The effects of liposuction on the face and body and how to fix pain, downtime risks and failures

Liposuction to reduce subcutaneous fat and aim for partial thinning

Aesthetic medicine to remove fat includes a “cutting” procedure that involves an incision in the skin and a “non-cutting” procedure that uses a machine or drug. is one of the surgical procedures in which the is inserted into the subcutaneous fat and the fat cells are aspirated (removed) .

Non-cutting treatments using machines and drugs basically aim to reduce fat by damaging fat cells and promoting metabolism, rather than directly removing fat. Therefore, multiple treatments may be required to obtain a sufficient slimming effect.

On the other hand, liposuction is a surgical procedure that physically removes fat cells, so it has an immediate effect and can reduce fat in a short period of time .

There are various types of liposuction such as "VASER Lipo", "Smartlipo", "Lipomatic", "Aquicell", and "Body jet", depending on the medical institution. it's different.

Subcutaneous fat is reduced by liposuction

There are two types of fat: “visceral fat” that adheres to the internal organs and “subcutaneous fat” that you can pinch with your fingers. Visceral fat is located under the muscles and cannot be removed by liposuction. Liposuction can remove the subcutaneous fat that is above the muscles and affects the appearance of the body line .

Women tend to have more subcutaneous fat than men, and men tend to have more visible visceral fat than women.

Liposuction is a surgery to improve appearance, not to lose weight

I sometimes hear people say, "Even though I've had liposuction, my weight and body fat percentage haven't changed that much." Subcutaneous fat has a lower density and a lighter specific gravity than water, so liposuction does not have a large effect on body weight or body fat percentage, which indicates the percentage of fat contained in the body.

For example, removing 1,000cc of subcutaneous fat will not result in a weight loss of 1kg. The purpose of liposuction is not to lose weight, but to remove fat and improve the appearance, so the weight does not change significantly, but the appearance changes as the fat in the treatment area decreases .

Unlike dieting, liposuction that is difficult to rebound

Dieting by exercise and dietary restrictions aims to reduce the size of fat by storing excess triglycerides ingested in meals and reducing the size of fat cells that have grown larger.

Neutral fat stored in fat cells is used and consumed again as energy when the body lacks the energy necessary for physiological functions.

Therefore, by going on a diet such as exercise and dietary restrictions, the stored neutral fat is released and the fat cells can be expected to shrink, but the number of fat cells itself does not decrease, so dieting makes the fat cells smaller. However, when the amount of exercise decreases and the amount of food increases, triglycerides may be stored again and become larger. This is the "rebound".

After liposuction, the remaining fat cells may grow due to lifestyle habits such as overeating and lack of exercise, but the fat cells once removed by suction will not return to their original size . With liposuction, the fat cells in the subcutaneous fat are sucked out and removed, so there is little chance of rebound.

Amount of fat that can be sucked at one time with liposuction and treatment area

In liposuction, in order to aim for a beautiful finished body line, we will leave the fat that should be left in consideration of the balance of the original body shape and the texture such as skin firmness and elasticity. Therefore, it does not mean that the more the amount of fat that is sucked, the more beautiful it will look.

Also, removing too much fat at once puts a strain on the body, so the amount of fat to be sucked in one treatment is said to be about 3,000cc to 4,000cc . However, since the way fat is attached differs depending on the part, the amount of fat to be sucked differs for each part , such as 30cc to 90cc for facial treatment on the cheeks and chin, and 1,000cc to 3,000cc for areas with a lot of fat such as the abdomen and thighs . .

Areas that can be treated

• cheek
• chin
• upper arm
• back
• waist
• waist
• upper abdomen
• lower abdomen
• buttocks
• Outer and inner thighs
• above the knee
• Calf

Due to the large amount of fat, if it is necessary to suck more fat than can be sucked in one treatment, the treatment is divided into multiple treatments. In that case, considering the burden on the body, we will leave a period of about 2 to 4 weeks.

However, it is possible to treat multiple areas at the same time, such as the upper arm and abdomen, as long as the amount of fat can be suctioned in one treatment .

