram.
What I find is that despite the fact
that you may not lose much weight with liposuction.
Or sometimes no weight.
That the changes in your body shape are profound.
Next I'm gonna be talking about,
what to expect during your consultation.
Firstly, it's important to gather all your medical history.
Any medications you're on.
Any past operations you've had.
Any problems with operations you've had in the past.
Especially with anesthetic.
So that your doctor will be informed of your past history.
It's important to tell your doctor
if you have any medical problems.
Such as bleeding disorders.
Or any allergies to medications.
Or anything really that you think might
be relevant to the operation.
During your first consultation,
your doctors gonna take a detailed medical history from you.
And from there determine your fitness for the procedure.
The next part of your consultation is examination.
And this is naturally a bit uncomfortable for people.
We try to make every effort to make it
as pleasant and comfortable for you as possible.
We give you a gown to wear.
And you are able to keep your undergarments on.
You'll be able to show your doctor which areas concern you.
And they'll be able to tell you
which areas, objectively, would be the best to treat.
To give you a balanced, proportionate body.
It's important to note that sometimes treating
one area alone, may have an impact on another area.
For example, treating the hips alone,
may make the outer thighs look bigger.
Or treating the inner thighs alone,
may put the inner knee out of proportion.
So it's sometimes important that you have someone who's
experienced in the area actually look over you and say,
this other area needs to be done in conjunction
with the area you're concerned about,
in order to give you the best result.
The doctor will also give you an idea of what to expect,
in terms of results from your liposuction.
There are some limitations of course, to every procedure.
And with liposuction, the main concerns that we think about
are the skin, and how it may look after the procedure.
For those who have had large amounts of weight gain.
Or have had, say large pregnancies.
You may have some concerns with taking out too much fat.
Because the skin may become lax or wrinkled.
So there are limitations in that sense.
The majority of people will experience
excellent skin retraction.
The actual procedure itself sets up
a bit of fibrosis under the skin.
And makes the skin stick to the underlying tissue.
So you actually get quite a good
skin retraction in most cases.
It's only compromised when the skin
is lax prior to the procedure.
Other limitations to liposuction
include the amount of fat you can remove.
Generally, in a healthy person,
there is a fair amount of fat that can be removed.
And generally the whole body can be done in one go.
In some cases, we need to perform two or more
liposuction procedures, to ensure that
we don't remove too much fat in one session.
And compromise the safety of the patient.
Other things we do in preparation for your liposuction
include blood tests, and electrocardiogram.
Check on your heart.
You may also be given some consent
forms to take home and read.
And other paperwork.
Including your cost for the procedure and the day.
Prior to the operation, you're also
required to see one of our nurses.
Who will fit you with a garment to wear after the procedure.
As well as take your vital signs,
blood pressure, pulse rate, oxygen levels,
and make sure you're ready for your
procedure from a medical perspective.
Now we'll discuss what to expect
on the day of the procedure.
First the out procedure is held
at our accredited day surgery.
And it is day surgery.
So no overnight stay is required.
We arrange a chauffeur to pick you up from your house.
And also drop you home at the completion of the procedure.
Depending on the person, and the number
of areas treated, you may have either
intravenous sedation, or a general anesthetic.
General anesthetic is a deeper form of sedation.
Usually used for large procedures.
And intravenous sedation can be used for smaller areas.
Or smaller procedures.
It is important that you fast for your procedure.
We ask you fast for six hours.
And this includes all food and drink.
Including water.
You'll be seen for one last time by
the nurse and doctor prior to your procedure.
And this will give you an opportunity to ask
any last minute questions that you might have.
A series of before photos will be taken.
And this is important, so you can actually see
the improvements after you have your procedure.
And also, you'll be marked with
a surgical marker prIor to your procedure.
Although the procedure is performed
under sedation or anesthetic,
we still utilize local anesthetic
infiltrated into the area that we're treating.
Now this has a couple of effects.
Firstly, local anesthesia provides
some immediate pain relief.
So that the degree of general
anesthesia required is lessened.
Secondly, the local anesthetic is combined with adrenaline.
