BODY PROCEDURES
Liposuction
Tummy Tuck
LIPOSUCTION
Liposuction
Liposuction is a form of treatment to firm and refines the skin, improving its contour and shape.
We can use liposuction to treat any areas of the body that carry unwanted excess fat including the hips, abdomen, buttocks, upper arms, breasts, and neck. We would only recommend using liposuction to remove localized areas of fat; it is not the right course of treatment for losing large amounts of weight or cellulite.
The Procedure
The procedure relies on the active removal of fat and then the passive process of the skin shrinking back to give the reduced and improved contour. It is therefore dependent on the ability of the skin to shrink back. This ability varies depending on the area treated the quality and elasticity of the skin and the age of the patient. The hips are an excellent area to treat. Other good areas are the tummy and thighs. 
A maximum of 3 liters of fat can be removed at one operation. Small 3-4mm incisions are used to access the fat and when healed are hardly visible. A suction device using long blunt 2-4 mm cannulas removes the fat.
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Incisions
We try to ensure all incisions are small and when possible hidden in a skin crease.
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Scars
These scars are small and tend to heal very well. Although a little pink initially in the first few weeks they then fade to white. Most patient's scars will heal well and will form extremely good quality scars over time. The length of time will vary for each individual patient.
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Smoking
If you are a smoker, try and stop for a minimum of five days before and after
surgery as it can reduce the chances of complications.
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Length Of Surgery
The Operation takes 45 minutes - 3 hours depending on the areas to be treated.
This can be done under local anesthesia though it is usually by general anesthesia.
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Length Of Stay In Hospital
Depending on recovery, patients can be discharged on the same day as day
surgery or spend a night in the hospital.
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Dressings And Stitches
You will have small stitches and water-resistant dressings on the incisions.
The area treated will usually be taped up and an elastic garment applied
immediately after the procedure. You will need to wear the pressure garment
day and night normally for 4 weeks.
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Post-Operative Instructions And Recovery
Day 1 You should be taking it very easy! Relax in the hospital or at home.
Day 2-5 You can be up and about but you may be in some discomfort.
Day 5-14 Your stitches will be removed and most of the swelling and bruising will settle over this next week. You will be feeling much better from here onwards. You can start exercising gently and build it up over the next 10 days. Whilst people vary in recovery, most patients are very comfortable at one week and feel stiffer than in pain. Recovery will depend on the size of the area treated.
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Time To Exercise
Patients usually feel able to walk a distance at 3 days and swim gently by 10-14 days. Strenuous exercise (aerobics etc) should be avoided for 3-4 weeks, contact sports for 6 weeks.
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Final Outcome
Although results will be noticeable immediately, you will continue to see improvement over the first three months.
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Follow Up
The team will check your wound and remove stitches dressings on day 5-7. You will then have an appointment at 1 month and then at 3 months.
Potential Complications With Liposuction
This is a routine operation that is a great success for the vast majority of patients. However, as with any procedure, it is very important you understand what can go wrong as well as right. The potential complications are listed below.
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• Recurrence: Not really a complication but you can put the weight and the shape can change if you do not control your weight. The fat cells do not come back but the ones left just become bigger
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• Small degrees of asymmetry: The same operation will be performed on both sides. However, the effects of surgery can be subtlety different on the two sides.
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• Scars: The quality of scars varies between patients. Skin irregularity: Small areas of irregularity can be observed.
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• Altered sensation: Some altered sensation can be noticed but usually settles over the first week. Bruising/bleeding: Usually minor but can be greater occasionally.
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• General operation risks: Chest infections, Blood clots in the leg or lung (DVT or PE).
TUMMY TUCK
( Abdominoplasty)
Tummy Tuck ( Abdominoplasty )
Tummy tucks are a form of treatment to re-shape the abdomen. This procedure is for patients who have excessive skin, fat, and stretch marks on the abdomen, commonly as the result of having children. Patients that opt for this procedure may have also lost their waistline and have divarication (separation) of the midline muscles giving further bulge to the tummy. This procedure does result in some weight removal but it is primarily for re-shaping the abdomen and not a means of treating obesity.
The Procedure
Full Abdominoplasty
This procedure is designed for patients with lots of extra skin and fat in the lower tummy. We remove the fatty tissue below the tummy button and elevate the skin above this area from the muscles down to the bikini line scar.
