LIPOPLASTY/LIPOSUCTION
(Fat Removal)

the facts…………………..

Your Consultation

Cosmetic surgery patients can safely be split into two groups.  Those born with, or who as they grow, develop features they do not like.  For example: a large nose, large breasts or even undeveloped breasts, protruding ears, or indeed, any feature that may make them unhappy.  Then there are those who are unwilling, or unable to come to terms with the effects of ageing, pregnancy or trauma.  Both groups may be unhappy to the detriment of their self-esteem.

Today in the United Kingdom, there can be few unaware of the benefits of cosmetic surgery and many consider it to be the “ultimate voyage of self improvement”.  However, good cosmetic surgery is not an accident, or a miracle, it has to be planned.

Planning starts with your consultation…..

Consultations should only be given by one person, a highly experienced surgeon who is the only one capable of determining whether you are a suitable candidate for the surgery that you are asking for.  Counsellors, lay or nursing, irrespective of their experience are not licensed to operate and although they may assist with simple explanations, you should not allow yourself to be placed in a situation where they advise surgery.  Most lay counsellor’s work on a commission basis and it is therefore unlikely that your best interests will figure prominently in their thinking.

At the consultation you will not find lay counsellors.  All consultations are carried out by highly trained Surgeons.

The patient prepared to accept advice from an unqualified source should not be too surprised if the standard of surgery reflects this fact.  Competent professionals will not be found associating with this type of organisation.  It may be wise to bear this in mind.

No substitute exists for a Pre-Operative Consultation.  It may be inconvenient; you may feel it unnecessary believing that you know what you want.  The truth is different.  Consultation is an integral part of any treatment you may have carried out.  It cannot be bypassed.

 We do not charge for Consultations.  A very high degree of knowledge and skill is required for a well-balanced opinion about the necessity for the operation in which you may be interested.  You must appreciate that even when the advice is not in favour of surgery, it comes from a highly qualified person who has given his time, attention and experience to your problem, consulting, both pre and post-operatively accounts for over 50 per cent of surgeons times and good ones do not give this time away.  Neither will they tell you that you need surgery when you don’t.  Surgeons build reputation not only by the work they carry out, but the work they decline.

The Consultation is free of charge, but if you do not attend a consultation when booked and have not informed us that you are unable to attend then a fee becomes payable.

Appointments for consultation may be arranged by telephoning the Patient Information Service.

Do’s & Don’ts

Considering cosmetic surgery?  The following simple rules should ensure that you end up looking better, not worse………..

• Avoid any organisation where “counsellors” are employed.  The only person qualified to advise you on your surgical requirements is the surgeon who is to carry out your surgery.  Nurse counsellors should also be avoided.  They have no training, which makes their advice of no use to you.  Counsellor usually means sales, which usually means problems.

• Do nothing until such time as you have consulted a highly experienced Surgeon.  Experience without training is not much use to you.  Always insist on a highly experienced Surgeon.

• Do not accept shared, or worse still, mixed accommodation.  You need your own room and bathroom.  Good surgeons will not be found working where conditions such, as this exists.

• Ask to speak to some of your surgeon’s previous patients.  Particularly those who have undergone the same treatment in which you are interested.  All competent surgeons have patients prepared to give testament to their competence.   If you were told that this would not be ethical, it would probably be better if you found another surgeon.

• Exercise caution when offered photographs depicting patient’s pre and post operatively.  There are several things to consider here.  The first is whether or not they are the property of the person showing them to you.  All too often the same photographs keep turning up with different surgeons claiming to have carried out the operation.

The second thing to bear in mind is the simple face that these photographs will represent the very best a surgeon or organisation can produce.  They are not going to show bad photographs.  If what you are shown does not impress, you should remember that what you are looking at is probably their very best.  You may not do anywhere near as well.

• All responsible surgeons and organisations publish detailed facts with regard to the procedure in which your interests may lie.  Avoid those whose information consists of nothing more or less than trumpet blowing.  Pictures of smiling patients do not tell you what you need to know.  Look for detailed information and explanations about the procedure, which should include the disadvantages and risks as well as the advantages.