Those suitable for liposuction

• Those who have more subcutaneous fat than visceral fat
• Those who want to change their appearance with one treatment
• Those who want to reduce partial fat such as chin and arms

Since liposuction is a surgery to reduce subcutaneous fat, it is not suitable for those who want to improve excessive visceral fat or those who want dramatic weight loss with a single treatment.

Those who cannot undergo liposuction surgery

Those with pre-existing illnesses or diseases
If you have a medical condition, you may need approval from your primary care physician.

Also, if you have severe diabetes or have kidney or heart problems, you may not be able to undergo liposuction.

Those who may be pregnant or who are pregnant
Since the anesthesia used during surgery may affect the mother's body, those who may become pregnant or who are pregnant cannot undergo liposuction.

Cannula and anesthesia to reduce physical burden and pain

After the procedure, symptoms such as swelling and internal bleeding may appear. The period until the symptoms subside and return to the original state is called "downtime", but it is not necessary to rest during this time.

Compared to the time when liposuction was first established, post-operative pain can be suppressed by devising cannulas and anesthesia. It can also make scars less noticeable.

cannula for liposuction

In the latter half of the 1970s, Dr. Illouz and Dr. Fournier of France devised a liposuction method using a cannula, and until about 20 years ago, the same size cannula used in Europe and the United States was used in Japan. was

After that, thin cannulas were made to match the physique of Japanese people, and now there are more types of lengths, shapes, and thicknesses, and treatments are performed with cannulas that match the site to be suctioned and the depth of the fat layer .

The cannula for suction is generally around 5 mm in thickness (diameter), and there are various types depending on the length and shape. the doctor will choose appropriately.

In liposuction, even a few millimeters difference in the thickness of the cannula used can significantly change the conspicuity of the post-surgery scar. There are also medical institutions that use as many cannulas.

Tumescent solution, a mixture of hemostatic and anesthetic agents

The "Tumescent Technique" developed by Dr. Klein in the United States in the 1980s made it possible to perform liposuction with reduced bleeding.

Tumescent technique (Tumescent method/wet method) is a method of injecting Tumescent solution, which is a mixture of physiological saline, hemostatic agent, and anesthetic (lidocaine), into the treatment site before performing liposuction. Tumescent solution has the effect of softening fat, suppresses bleeding and acts as a local anesthesia .

By diluting the anesthetic lidocaine and injecting it, a large amount can be safely used, and the fat layer swells evenly, making it easier to check the fat layer .

However, the anesthetic solution also causes swelling after surgery, so in general, immediately after surgery, a nurse manually squeezes out the remaining anesthetic solution from the surgical site.

Furthermore, after that, the surgical site is compressed and fixed, and after waking up, the anesthetic solution is squeezed out again before returning home, which is said to further reduce postoperative swelling.

anesthesia used in liposuction

In some cases, the operation is performed only with local anesthesia by the Tumescent method, and in some cases, other anesthesia such as intravenous anesthesia or general anesthesia is used together with the Tumescent method.

Risks/failures of liposuction and how to correct them

risk of liposuction

Liposuction has a great fat reduction effect that can be felt in a single procedure, but since it is a surgical procedure, there are risks and side effects. Even in these days when safety has improved due to advances in medicine and surgical methods, there is still a possibility of life-threatening serious risks and complications depending on the knowledge and experience of the doctor in charge.

Liposuction has the following risks, but it can be said that these risks can be reduced by the doctor's experience .

Risk of anesthesia trouble

In particular, general anesthesia puts a heavy burden on the body, so there are cases of dizziness and nausea after the anesthesia wears off. In addition, the wrong amount of anesthesia or the use of an anesthetic that does not suit your body may cause shock symptoms or allergies .

risk of injury to internal organs

If the number of cases of liposuction is small and an inexperienced doctor is in charge, the internal organs may be damaged during liposuction in the abdominal surgery.

Risk of causing fat embolism

If a blood vessel is damaged during surgery and fat enters the blood vessel, it may cause an embolism. Pulmonary embolism, cerebral embolism, and ocular artery may lead to blindness due to fat-filled blood vessels.

risk of infection

Although it is usually unthinkable, if you undergo surgery at a medical institution that has problems with hygiene management such as reusing medical instruments, there is a risk of bacteria entering and causing an infection when incising the skin and inserting a cannula. there is.