Which helps to constrict any blood vessels
in the area we're treating.
Which makes liposuction a virtually bloodless procedure.
Thirdly, local anesthetic has a bacterial static effect.
Which means that it stops infections from happening.
The liposuction procedure itself
is actually a very simple procedure.
It involves using a cannula.
Which is a fine metal rod with an aperture at the end.
Negative pressure is applied to this cannula,
which suctions fat from the body.
However, it really is the rasping effect
of the aperture on the cannula which removes most the fat.
The negative pressure simply collects the fat.
So, it's like plucking grapes from a vine.
The cannula's used basically
to make tunnels through the fat.
And to remove fine tunnels out of the body.
Now, it's done from different points,
in different directions.
So you get a cross-action effect.
Which gives you a very smooth effect.
The incisions that we make for liposuction
are actually very small.
And they're smaller than my little finger.
These heal up usually to a very fine line.
Which you can barely see.
And we endeavor to put these
incisions in inconspicuous places.
For example, the underarms.
Or, under the arm.
Or even at the edge where the nipple
meets the skin, so you can't see the scar.
During the procedure, the fat thickness,
and the skin thickness are constantly being assessed.
As well as the skin's ability to rebound.
So, we eventually reach a point,
where the liposuction is stopped.
And we've achieved a nice even result.
Where we feel that the skin will
be able to retract back and look nice and smooth.
At completion of the liposuction,
the entry points are sutured.
And the compression garment is applied.
This helps to reduce swelling
and bruising after the procedure.
As well as reduce any pain or discomfort
associated with movements after the procedure.
The garments also help the skin to retract
and move into their new position.
We generally recommend that the garment
is worn for three weeks.
And during the first week we're very strict.
We only let you take off the garment once on day three.
At your appointment.
And at day seven.
So showering is limited for the first week.
Depending on the area treated, and the person,
we often use a foam underneath the compression garment.
Now this helps add a fairer level of compression.
As well as massages the area to reduce
any bruising that might occur.
Now I'm gonna talk about what to expect after the procedure.
Now, for most people, this is the worst part.
And the most painful part.
It is quite sore after the procedure.
Quite tender.
And generally I say that the first
two days are the worst two days.
The first two days you really
require some strong pain relief.
Usually pen-ing-fort.
Or some anti-inflammatory like Voltaren.
Or Mobic.
You'll feel rather stiff moving out of a certain position.
For example, out of sitting from a chair.
Or lying in bed.
Is gonna be quite difficult.
And often, you'll need to do this slowly.
The areas that you had treated are going to be very tender.
If anyone touches those areas.
Or if you accidentally bump into something
it'd be quite uncomfortable and painful.
Usually by about one week,
you're feeling a lot better though.
And you're able to resume,
sort of light activities like walking.
Or going back to work.
Over the next two to three weeks,
you'll have some residual stiffness and soreness.
And the areas that you have treated might feel quite numb.
The numbness can persist sometimes for some months.
But this is quite normal.
And nothing to be alarmed about.
Some people may experience some
hardening of the fat in the treated areas.
And this is also very normal.
And this can also persist for some time.
Usually most people will be able to return
to their full exercise regime after about three weeks.
In terms of postoperative appointments,
we see all out patients on day three.
Where any foam's removed.
And we also perform a manual emphatic drainage massage.
This helps to reduce any swelling
and discomfort from the area.
On day seven, you also come see us.
And on this day, we'll do another
manual emphatic drainage massage.
As well as remove any sutures.
So now for the exciting part.
When do you see the results?
Often you can see the results immediately after liposuction.
The area will feel smaller and look smaller.
However usually the skin hasn't had time to retract
at this point, so the skin may appear a bit loose.
After three days you see a even better result usually.
And you get a sneak peak of this when
we remove your garments on your review appointment.
After about another week, sometimes swelling
kicks in and masks result.
So you still see the result, but the area
might be a bit more swollen than it was on day three.
In the end, the best results are seen
usually from three to six months after procedure.
This is the time where the skin
has had more time to retract.
And tighten.
The swelling has usually completely gone by this time.
