Non-invasive fat removal
Fat removal and body contouring are increasingly popular and many clinics offer non-invasive treatments such as fat freezing, mesotherapy and muscle toning devices alongside more traditional liposuction.
Unlike liposuction, these treatments use methods to reduce fat without the need for surgery. No anaesthetic is required and the treatments generally target smaller areas than liposuction. Recovery time is minimal and patients can generally return to normal activities immediately.
Tumescent liposuction is one of the most commonly performed medical aesthetic procedures in the UK and United States. The tumescent technique allows liposuction to be performed under local anaesthesia, minimising blood loss and the risk to the patient of a general anaesthetic.
In recent years, various devices have emerged to complement traditional liposuction including vaser liposuction, laser liposuction, MPX laser and body jet liposuction. There is no robust clinical evidence to suggest any are better or safer than others, and most modern forms of liposuction are considered safe and effective when performed by an expert doctor or surgeon on properly selected patients.
BCAM is not in a position to recommend any devices and encourages patients to discuss their treatment with a BCAM doctor who will be able to offer recommendations based on what is desired and achievable.
Liposuction is not a replacement for a healthy diet and exercise but can be used to effectively slim down stubborn fat in various areas of the body including the abdomen, thighs, knees, love handles, male breasts, chin and neck.
There is a limit to how much fatty tissue can safely be removed in one session depending on the patient’s weight, general health and body fat percentage. There is also a limit to how much local anaesthetic (Lidocaine) can be used in one treatment.
The following general information applies to all the various tumescent liposuction techniques, with or without the use of additional devices as mentioned above.
Tumescent liposuction is generally performed for the reduction of focal adipose accumulations that are unresponsive to diet and exercise. There are forms of liposuction used for specific purposes, such as micro-canula liposuction for breast reduction as an alternative to traditional breast reduction surgery.
Other conditions that may benefit from tumescent liposuction include lipoma removal, axillary hyperhidrosis (excessive sweating), lipodema, evacuation of haematomas and staged liposuction for patients who are obese.
Patients must have realistic expectations about the outcome of treatments and should be in good physical health. A healthy well-balanced diet is important in maintaining the postoperative results as well as in ensuring excellent healing during the convalescence. Crash diets immediately prior to the consultation in order to be considered as a candidate for surgery may increase the risk of complications as a consequence of electrolyte imbalances or nutritional deficiencies.
The physician should be confident that patients’ motives are well-founded and that the discontent with their physique is not due to mental health issues or general unhappiness caused by other problems.
Some patients have tried to diet many times in their life but tend to regain the weight. Not uncommonly, patients who undergo liposuction notice that their appetite decreases for several months postoperatively. This decreased appetite can provide the impetus for the patient to protect his or her investment by not overindulging in the future.
- Unrealistic patient expectations
- Poor physical health of patient
- Morbid obesity (there is a higher risk of mortality from fluid shifts)
All patients should have a pre-treatment consultation where their medical history is explored in detail: medication intake; medication allergies; prior surgeries and results, including scarring; history of medical diseases, especially bleeding diatheses; personal and family history of cerebral vascular events; phlebitis; seizures; myocardial infarctions or angina; congestive heart failure and hepatic disease all should be discussed. The patient’s goals should be explored, and a realistic outcome should be discussed.
Explanation of the procedure, its risks, alternatives, benefits, and convalescence should be fully explained, and questions should be answered.
- These treatments are performed on an outpatient basis, taking only a few hours, and the patient can return home the same day
- Returning to normal activity is possible within a few days for most patients
Common and expected side effects include swelling, bruising, post-treatment discomfort and leakage from incision wounds.
Complications of liposuction performed with a tumescent technique are minimal. The most significant complications have been attributed to concurrent sedation or general anaesthesia or fluid shifts secondary to large volume liposuction (more than 5 litres).
Reported complications include infection, irregularities, seromas, haematomas, burns, scars, temporary skin hypersensitivity and/or numbness, hyperpigmentation and contact dermatitis.
Questions to ask your BCAM doctor
- Am I a suitable candidate?
- What type of treatment do you recommend and why?
- What training have you had?
- How many treatments have you performed?
- What can I expect during and after the treatment?
- What side-effects am I likely to experience and what do you recommend to manage and help with these?
- What complications have you experienced with your patients and how many?
- How have you managed these complications?
- What are the post treatment guidelines?
- What follow up do you recommend?
- Where do you perform this treatment and is the premises CQC registered for the treatment?
- What out-of-hours arrangements do you have?
- Can I see before and after photos of patients you have treated?