Liposuction and liposculpture

DR ALI PIRAYESH

“The biggest predictor for a successful liposuction treatment is not the machine, the size of the cannula, or the technique used, but the experienced and specialised surgeon who gently and artfully contours your body.”

Recovery

Treatment

Anaesthesia

Consultation

Liposuction

Under the influence of hormones, excess fat deposits can be stored in certain places in the body. Unfortunately, such deposits cannot be remedied with exercise and diet. Liposuction is a safe treatment used worldwide by millions of satisfied patients to make their bodies leaner and look more toned. Liposuction results are permanent; if your weight remains stable after treatment, the removed fat cells do not return. Liposuction has dramatically improved in recent years: the tumescence technique causes almost no blood loss and is virtually painless with a quick recovery.

Liposculpture

Liposculpture is an advanced version of liposuction, where fat is removed, and the remaining fat is ‘sculpted’ so that it is symmetrical and in proportion to the underlying muscles and makes the body look more slender and toned. Liposculpture is also called 'body contouring. That is not surprising because the surgeon must show great artistic talent and attention to detail. He effectively ‘shapes’ your body into an improved, natural-looking version that will please you for years to come.

It all starts with a consultation

No two women’s bodies are the same. The cosmetic needs and expectations of patients are unique. To ensure that you are happy with the result of your treatment, Dr Pirayesh develops a customised surgical plan for each patient. During the consultation, he will take the time to get to know you, discuss your requirements and help you make an informed decision.

He will ask about your general health and medical history and examine the area you want to be treated. He will explain which technique is the best option for you, where the incisions will be, the results you can expect, and the necessary aftercare.

Dr Pirayesh will also answer any questions, give instructions on preparing for the operation, and inform you about the cost.

Facts about liposuction:

Most body parts treated with liposuction and liposculpture:

Thighs: Some women suffer from ‘saddle bags’; these can be treated very well with liposculpture. Women can fit into their tight pants again when the fat deposits on their thighs are removed. When women suffer from excess fat on their inner thighs, rubbing while walking can lead to irritated skin and hyperpigmentation. After liposuction, these symptoms are often entirely resolved.
Buttocks: the contours of the buttocks can be significantly improved with liposuction. Often, fat harvested from elsewhere on the body is used to make the buttocks fuller: lipofilling.
Belly: another sought treatment for both men and women is the removal of stubborn fat deposits from the abdomen by liposuction. This treatment is often combined with a tummy tuck in case of excess skin and a bulging belly.
Breasts: liposculpture can also be used to reduce the size of breasts of women as well as men (male breast reduction)
Arms: this type of liposuction aims to remove excess fat accumulated on the upper arms and tone the skin.

Facts about liposculpture:

Liposculpture is not just the loosening and suction of excess fat (liposuction) but is also performed to shape the remaining fat, making it symmetrical in proportion to the underlying muscles. Liposculpture results are often deceiving: although the difference in contour suggests that a more significant amount of fat has been removed, it is usually a relatively small amount. In general, liposuction is conducted with the tumescent technique, which has the following advantages: very little loss of blood, almost no pain, and a speedy recovery.

Other areas we successfully treat

Waistline

Hips

Flanks or 'love handles'

Arms

Knees

Thighs

Face (cheeks)

Neck (jawline)

Breasts (reducing the breast size for men and women)

To lipo or not to lipo?

Liposuction alone cannot eliminate cellulite and cannot tighten loose skin. In such cases, a combination of treatments is needed to achieve beautiful results.
Liposuction is not a quick and easy alternative to a healthy diet: when, after the fat is removed, you gain weight again, this new fat will more than likely surround your internal organs, and this puts your health at risk.
Liposuction cannot be used to remove visceral fat, so patients who are obese are not good candidates for liposuction.

Customised treatments with different techniques

01/ Traditional liposuction

With this technique, fat is suctioned by negative pressure (vacuum). This old-fashioned technique often results in swelling and bruising. The conventional cannulas have a relatively large diameter so that the fat can be removed quickly. But in using any cannula larger than 3 mm. in diameter, there is a greater risk of lumpy and uneven skin. This inexpensive liposuction is often performed in the Netherlands but certainly not at APS.

02/ Power-assisted liposuction

With this much more elegant liposuction technique, fat cells are detached from the surrounding tissue by vibrations so they can be removed more easily and gently. Because there is lower pressure, there is much less damage to the surrounding tissues than with traditional liposuction. Scientific research has shown that recovery times are faster with this method, with a more uniform skin surface and smoother contour. This is one of the main reasons why Dr Pirayesh usually prefers this form of liposuction.

03/ Laser-assisted liposuction

Also referred to as Smart Lipo or SlimLipo. This relatively new technique uses a laser to liquefy the fat cells and remove them through a tiny cannula. Although this technique can somewhat cause the skin to tighten, that effect is limited and can cause burns to the tissue. For this reason, APS does not use this technique.