Risk of heavy bleeding

If hemostasis is not done properly or blood vessels are damaged, anemia and shock symptoms due to excessive bleeding may occur. There is also the risk of blood pooling in the body and forming a hematoma .

Liposuction failure and how to fix it

If the design is not as desired, such as "the finish is unnatural" or "there is a left/right difference," or if the skin has become uneven due to uneven removal of fat, revision surgery is required to correct it.

Some medical institutions accept corrections for failures such as irregularities in the skin caused by liposuction in the past, even if it was a case of another hospital. However, if the desired result is not achieved or the effect of fat reduction is not felt, it is necessary to consult with the medical institution where the surgery was performed.

Unnatural lines, unevenness, left-right difference, fat leftovers

Since the ease of liposuction differs depending on the part, liposuction is performed while being careful not to make it look unnatural by sucking as much as possible in the easy-to-suck part. In addition, the upper arms, waist, thighs, etc. may be asymmetrical from the beginning, so the treatment is performed considering the balance.

If there are still unnatural lines, left-right differences, or unremoved fat, the fat collected from another part is injected or liposuction is performed again to adjust it.

leave a scar

The incision for inserting the cannula is made in an inconspicuous position, such as the upper arm or the base of the thigh, overlapping skin wrinkles. In the unlikely event that the scar is conspicuous even after 6 months after the surgery when the swelling and swelling subside, improvement can be expected with other cosmetic treatments that make the scar less noticeable.

too much fat

Excess fat cannot be replaced and can cause sagging skin. If too much fat has been removed and the line has collapsed and the skin has sagged, we aim to improve it by injecting fat collected from another part .

In addition, if sagging skin is expected in advance by aiming for the desired body line, surgery to remove sagging skin is considered.

leftover fat

Immediately after the treatment, swelling and swelling make it difficult to see the treatment effect. After about 3 months, when the swelling subsides, it will be confirmed, and if it is determined that there is leftover, liposuction will be performed again .

Cost of liposuction

Liposuction is not covered by insurance and is self-funded.

The price of liposuction varies depending on the medical institution, but the market price is about 200,000 yen to 400,000 yen per treatment site . However, the items included in the cost differ depending on the medical institution.

For example, after surgery, it is necessary to compress and fix the treatment site with a bandage or supporter . Please check with each medical institution about what is included.

Also, if you want to treat the entire abdomen, you may have to perform 3 parts, upper abdomen, lower abdomen, and waist, in which case it may be counted as 3 parts.

Flow of liposuction procedure

Some medical institutions recommend hospitalization if there is a large amount of fat, but more and more medical institutions are offering day care to meet the needs of those who find it difficult to take time off or who wish to undergo treatment in a short period of time.

Precautions before operation

• Refrain from eating and drinking water before the procedure.
• Due to anesthesia, I cannot drive a car after surgery, so I will use transportation to go to a medical institution.

General procedure on the day of surgery

Precautions after surgery

On the day of the procedure, you will be relaxed and calm. If it is desk work, it is possible from the next day. Work that involves physical activity should be checked with the doctor during the examination on the third day.

Refrain from strenuous exercise, drinking alcohol, and stimulating the affected area for about a week after surgery.

You can take a shower from the day of the surgery, but you can take a shower in the areas other than the area where the pressure is fixed because the pressure fixation will be continued for 3 days after the surgery. After the examination on the third day, the pressure fixation can be removed when showering, so you can take a full-body shower.

In the case of facial liposuction, makeup can be applied from the next day or two days after the surgery.

Post-surgery progress/downtime and how to spend it

The ★ mark on the table indicates the timing of hospital visits, but the above schedule is for reference only, and the actual progress may vary from person to person. Please follow the instructions of the medical institution undergoing surgery regarding the actual hospital visit schedule and how to spend time after surgery.

Immediately after surgery, swelling and swelling may make you look fat temporarily, but as the days pass, the swelling and swelling will subside, and you will be able to feel the effect of slimming and slimming your face.

Pain after liposuction surgery

There are individual differences in pain after the anesthesia wears off.