The tummy button is brought out at the new position. A benefit of having the full abdominoplasty is that before stitching the skin, we can tighten the muscles to give a much-improved shape and waistline.
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Mini Abdominoplasty
This procedure is designed for patients with some extra skin and fat, but not enough for all of the lower regions to be removed. This scar extends just beyond that for a caesarian section compared to the scar that goes from hip to hip in the full abdominoplasty.
The tummy button is not touched and only the lower tummy is addressed in the procedure. The muscles are not generally tightened but can be and this can be discussed during your consultation. This method is often used with liposuction.
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Scars
The position of the scars will depend on the technique used (as above). Scars tend to be quite pink in the first 6 weeks moving to purple over the next 2-3 months and then fade to white. Most patients will form very good quality scars over time. The length of time will vary for each individual patient. A small group of patients forms raised or stretched scars.
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Smoking
If you are a smoker, try and stop for six weeks before and after surgery as it can reduce the chances of complications.
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Length Of Surgery
The operation takes 1 - 3 hours depending on the areas to be treated. This can be done under local anesthesia though it is usually by general anesthesia.
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Length Of Stay In Hospital
Usually 1 or two nights. Mini-abdominoplasty usually one night or in selected cases in a day surgery program.
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Dressings
You will wake up with dressing with steristrips on the wounds and strapping on the abdomen. The heavy strapping will be removed on discharge from the hospital and new lighter dressings applied if needed. The lighter dressings are required for a further 7-10 days. Therefore no dressings are needed after two weeks providing all is healed well.
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Drains
The use of a small surgical drain into the abdomen is common to remove any unwanted blood/fluid. Patients usually have drains for 48-72 hours. Occasionally patients will be kept in longer.
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Abdominal elastic garment or Corset
This will be used for 4 weeks following surgery and should be worn as much as possible for the first 10 days.
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Time To Exercise
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Patients usually feel able to walk a distance at 7-10 days. Strenuous exercise (aerobics etc) should be avoided for 8 weeks. The important point is to avoid excessive stretching of the muscle tightening and the scars over the first few weeks. The sexual activity needs to be similarly judged with respect to this. It is usually best avoided for the first 2-3 weeks.
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Post-Operative Instructions
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Day 1-4 You should be taking it very easy! You should not be looking after very young children or doing housework without help.
Day 5-14 You can start doing more including longer walking, shopping, etc. You will still be uncomfortable during this period becoming quite a pain-free by the end of the second week.
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If all wounds are fine at two weeks you are unlikely to ‘damage’ anything by increasing your activity, so build up activity, as you feel fit.
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Follow Up
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We will check your wound and change the dressing as needed by day 5. You will have the follow-up check at 1 and at 3 months.
Final Outcome
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This operation gives a good result almost immediately. However, the tissues soften over time and into the optimum shape after 3-6 months depending on the cases.
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Potential Complications With Tummy Tucks
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This is a routine operation that is a great success for the vast majority of patients. However, as with any procedure, it is very important you understand what can go wrong as well as right. The potential complications are listed below.
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Loss of skin: This is rare and usually occurs if a surgeon removes too much tissue, making the closure too tight, or operating on a patient with high-risk factors (smoking, obesity & diabetes). It very rarely happens in low-risk patients. It does occur, recovery can take many weeks and will result in a low-quality scar. Before any procedure, we access your medical history to identify whether you are a suitable candidate.
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Scars: The quality of scars varies between patients.
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Seroma: This is a collection of body fluid under the skin. It presents as a firm mass and needs a needle aspiration to solve.
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Bleeding: A blood clot can collect in the abdomen needing you to go back to theatre for its removal. This only occurs in approximately 1% of patients within the first 24 hours post-surgery.
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Infection: Very uncommon but if occurs you may need a course of antibiotics.
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Pain: A small group of patients experiences a lot of pain from the muscle tightening that can persists for a number of weeks
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Loss of sensation: The area just above the scar in the mid-line can have altered or absent sensation.
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Blood clots to legs and lung (DVT and PE): Although still rare it is important to avoid these by not smoking, being excessively overweight and moving about after surgery as soon as possible.