04/ Ultrasound-assisted liposuction (UAL)

Fat cells are liquefied using ultrasonic waves radiated via a cannula for easy removal. This treatment often causes prolonged swelling. For this reason, APS does not use this technique.

05/ Micro liposuction

This treatment is hardly invasive because an extra small cannula is used, which removes fat locally; it is often used to tighten the neck and jawline.

06/ Radio frequency-assisted liposuction

A newer technique in which radio frequency is used to melt the fat from the outside before removing it. With this method, the skin is tightened the most, but the high temperatures can injure the skin and leave the skin wrinkled.

07/ Tumescent technique

A revolutionary technique in which a large amount of anaesthetic solution is injected into the fatty tissue, causing the fat to swell (tumesce), making it easier to remove through a narrow cannula and then shape the body. The tumescence technique allows for minimal blood loss and is virtually painless with shorter downtime.

08/ Super-wet technique

Similar to the tumescent technique, but the amount of anaesthetic solution injected is much smaller. This method is used where only a minimal contour improvement is needed.

During your consultation, Dr Pirayesh will determine which liposuction technique will yield the best results.

Liposuction/Liposculpture overview and timeline

Duration of the procedure: depending on how many zones are treated, ½ to 6 hours
Anaesthesia: local or light general anaesthetic administered by a specialised anaesthetist
Length of stay: outpatient, you can return home about 4 hours after surgery. You need to arrange transportation because you cannot drive yourself home.
Post-treatment: swelling and tenderness. We will provide you with a compression garment that you must wear day and night for a few weeks to prevent swelling (you may take it off to shower). You will receive pain medication and instructions on wound care.
Complications, rare: fluid retention, infection, raised and livid (minimal) scars.
Recovery time: In general, liposuction is not very painful; you will experience some pain for the first four days, which can be managed with the proper use of painkillers. The total recovery time is usually about four weeks, during which you must refrain from lifting and vigorous exercise. After 4 to 6 weeks, the compression garment is removed, and you may resume exercising. You have tiny, hardly visible scars where the cannula was inserted.
Results: liposculpture is an excellent way of contouring the body in case of stubborn deposits of fat that cannot be removed by diet or exercise. However, positive and lasting changes in lifestyle, nutrition and exercise are often needed to retain the results.
Scarring: the drain is painlessly removed within 2 to 4 days after surgery. Dr Pirayesh has developed a program, APS Scar Care, including aloe vera-based creams, laser treatments, and (if necessary) injections to ensure that your scars heal in the best possible way.

Liposuction in six steps

On the day of your surgery, Dr Pirayesh will carefully mark the fat deposits to be treated. In addition, photos will be taken for your medical record.

Step 1. Anaesthesia

The anaesthetist will discuss the anaesthesia before your surgery and answer any questions.

Step 2. Different techniques

Dr Pirayesh will discuss the best combination of treatments with you before the procedure.

Step 3. The incisions

After the local or light general anaesthesia is administered, Dr Pirayesh makes small (3 mm.) incisions around the area that require treatment.
Dr Pirayesh injects the area with an anaesthetic solution and something to constrict the blood vessels.
Depending on the selected technique, instruments and devices are chosen to loosen the fat cells between the skin and muscle with minuscule cannulas.
As soon as the fat cells are detached, they are removed with the aid of the PAL device (power-assisted liposuction) using a cannula or a small, narrow, and long tube.
During the procedure, Dr Pirayesh continually checks whether the desired shape has been achieved and whether the proportions are correct and symmetrical. It is important to remember that only very experienced plastic surgeons have the artistic skills needed for a truly beautiful outcome.

Step 4. Suturing and bandaging

The incisions are closed with tiny sutures, and the treated areas are bandaged with special bandages and compression garments to prevent swelling.

Step 5. Recovery and aftercare

You will remain in our surgery clinic for the next few hours, in the care of Dr Pirayesh and his team, until he feels it is safe for you to return home. You need to be picked up by someone, so you will arrive safely home to recuperate. You will almost immediately see a change in your body, even though it remains hidden under special compression garments for a while. Dr Pirayesh provides you with specific, written instructions on aftercare for the weeks after the procedure.

Liposuction is generally not very painful; patients tend to recover quickly and experience few side effects.
Depending on the amount of fat that is removed, you will experience some pain for the first four days, which can be managed with the proper use of painkillers.
During recovery, you must avoid the solarium or sauna and not drink alcohol or take blood thinners like aspirin (paracetamol is allowed).

Step 6. Wound healing and scarring

Dr Pirayesh is very savvy when it comes to promoting rapid healing. He has developed a customised regimen, APS Scar Care, including creams based on aloe vera, laser treatments, and (if necessary) injections to ensure that your scars heal in the best possible way.

This regimen has ensured that many of Dr Pirayesh’s patients have hardly noticeable scars. However, it is impossible to pre-determine if patients will have problems with their scars healing.