Liposuction

In context of Nepal, it’s a new and emerging surgical procedure to remove the excess fat that is hard to lose with exercise and diet. With the increase in health concern, people have shifted more towards having a good body shape, but despite the exercises and diet control, they are not achieving the target and so get easily fed up, as they want instant results. This doesn’t mean that liposuction, which is also known as lipoplasty or body contouring procedure, is an alternative to the weight-loss method.

Liposuction in simple terms refers to sucking out the excess fat from the body, specifically from the abdomen, buttocks, hips, thighs, arms, and neck, and in males, from the moobs. Though it seems like a regular surgical procedure, it’s more of an art, as it shapes (contours) these areas.

The ideal candidates for undertaking this procedure are the ones that have excess fat in certain areas of the body that appear out of proportion, and have good skin elasticity. It doesn’t address the sagging or loose skin, thus, after the liposuction the inelastic skin may appear to be hanging, and this needs to be addressed surgically with other procedures like tummy tuck or body lift. Another criteria to fit as an ideal candidate is the ones who have excess fat, but are close to their desired body weight and are on a strict diet plan (which is to be continued even after the procedure), as liposuction is not a weight-loss method.

Depending upon the technology that is being used to assist the fat removal process, liposuction is categorized into different types. Each of the different techniques has its own advantages and disadvantages, but the skill and experience of the plastic surgeon performing this procedure will make the biggest difference in the outcome. Some of the types that are current in practices are: a) Tumescent Liposuction, b) Ultrasound-assisted Liposuction, c) Laser-assisted Liposuction and d) Suction-assisted Liposuction.

The average cost of this procedure is around US$3000, which if calculated against the current exchange rate of NRs 119.07 will roughly be around NRs 3,57,210. Looking at this figure, it’s quite high for an average Nepali to think of undertaking this procedure, but luckily, it’s the figure based on the American study. We Nepali plastic surgeons are charging the very minimum to enable the average Nepali to be able to undertake this procedure. But, depending upon the size and volume of the area to be dealt with, the price range might fluctuate, and it also may fluctuate between the surgeons. There is no statistical data of the cost price, but it may range from NRs 50,000 to 200,000.
This procedure can be done outpatient-based, meaning, not requiring admission, and can be safely performed under local anesthesia or intravenous sedation. But, if the candidate has apprehensions, then they can be admitted and the procedure can be done under general anesthesia. Generally, the entire procedure takes under an hour, or up to a couple of hours or longer, depending on the number of areas treated or volume of fat to be suctioned. For inserting a cannula, one or more 5 mm small incisions are made near the treatment area and the fat beneath the skin are loosened to be suctioned out.

When the procedure is performed by a qualified plastic surgeon, recovery from the procedure can be remarkably quick, with many patients being able to return to his or her work within a few days, depending upon the physical requirement of their jobs and extent of the procedure that they have undergone. Prophylactic antibiotics and pain medications are prescribed along with hemostatic medication. A tight bandage is placed to obliterate any dead space between the skin and underlying tissue, so as to avoid any collection of the oozing blood and serous fluid. For a few weeks, compression garment is to be worn to minimize the swelling and optimize optimal skin contraction. With proper care, scars will significantly fade over two to three months, and they will be barely visible after a year or so.

The common side effects that can be encountered after undergoing this procedure are bruising and swelling that can last up to months, numbness lasting up to eight weeks, inflammation, fluid oozing out from the wound, and scar. The dreaded complication of this procedure are lumpy and uneven results, collection of blood under the skin (hematoma), persistent numbness, changes in skin color, pulmonary edema and pulmonary embolism, damage to internal organs with excess bleeding, and infection and allergic reaction to the anesthetic drugs in very few cases.
With this procedure, the fat cells are removed and the results are noted instantly, but with increase in weight, storage of the excess fat in other locations will cause changes in the overall appearance. Thus, it is important to maintain a stable weight for the new look to remain optimal.

The best way to find out whether one is the right candidate or not for a liposuction procedure is to consult a certified plastic surgeon.