You’ve finally taken the plunge and had that lipo procedure you’ve always wanted. The bad news: instead of the slim and trim body you’ve been dreaming of, you end up with lumps and bumps. So what went wrong? Dr Jennifer Irvine reports on post liposuction complications and how best to treat them.
Liposuction, whether conventional or assisted, is the most commonly performed cosmetic procedure in South Africa. Fortunately, the safety and cosmetic outcomes have improved significantly with the use of tumescent anaesthesia. Yet these two parameters are also very much dependent on the experience of the doctor performing the procedure, as well as their attention to detail. Treating large areas and doctor fatigue are often associated with the complications that lead to patient dissatisfaction.
Commonly occurring post liposuction complications
Lumps, bumps, divots and ridges commonly occur post liposuction. These present within the first two weeks, and become pronounced up to four weeks. They can be as a result of the normal healing process, or as a result of too much or too little fat being removed from localised areas. Good compliance when wearing the post liposuction compression garments significantly improves the cosmetic outcome, while minimising these irregularities.
Fortunately, post liposuction irregularities can be corrected with a revision procedure, which is best performed after six months. However, removal of localised lumps can be difficult with conventional liposuction, and better results are often achieved using laser-assisted liposuction.
Within my practice, I treat all post liposuction patients with VelaShape from six weeks. It helps to smooth out irregularities and potentiate a smooth result and skin tightening.
How does it work?
VelaShape’s mechanism of action combines bi-polar Radio-Frequency (which targets the hypodermis by controlled thermal stress) and Optical energy (which targets the dermis). The delivery of these energies is further facilitated by concurrent application of vacuum.
The thermal energy delivered to the dermis causes immediate collagen contraction and stimulates neocollagenesis. The suction action of the VelaShape also facilitates lymphatic drainage, and aids quicker resolution of swelling. There is also a place to use VelaShape pre-liposuction. It helps to soften the fat, making it easier to work in and deliver smoother results.
Removal of too much fat from an area (even if uniform and smooth) can also give a result that is not aesthetically pleasing, and results in disproportion.
Excessive superficial liposuction can also lead to significant problems. Damage to the superficial blood and lymphatic vessels can cause scarring, lumpiness and irregular blotchy discolouration to the skin. Sadly, this discolouration is not treatable.
Bruising and swelling
The use of the tumescent anaesthesia technique has significantly decreased the severity of bruising, and this is a result of the vasoconstrictive effects of the adrenalin. Clients undergoing liposuction should also be advised to avoid substances that increase the risk of bruising, such as NSAID, Garlic, Vitamin E and Omegas. Bruising and swelling is often worse distal to the site of liposuction once the patient is mobile, which is due to the effects of gravity. Good compression garments can help prevent this, and informing the clients about this phenomenon will save them undue worry.
“It is not how much fat is removed but the fat that remains after liposuction that determines success” Dr Pierre Fournier
Hyperpigmentation can occur at the incision site, which is caused by friction from the cannulas moving in and out of the small incisions.
The risk is much higher in darker pigmented skins, and these patients should be warned prior to the surgery of this risk. This post-inflammatory hyperpigmentation does lighten with time, but can be actively treated with topical applications or lasers.
Infection is a risk with all surgical procedures, so all patients should receive prophylactic post-operative antibiotics to prevent infection. Keeping the incision sites clean and infection free is also important.
The incidence of haematomas (a collection of blood), and Seromas (a collection of serous fluid), has also significantly decreased with the use of tumescent anaesthesia. This is due to the vasoconstrictive effects of the adrenalin. Should a haematoma or seroma occur, it is best managed with drainage and compression.
In conclusion, improved techniques and equipment (in the hands of an experienced Doctor, of course) have led to both conventional and assisted liposuction becoming safer procedures with good results and high patient satisfaction. The more frequently occurring complications are easily managed and short lived.
A note from from A2: At A2 Magazine, we recommend having all and any “minimally” invasive procedure (including laser assisted lipo) performed by a trained and certified cosmetic and/or plastic surgeon in a sterile and safe environment supported by a trained nursing team who are equipped to help the doctor in the event a procedure goes wrong. It is also HIGHLY recommended to ask your doctor questions, request their training certificates and when in doubt, get a second opinion. It is your body and the only one you have, you have the right to choose a doctor with whom you feel safe.
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