Liposuction or liposuction is a surgical technique consisting in the extraction of fat from the subcutaneous cellular tissue of the skin by means of cannulas connected to a vacuum system that literally sucks it out. It is a technique that uses incisions of a few millimeters in the skin through which the cannula is introduced in the anatomical places where fat accumulates producing unaesthetic adiposities.
Liposuction can be performed on any part of the body, including the abdomen. Unlike abdominoplasty, abdominal liposuction does not involve large incisions, nor does it detach the skin of the abdomen, nor does it remove excess skin, nor does it act at the level of the SMA (muscular aponeurotic system) or the navel. It is a more conservative technique, less invasive, it acts at a more superficial level, on the skin, tangential to the underlying muscular plane, with little postoperative discomfort, a very fast recovery for the patient and with hardly any scars. Liposuction models or sculpts the figure acting only on the fat of the skin, hence the name “liposculpture”.
Elasticity and skin retraction: key aspects for liposuction.
Liposuction is a technique that cannot be generalized to all patients presenting obesity or excess body fat. The quality of the skin and its degree of elasticity and retraction must be carefully evaluated. When the skin is elastic, of good quality, without stretch marks or scars and the anatomical area allows it, liposuction can be considered, because after the emptying of the fat, the adipose panniculus of the skin remains hollow, excavated by numerous tunnels carved by the cannula that must then be occluded, flattened by the elasticity of the skin and by the help of an external compression exerted by an orthopedic girdle.
In this way, in the specific areas where work has been performed, the skin is significantly reduced in thickness and the patient’s silhouette is molded. If the skin is not elastic or is frankly deteriorated, as happens when there are many stretch marks, the skin will not retract, and in this case the situation results in a sagging skin that is even more unsightly. Therefore, when there is sagging and redundant skin, for example, after pregnancy or after significant weight loss, liposuction is contraindicated and other surgical techniques must be used.
For which patients is it indicated?
Liposuction is indicated for people who present localized accumulations of fat in very specific areas, with healthy skin and good elasticity. It is frequent that in young women these accumulations occur in a constitutional way, especially in the lower limbs. At this level, they are characteristically located in the trochanteric regions (“cartridge cases”), on the inner sides of the thighs and knees (they rub when walking). They also tend to appear on the flanks (waist area) and in the abdomen at the periumbilical level.
In men, most of the time liposuction is performed on the trunk, due to excess fat in the abdomen and flanks. And in certain cases, abdominal liposuction can be complementary to an abdominoplasty to finish reshaping the abdomen in the same surgical act.
Risks and complications
Like all surgical techniques, liposuction has its specific risks. Commonly, it is a type of surgery that lends itself to intrusion because it tends to be trivialized since it acts internally in the deep layer of the skin without leaving external scars. Every day there are more and more people who perform it without being surgeons and this is the main risk.
From time to time there is news of a patient who has died after undergoing liposuction. The problem is not in the technique itself, but in the professional who performs it. It is essential to have a sufficient degree of experience before venturing to perform this surgery, because here we work in a closed field without seeing what is being done, the surgeon’s eyes are his hands, which at all times must control the tip of the cannula that is acting under the skin to avoid perforations of internal organs, which initially go unnoticed but undoubtedly derive a serious risk to the patient’s life.
Apart from this medical-legal observation, liposuction should never be performed on patients who have excess redundant skin because it aggravates the sagging and in general, in those types of skin of poor quality, with stretch marks and without elasticity because it will not produce the necessary retraction of the skin to reconfigure the silhouette.
It is very important to evaluate these aspects in particular when it comes to abdominal wall surgery, in order to know how to choose the most appropriate surgical technique, since sometimes there are intermediate situations, which lend themselves to confusion in which liposuction is ill-advisedly indicated instead of abdominoplasty, with the consequent failure in the result.