In addition, the degree of pain varies depending on the area to be treated, and it is easy to feel pain in a wide range of areas such as the thigh and abdomen, and there is pain similar to muscle pain. It is said that you are more likely to feel pain when your body vibrates, such as when you stand or sit, walk, or go up and down stairs, so you need to give yourself more time than usual to perform each movement.

However, in addition to devising cannulas and anesthesia, surgery using the latest equipment can be performed without damaging the fibrous tissue around the fat, so it is rarely accompanied by pain that makes it impossible to walk.

Since the way pain is felt varies from person to person, some people may go to work the next day if they have a job that does not require much physical movement, such as desk work, but depending on the extent of the treatment and the amount of fat, rest at home for a few days. Some medical institutions recommend it. The pain peaks for 2 to 3 days, but gradually changes to mild pain .

Post-surgery massage and stretching

Although it is necessary to rest immediately after surgery, it is recommended that self-care massage be performed from about 3 weeks after swelling and pain subside.

After surgery, a phenomenon called "contracture" occurs in which the skin becomes stiff as if it were pulled by cells that are not accustomed to the state where some fat is gone, but it is expected to be reduced by massaging. I can do it.

When massaging, pinch and pull the unevenness of the skin to loosen the skin. Stretching, which gently pulls the skin and stretches it out, is also effective. Neglecting to massage can leave your skin feeling stiff and uneven.

Compression fixation after surgery

Compression immobilization is performed for 3 days after surgery , and from the 4th day, compression immobilization is performed except when showering . After that, it is recommended to continue for about 1 month after surgery to prevent swelling .

Items that perform pressure fixation may be prepared by medical institutions, or you can purchase commercially available items yourself. For liposuction around the face, there is a face supporter, an inner type for the upper body, a waist nipper for the waist, and a girdle type for the thighs. .

If you are going to buy one for yourself, it is a good idea to consider the ease of putting it on and taking it off so that it does not interfere with your daily life, such as choosing a garter belt instead of stockings to compress your thighs.

Correct compression and fixation leads to prevention of skin irregularities and skin rashes that cause pigmentation, so be sure to check how to do it at a medical institution.

Good treatment for post-surgery maintenance

Liposuction and Indiva or Endermologie

There are “Indiva” and “Endermologie”, which perform high-frequency treatment, to relieve the contracture that causes the skin to harden after liposuction. As post-surgery care, some medical institutions offer plans that include Indiva and Endermologie treatments in advance.

By irradiating and warming the sucked area with high-frequency energy, which is the energy of electromagnetic waves, INDIBA can be expected to reduce internal bleeding, swelling, swelling, pain, stiffness and unevenness of the skin after liposuction. It is also used for scar recovery.

Endermologie is a treatment method that uses a roller to loosen fat, and can be expected to have the effect of softening hardened fat . It regulates blood circulation and lymphatic flow, increases metabolism, and discharges waste products, so it can be expected to be effective in alleviating swelling.

Both Indiva and Endermologie are performed about 3 weeks after the liposuction surgery, after the swelling and pain have subsided.

How to distinguish between a “good doctor” and a “suitable doctor”

The results of liposuction are highly dependent on the skill of the individual doctor. It goes without saying that the machine used for liposuction is used properly, but the most important thing is how many cases we have accumulated.

Cases with large changes look good, but it is not limited to such cases, but asking a doctor who presents many cases of various body types is the best way to meet a "skilled doctor". It is important.

In addition, it is important to always judge with your own eyes and feet. The amount and reputation are hints for choosing a medical institution, but it is not always the case that a medical institution with high reviews and high ratings will perform the treatment you want. In order not to regret after surgery, visit multiple medical institutions and check if there are any problems with the following.

1. Is it possible to receive satisfactory counseling ?
2. Do you listen to your wishes properly , not just the recommended treatment of the medical institution?
3. Is there a clear explanation of not only the benefits of the treatment but also the risks and side effects ?

Also, please understand and agree with the correction method in case of failure before undergoing liposuction.

Related article

• Effect, downtime and risk of Vaser liposuction that aims to reduce fat on the face and arms

Mods Clinic Liposuction

Dr. Hirofumi Nagano, who supervised the article, taught me about liposuction.