Liposuction

Liposuction is a relatively safe and effective, minimally-invasive surgical procedure that removes excess fat tissue from different sites on the body, thereby improving overall body contour. It is NOT a weight reduction procedure.

At CapeMAC, we use a specific power-assisted device called the “Euromi” Nutational Infrasonic Liposculpture (NIL) to ensure quick, effective and safe results.

Gone are the days when going under the knife was the only way to increase or change the size of the face, breasts, buttocks, calves, etc. Natural fat transfer, or body augmentation, is growing in popularity as it is an alternative to implants and gives a natural-looking enhancement! Fat transfer, otherwise known as fat grafting, takes fat from one area of the body, where we do not want the fat or can spare it, and moves it to another area of the body, where we do want it.

It is a redistribution of fat with the purpose to augment or fill volume-deficient areas. As the tissue is coming from the same patient that it is being transferred to, fat transfer is often referred to as “autologous fat transfer”. (Autologous means cells or tissues obtained from the same individual.) Fat transferred is the ideal filler to add volume where it is desired as it is a relatively safe, long-lasting, and well-tolerated procedure that achieves natural-looking results.*.

The Liposuction Procedure

The areas of the body that most patients request liposuction for include the abdomen, the thighs, calves and ankles, buttocks, love handles, the neck and the back, as well as the arms. However, various other affected areas and just about anywhere on the body can be treated. Please note, however, that excess body fat is usually stored as deposits within fat cells, between the skin and outer muscle layers. Fat deposits stored inside the abdomen and around the internal organs cannot be removed with Liposuction.

Through new innovative designs and minimally to non-invasive techniques, we are now able to practice safer, yet effective Liposuction*. The liposuction procedure done at CapeMAC is performed under local anaesthesia and conscious (mild to moderate) sedation. You are given a sedative to calm you down (depending on your level of anxiety) and then anaesthetic fluid containing adrenaline (epinephrine) and lidocaine is slowly infused into the fat layer to be treated. The anaesthetic fluid numbs the areas to be treated and also helps to ‘emulsify’ the fat, thereby ensuring easier removal of the tissue. It also helps to minimise post-operative bruising and bleeding.

The liposuction procedure is done in a theatre setting. The procedure commonly takes between 1 and 3 hours to complete – depending on the area being treated and the volume of fat that can be removed. Since there is no general anaesthetic used and the liposuction procedure is minimally invasive, no hospital stay is required and you can be discharged soon after the procedure. Patients are usually up and about within a few hours and can even be back at work on the following day (depending on the nature of your work and extent of the liposuction procedure) and be fully recovered within two weeks*. You will be given adequate pain medication and a prophylactic course of antibiotics after the procedure. You will also be given a follow-up consultation with the Doctor for a day later and then routinely followed-up.

After the procedure, a suitable compression garment will have to be used continuously (day and night) for the first 14 to 21 days, and then only at night for up to 6 weeks afterwards*. Pressure garments are used to compress the treated area in order to prevent swelling and bruising and to smooth out the treated area. This is a very important part of the treatment and is crucial towards achieving a good final result. Final results are seen between 3 to 6 months after the liposuction procedure, once all the healing has settled.*

Which areas of the body can be treated by liposuction?

The areas of the body that most patients request liposuction for include the abdomen, the thighs, calves and ankles, buttocks, love-handles, the neck and the back, as well as the arms. However, various other affected areas and just about anywhere on the body can be treated. Please note that fat deposits stored inside the abdomen and around the internal organs cannot be removed with Liposuction.
Is abdominal liposuction better done before or after pregnancy?

There is no additional health risk involved with having liposuction of the abdomen and flanks area done before pregnancy as compared to after pregnancy. Liposuction while pregnant is certainly not an option though! Dr Bagwandeen does not recommend liposuction treatment if the patient is considering pregnancy in the near future – like within the next year. In fact, for any type of cosmetic surgery, especially for areas involving the abdomen or breasts, it is advisable to wait until after the pregnancy, or even after you are completed with having children (females, of course!). The reason for this is that the pregnancy state will change the female body. Your abdomen grows and stretches during pregnancy. Most women experience weight gain or weight fluctuations during pregnancy. Some women are able to get back into their pre-pregnancy shape. Some women do not. How the pregnancy affects the body and whether changes are permanent differs from patient to patient. A pregnancy might also alter the result of any liposuction that was done on the abdomen before the pregnancy. However, if you want to feel better and have a body shape that you find more pleasing now, then liposuction before pregnancy is still fine, as long as it is not done too soon before pregnancy. Should you be unhappy with your figure after pregnancy, liposuction can also be done to help regain your more pleasant, pre-pregnancy body and after you have acquired a stable weight.
Which areas do women most commonly have treated by liposuction?