Any firmness or hardness that may
have occurred is usually gone.
And any residual fat that was in
the area treated has now also gone.
Finally, we'll move on to the last part of our video.
Which is discussing the complications
associated with liposuction.
Now all surgical procedures have
a particular risk and benefit.
We obviously assess you for these benefits
and risks prior to the procedure.
So, before we even go into procedure,
we know that you're gonna be a good candidate.
And a suitable candidate for the procedure.
Although this reduced the rate of complications,
it is still important to understand the potential
risks of the procedure before going ahead with it.
I like to separate the risks
of the procedure into two categories.
Firstly, cosmetic risks.
Where you might not be happy with the end result.
And usually these are amenable to correction.
And the other category of risk
is the medical or surgical risk.
And these are common to any procedure
that you might have done, not just liposuction.
Firstly we'll talk about the cosmetic complications.
Although the vast majority of our patients
are extremely happy with their procedure.
And it makes a huge impact on the way they
feel about their body and their confidence.
It is still important to understand that
cosmetically, sometimes it is possible to have some
irregularities or unevenness with your liposuction.
We always aim to perform a very smooth liposuction.
And we always consider the ability
of your skin to retract when we're doing the liposuction.
Asymmetry can also occur from left to right.
And this is correctable with
a further liposuction procedure.
It's also possible to have too much fat taken out.
Or to little fat taken out.
Now both of these are considered as complications.
As the patient may not be happy with the end result.
In the case of too little fat being taken out,
this can be easily remedied by having another procedure.
In the case of over liposuction, which I believe
is a worse case scenario than under liposuctioning.
Fat may need to be replaced in the area.
By, say grafting from another area, back into that area.
Finally, sometimes fat can redistribute in areas
which are not favorable to you.
For example, after an abdominal liposuction,
fat may redistribute into the hips.
Or the hips may appear proportionately
larger than the abdomen.
So really what is required here is pre-planning.
To make sure that we target all areas
that are out of proportion.
And make sure we treat them all without
missing one or two areas.
Other things that may occur, and this might
not be a complication for everyone.
Far sometimes can redistribute to the breasts.
And increase breast size.
Now I'm gonna talk about the surgical
and medical complications of liposuction.
Firstly, the anesthesia.
Now, although modern anesthesia is extremely safe.
And usually we equate the risk
of anesthesia to the risk of driving a car.
There are sometimes problems with breathing.
Or airway problems that may cause problems with anesthesia.
There are also rare surgical or medical
complications like infection.
Which can be very serious.
This is a very unusual complication.
Seroma, or a collection of fluid
in the areas treated, is also another complication.
It's very unusual nowadays with modern compression garments.
Which basically push the area together.
And prevent any fluid from accumulating underneath the skin.
If it does occur, usually a drainage procedure
needs to be performed to get rid of the fluid.
Worse than expected scarring is another
complication that can occur.
In most cases, patients have just
a fine white line where the wound is healed.
But, in unusual cases, in particular those
who are prone to keloid scarring,
or the formation of excessive scar tissue,
there may be a lump or a larger scar than expected.
And this often requires treatment with
an injection of corticosteroids into the scar to flatten it.
Other complications that may occur during the procedure
include toxicity to the local anesthetic we use.
This is unusual.
And we are very vigilant on how
much local anesthetic is used during each case.
Also we always ask patients who are
on particular medications which inhibit
the breakdown of these local anesthetics,
to come off them, usually two weeks before.
Or reduce the dose of local anesthetic accordingly.
The amount of fat that is removed
also has to be carefully considered.
We have to be aware that taking out too much
fat can cause a loss of circulating volume.
Which can lead to a feeling of being faint.
Or collapse at worse case.
And this may require hospitalization
to replenish the body fluids.
Overall, liposuction is a very safe procedure.
And we perform a lot of these procedures each year.
One of the things I love about liposuction
is the results that I see in patients after their procedure.
They often can go to the beach
where they wouldn't have normally.
Or wear clothes that they wouldn't ordinarily wear.
It makes a huge difference to people's self-esteem.
Their confidence.
And how they feel about their body shape.
(upbeat music)