Liposuction

Liposuction is one of the most requested types of cosmetic surgery, but it's also possibly the least understood.

What is it?

A way of permanently removing pockets of stubborn fat from areas such as the hips, thighs and tummy.

What can it do for you?

It'll make you look thinner, but it's not really meant to be used to lose weight.

Liposuction is a way of re-proportioning the body - if, say, you've got a very pearshaped figure - or a way to remove areas of stubborn fat that won't disappear with diet or exercise.

It's also important to realise that it not only can't remove cellulite, it may even make it worse.

The procedure

First you'll stand in front of the surgeon, who'll mark exactly which areas of your body will be targeted. The procedure is usually carried out under general anaesthetic.

In a liposuction operation you make a number of small nicks in the skin

You then introduce a fluid containing local anaesthetic and adrenaline into these - this fluid helps make it easier to extract the fat, but is also designed to improve recovery.

In this 'wet' liposuction, the adrenaline reduces bleeding and bruising while the local anaesthetic makes things less painful in the days after the surgery. Once the fluid is in place, the surgeon introduces a tube called a cannula and uses this to break up the fat, which is sucked out with a vacuum pump or syringe.

This used to be quite a brutal process, with the surgeon using the cannula to physically churn things up. Now surgeons have thinner cannulas, which are less destructive, and can also use ones that emit ultrasound waves (known as ultrasound-assisted lipoplasty) to release fat from the cells.

Cost

Major liposuction normally costs about £6,000.

Recovery time

Liposuction makes you feel as if you've been kicked by a horse - you'll be bruised and in pain for at least two days after surgery.

After this, exactly how long it'll take to recover depends on how much fat has been removed and where it's come from.

You'll probably be up and about in a few days, but from seven to 10 days off work are recommended. You'll be bruised for up to a month after surgery and you'll have to wear a support garment day and night for two to three weeks to minimise postoperative swelling.

However, it can take up to six months for all the swelling to disappear, and only then will your new shape be completely revealed. You'll also be left with tiny scars where the incisions were made.

What can go wrong?

This type of liposuction is most definitely major surgery, so there are the usual risks associated with a general anaesthetic as well as the risks of infection and deep vein thrombosis. People have even been known to die as a result of liposuction surgery, though this is extremely rare.

The most common problem is patients being unhappy with the results.

If you've got a really perfectionist surgeon, up to 40 per cent of operations need a touch-up to ensure perfect symmetry and a clean result. On average, one in 10 liposuction surgeries are redone.

Lipo doesn't get rid of cellulite because the fat is removed from deep in the body, whereas cellulite is caused by fat just under the skin.

In fact, it can make cellulite appear worse as it's more noticeable when you're thinner.

Finally, if your skin has been stretched by pregnancy or other weight gain or is low in natural elasticity because of age or skin type, it might not snap back properly over the area and could end up looking saggy.

How long does it last?

It's permanent - in the areas where the fat has been sucked out, at least.

Once you reach adulthood, you don t make new fat cells. You gain weight because the ones you have enlarge.

If those cells have been removed, they can't plump up - but it doesn't mean you cant gain weight elsewhere. It's very important to control your weight after liposuction.

Experts

Adam Searle, 82 Portland Place, London (020-7637 8008), is currently president of the British Association of Aesthetic Plastic Surgeons (BAAPS).

• Nick Percival, 55 Harley Street, London (020-8735 6060) is on the council at BAAPS.

• Adrian Richards, AR and Associates (0800 3285743, www arandassociates.com).

• Simon Withey London Plastic Surgery Associates, 30 Devonshire Street, London (020-7908 3777, wwwlpsa.co.uk).

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