The most frequently treated areas for women are the abdomen and hips, love-handles, breasts, outer and inner thighs, anterior thighs, knees, arms, especially the back of the upper arm, the buttocks, cheeks, chin and neck.
Which areas do men most commonly have treated by liposuction?

The most frequently treated areas for men are the abdomen and flanks, the chest area, as well as the neck and chin area.
Can liposuction be used to reduce breast size in both men and women?

Yes, liposuction breast reduction can be an excellent alternative to traditional breast reduction surgery in suitable candidates – both women and men. When compared to traditional breast reduction surgery, liposuction breast reduction allows for a more rapid recovery with fewer complications. It also reduces breast size with minimal (if any) scarring. In men, most of the breast tissue (“man boobs/moobs”) can be removed. In women, the breast size can be reduced by 30% to 40%. The reduction in weight of the breasts and the natural elasticity of the breast tissue and skin will elevate or lift the female breast noticeably after the procedure. Patients with breast asymmetry are also excellent candidates for liposuction breast reduction treatment, allowing for the reduction of the larger side without adding scars to one side of the chest, whilst yielding improved symmetry of the breasts. We can also incorporate fat transfer to a breast to improve symmetry. Postoperative recovery after breast reduction liposuction on female and male patients is very quick, with patients typically able to return to work in one to three days.*
Can liposuction remove belly fat?

The fat that is stored between the internal abdominal organs is usually referred to as “belly fat”. It is also called visceral fat. This kind of fat is not treatable with liposuction surgery. It can only be reduced by rigorous weight loss. CapeMAC will not do abdominal liposuction on a patient who has mostly belly fat as the liposuction surgery would result in very little improvement in the body contour. Our doctor will gladly discuss details on how to lose belly fat and get back into a healthy and comfortable weight zone as part of our Medical Weight Management programme. In contrast however, the fat deposits in the outer abdomen (between the skin and the muscle layers) are easily removed with liposuction. This is one of the commonest treated areas with liposuction surgery and can produce great results with an improved, much more flattering body shape.*
Can liposuction help with major weight loss?

Liposuction is not a weight reduction procedure and not a reasonable treatment for obesity. Liposuction is rather a contouring procedure, assisting the patient in finally removing those unwanted and usually stubborn fat deposits. Thus, you may need to lose weight to be a better candidate for liposuction. For desired major weight loss, please visit the section for medical weight management on this website. Liposuction can be combined with, or can be part of the medical weight management. This will be discussed with you during your initial consultation with the Doctor.
Can liposuction help to improve cellulite?

No. Liposuction helps to improve the shape of the body, not the skin. It is not meant to improve the look of cellulite. However, there are different treatment options available to help with skin tightening, removal of stretch marks and cellulite, for example Mesotherapy, Body Slimming Machines “Alice” or “Luna”, Laser or IPL treatments or radio frequency treatments! Please visit our treatments section or contact us at CapeMAC for a consultation on which treatment options will work best for you.
Can liposculpture help to improve loose skin?

No. Liposuction helps to improve the shape of the body, not the skin. It is not meant to improve the look of loose skin. However, there are different treatment options available to help with skin tightening, removal of stretch marks and cellulite, for example Mesotherapy, Body Slimming Machines or radio frequency treatments! Please visit our treatments section or contact us at CapeMAC for a consultation on which treatment options work best for you.
How do I best choose the right practitioner and practice for my liposuction?

Your decision as to which practice or practitioner to choose should be based on the practitioner’s reputation, the practitioner’s apparent skill and the practitioner’s experience. In addition, the practitioner’s ability to communicate with you in a manner that is professional, sincere, unhurried and that makes you feel comfortable is of utmost importance. Please also see the information on “How to choose a Medical Aesthetics Practitioner”. We hope this helps you make the right choice.
When do I have to make my decision?

