Lipectomy means removal of fat by surgery. In lipolysis, the surgeon loosens and removes the fat from an area by using long or short metal tubular instruments connected to a suction machine . The suction tubes are usually made of stainless steel. The tips are blunt. The tubes have 1 to 5 holes near the tip on one side or on different sides. The suction machines used for this purpose create very powerful negative pressures (1 torr to 35 torr at sea level). Lipolysis was started in France in late 70's and since 1981 is in practice in the United States and other parts of the world.

Fat collections of the Hips, Thighs, Buttocks, Abdomen, Arms, Under the Chin, Upper Torso, etc., can be reduced by this procedure.

Can one's weight be reduced by this operation? Who is a good candidate for Lipolysis? Lipolysis is neither a substitute for dieting, nor a cure for obesity. Persons with reasonably normal weight and healthy elastic skin with extra localized fat in certain areas, get the best results from this procedure. (Healthy elastic skin has the capacity to shrink after the surgery). Even though Lipolysis can be done on patients upto 40 to 50 years of age, it is not normally done if the skin is loose in the particular area. One could have loose skin after losing a lot of weight or after the pregnancy or due to ageing. In these patients, in addition to Lipolysis, some of the skin should also be removed, to get a satisfactory contour.

A case of liposuction
Before operation		After operation

The fat cells that are removed are removed for ever and do not come back again. Most of the fat cells are situated under the skin. A total number of fat cells present in a person's body does not increase as one grows older or when one gains weight. When a person gains weight the size of the fat cells increases as more fat is being deposited in it. When one loses weight, the fat is mobilised out of the fat cells and so these cells become smaller in size. Only liver and skin have the capacity to regenerate in the human body. Fat cells cannot regenerate or multiply. And so, the fat cells that are removed are removed for ever.

Surgical Procedure :

A small cut about 4 mm to 10 mm is made, a few inches away from the area to be suctioned and the suction cannulae are inserted. The cuts are usually made in the skin folds and so, the scars are not much noticeable. Depending upon the areas to be suctioned and recontoured or reduced, anywhere from 600 gms to 6000 gms of the material is removed in one sitting - If more material is removed blood transfusions may be required.

After The Surgery :

After the surgery, snug or tight dressings will be applied for 5 to 8 days to promote the shrinkage of the skin and to minimize the swelling. In most instances one is required to wear a support or a girdle for several weeks or months during the healing time. One could feel localized areas of hardness or firmness in the suctioned areas for 1 to 4 months after the surgery.

One may require oral pain medication for one to two days after the surgery. During the healing period, numbness or discomfort could be present for a varied periods of time. After the surgery, there will be swelling in the areas of the surgery. Even though most of the swelling has gone in the first 2-3 weeks, it takes 2-4 months for all the swelling to be gone. Discoloration could last upto several weeks after the surgery.

Even though the patient is required to stay only one day in the hospital, one should stay within the close reach of my office for about 10 days, for follow up care. Even after multiple area lipolysis one should be able to be up and around in 1 to 2 days and back to most of the normal activities in 10 to 14 days.

Results :

Results depend upon the expectations of the patients and the amount of fat that is suctioned from the given area. Usually patients with good elastic skin and who come for recontouring a particular area are very happy. Older patients and patients with over weight could be unhappy. Perfection and symmetry are not possible in every patient. Also in some patients, all unwanted fat cannot be removed in certain areas in the first sitting. On these patients, the lipolysis may have to be repeated. But, a second lipolysis cannot be done until all the swelling is gone from that particular area (i.e. about 4 months)

On rare occasions, rippled or uneven skin or areas of loose skin could result from this surgery, which might require further surgeries to correct them.