Don not ever feel pressured to make any decision relating to your body and health. Regard your initial consultation with the Doctor as an opportunity to gather all the information you need to make a reasonable decision about having liposuction done for yourself. Should you have further questions after your first consultation, please return to see the Doctor for a second consultation.
How much liposuction is 'safe' during a single procedure?

The ‘safe’ volume of fat tissue that can be removed by a single liposuction procedure varies depending on the patient’s body weight, the patient’s body mass index (BMI) and the technique used to perform the procedure. Studies show that patients with a higher BMI and higher body weight can have more volume removed than patients with a lower BMI and lower weight to start with. In general, the greater the volume of fat removed in a single liposuction procedure the greater the risk of complications. Five litres are commonly regarded as “large-volume liposuction”. For a patient, who wishes to remove more than the usual amount of fat and/or fat removal from several different areas of the body, our doctor will divide the liposuction treatment into separate procedures.
What are the complications and risks of liposuction surgery?

Studies show that liposuction as a procedure is associated with a very low complication rate, with major complications occurring in less than 1 in 1,000 patients. Complications and risks increase when doing too much liposuction on a single day (taking too much volume of fat out at once), or doing multiple unrelated surgical procedures on the same day that the liposuction surgery is performed. Rare problems that can arise as with any surgical procedure include infections, bleeding, skin ulceration, and nerve injury. Liposuction is a safe procedure when performed by an experienced practitioner.*
Does liposuction require a general anaesthetic?

The liposuction procedure done at CapeMAC is performed under local anaesthetic and conscious sedation. You are given a mild sedative to calm you a bit (depending on your level of anxiety) and then anaesthetic fluid containing adrenaline (epinephrine) and lidocaine is slowly infused into the fat layer to be treated. The anaesthetic fluid numbs the areas to be treated and also helps to ‘emulsify’ the fat, thereby ensuring easier removal of the tissue. It also helps to minimise postoperative bruising and bleeding.
How long does the actual liposculpture procedure take?

The liposuction procedure commonly takes between one to three hours to complete – depending on the area being treated and the volume of fat that can be removed.
Does the liposculpture procedure require hospital stay?

Since there is no general anaesthetic used and the procedure is minimally invasive, no hospital stay is required and you can be discharged soon after the procedure and if all is well. Almost all patients are up and about within a few hours and can even be back at work on the following day (depending on the nature of your work and the extent of the procedure). Your Doctor will advise you further in this regards.
Can I see before and after pictures?

Due to new regulations regarding sample patient pictures, we do currently not publish any before or after pictures of patients.
How much fat can be removed with liposuction?

The maximum amount of body fat that can be safely removed during one liposuction session amounts to usually between 3 to 4 litres*. This partially depends on the patient’s height and weight and overall health condition. Studies show that patients with a higher BMI and higher body weight can have more volume removed than patients with a lower BMI and lower weight to start with. In general, the greater the volume of fat removed in a single liposuction procedure the greater the risk of complications. For a patient, who wishes to remove more than the usual amount of fat and/or fat removal from several different areas of the body, our doctor will divide the liposuction treatment into separate procedures. The recovery time between two procedures will usually be about three to five weeks.
How soon after the liposuction procedure will I see results?

The postoperative swelling following liposuction surgery will subside within the 4 to 6 weeks after the procedure. Patients do typically see about most of their final liposuction results within 2 to 3 months after surgery. The full results can be seen 6 months after the procedure and once all the swelling and healing has subsided*.
How long will the results of liposuction last?

The fat cells removed by liposuction do not grow back. Thus, the new shape created by the liposuction treatment should be long-lasting. Later weight gain and/or the process of ageing might affect the new body shape though as the remaining fat cells can increase in size and volume. If a patient does not gain weight after a liposuction, the results are long-lasting. However, with increasing age, the fat deposits of the body might naturally change both in size and location. Yet, the benefits of a successful liposuction will always be apparent. If a patient gains a moderate amount of weight after liposuction, the benefits of the liposuction will still be apparent. Remember, fat usually accumulates in all areas of the body and it does so in proportion to the amount of fat cells in each area. Remaining fat cells simply grow in size. In areas where fat cells have been removed by liposuction relatively less fat accumulates compared to areas not treated by liposuction. This is why some patients notice more fullness in a new area when they gain weight after the liposuction surgery. In general, the more weight a patient gains after liposuction, the less dramatic the results of liposuction will be. So the key is to maintain your weight or to even continue to lose weight after a liposuction treatment. Liposuction is not a substitute for a good, well-balanced, healthy nutrition and exercise. Both are critical to a lasting result. Our doctor will gladly discuss details on how to maintain or get back into a healthy and comfortable weight zone as part of our Medical Weight Management programme.
Will the fat cells grow back after liposuction?

The fat cells that are removed during the Liposuction procedure are removed permanently – they will not grow back. Please note though, that with weight gain, other, still existing fat cells simply get bigger by accumulating more water and fat within the existing cell.
What happens if I gain weight after liposuction?

After liposuction, relatively less fat will accumulate in treated areas compared to untreated areas. However, the more weight a patient gains after liposuction, the less pleasing the results of liposuction will be as the new contours and proportions would be a little less visible. The patient will still look better as compared to not having liposuction, but the results would not be optimal. Once the patient loses weight again, the contours should resume the size and shape from after the liposuction procedure.*
Does liposculpture leave visible scars?

Scars are not a common problem with the liposuction performed at CapeMAC. Today’s techniques use very small cannulas (small stainless steel tubes) and require only very small incisions for entry points.*
Can I go home on the same day?

We use the Tumescent Technique and conscious sedation for analgesia during liposuction. No general anaesthetic is used, hence no hospital stay is required. Patients require a relatively short period of observation in a recovery room after the procedure. There is virtually no blood loss and with local anaesthesia, there is rarely any nausea or dizziness. You can go home on the same day if all is stable after the procedure. Usually, patients are discharged home about 2 hours after completion of liposuction. Even though you will be able to move about unassisted, is essential to have a friend or family member fetch and drive you back home after the treatment. We also strongly recommend that you do not drive yourself for the first 24 hours after liposuction surgery.
What is the downtime after liposuction surgery?

The downtime (and recovery time) after liposuction treatment will depend largely on how many areas are being treated and the overall extent of the procedure. Furthermore, every patient is a bit different with regard to pain tolerance and healing abilities. Overall, liposuction is one of the easiest operations to recover from. Some patients are back at work after only one day, some feel more comfortable with taking a week off. At CapeMAC, we usually recommend that our patients take between 3 to 5 days off after liposuction. During this time we ask patients to rather stay at home and relax. The less active you are, the less swelling or bruising you will experience and the sooner you will recover and see your final result. We do insist that you move about regularly though, so as to prevent any complications after surgery such as blood clots from remaining sedentary for prolonged periods of time. If you are pain-free and fully ambulant, then you can always return to work earlier. Keep in mind: Patients who take the full week off end up ahead because they look and feel better sooner.
What is the recovery time?

It is usual that you will require some pain medication for a period of time after surgery. Most patients take pain medication for the first 1 to 2 days. You can still be a little sore after a week, or see some bruising for about 1 to 2 weeks. This might occur especially after a long day at work. There might be some areas of residual tenderness several months after the surgery. This is usually very mild and not too troublesome. The swelling decreases significantly by week 3 but may take 3 to 6 months to completely resolve.
When can I exercise?

You will be up and about on the day of your liposuction procedure. The less active you are, the less swelling or bruising you will experience and the sooner you will recover and see your final result. This is why we recommend taking up your exercise routine not earlier than about 4 weeks after surgery. However, on the day after the surgery, take a short easy walk. This promotes healing. You might also engage in very mild exercise if you feel up to it in the days after the procedure. Please consult your Doctor for further advice in this regards.
When can I fly?

In most cases you may fly 2 days after the surgery. Just make sure that you will be able to make yourself comfortable on the plane and do walk around every hour while on the plane.

We hope that this helps you understand a little more about Liposuction and assists you in making a better choice for your aesthetic treatments. To find out if Liposuction is the right treatment option for you, please contact us at Cape Medical Aesthetics Centre. Also, if you might still feel anxious about the use of Liposuction, Dr Manoj Bagwandeen will be glad to discuss any queries and questions you may have. You are welcome to visit with us at CapeMAC in Plattekloof, Cape Town for more information and to get further advice on looking and feeling even better.

* Please note individual results may vary. Results are not guaranteed.

Liposuction

The Liposuction Procedure

​