• Ensure that your levels of expectation are realistic.  Plastic Surgery is not going to turn you into a film star, nor much sought after employee, not is it going to mend marriages.  In fact, apart from improving some aspect of your appearance there is very little else you can justifiably expect from it.

If improvement of appearance is all you ask from your surgery, you will no doubt be delighted at the increase in self-confidence and rapid return of self-esteem.  However, as stated above, ensure that your expectations are realistic by discussing carefully with your surgeon just what can be achieved.

• Do not have surgery to please someone else.  This is a private solution to a personal problem and surgery carried out for this reason is rarely successful.  If you have surgery, have it because you want it, not for somebody else.

Considering Treatment?

Today it has become almost cultural to take vitamins and food supplements as an aid to maintaining health.  However, if you are considering aesthetic plastic surgery and regularly take food supplements please read the following very carefully.

Likewise, if you are taking any medication on a regular basis, the following information is of importance to you:

The following must not be taken two weeks prior to surgery being carried out and for the two weeks following:

Effamol G     Primrose Oil     Wheatgerm With Vitamin E      Evening Primrose Oil     Salmon Oil Capsules    Cod Liver Oil Capsules
Multi-Vitamins with E

No anti-inflammatory agents (mediations for the treatment of swelling, bruising, pains, etc) including:

 

No Naturopath preparations including:

 

Do not take medications containing salicylates including:

 

Or anything containing Aspirin.  You may take paracetamol.

Monoamine Oxidase Inhibitors (Moams), prescribed for depression must not be taken, nor any medication used to thin the blood.

Smoking may seriously affect the outcome of any surgery you may be contemplating but particularly in the case of:

 

You should stop smoking ideally from six weeks pre-operatively and for two weeks post-operatively.  If you can stop for this period of time why not stop permanently?

Please contact us if you require explanation or further information on the above.

Lipoplasty/Liposuction
(Fat Removal)

This booklet has been prepared to answer many of the frequently asked questions about Lipoplasty/Liposuction (Fat Removal).  The information contained within is important to everyone thinking about such treatment and we recommend that all sections be read carefully.

You must not use this Lipoplasty/Liposuction (Fat Removal)) information as something on which to base final decisions without the benefit of an individual examination.  Descriptions of the surgical details are in general terms and will not apply to everyone.  This Lipoplasty/Liposuction (Fat Removal) information may, however, serve as a starting point for your enquiry and space has been provided at the back of this booklet for “note-taking”.

The material contained within this Lipoplasty/Liposuction (Fat Removal) booklet was designed to allow careful consideration at home of both the procedural and surgical details of the operation in which you are interested.  It is free of photographs, makes no recommendations for surgery and in no way should it be considered promotional material for the hospital.

If you consult a surgeon you do so in the knowledge that he endorses the basic concept of this Lipoplasty/Liposuction (Fat Removal) booklet.  Wherever his ideas or methods differ from those described within, he will draw this to your attention and describe his own preferences and the reason for them.

Differing methods should not be considered as deviating from normal, or accepted procedures.  There are hundreds of variations for each surgical procedure carried out and your surgeon has a duty of care to ensure that he selects that, which is appropriate for you.

Why have Aesthetic Plastic Surgery?

Examine your reasons – make sure that your expectations are realistic – have a positive attitude remember plastic surgery will not resolve your major life problems but should boost your confidence and self esteem.

Do not have surgery to please someone else, these are private solutions to personal problems and surgery for this reason is rarely successful.

When a reputable surgeon and anaesthetist carry out an aesthetic surgery operation, it is rare for severe complications to occur, but nothing can be guaranteed absolutely.

However, in very difficult cases it is conceivable that several procedures may be required before the ultimate end result will be achieved.  If this is the case, you will be advised of this fact before you are allowed to elect for surgery, and the price you are quoted will include the close of all surgery necessary.

Rarely is aesthetic plastic surgery covered by insurance policies.  Surgery required to correct poor attempts at cosmetic surgery may be covered by medical insurance if it can be shown that the correction of previous surgery is essential to the health or well being of the insured.

When surgery is carried out to correct the result of poor surgery carried out elsewhere, it is done so on the basis that more than one surgical procedure may be required and that such procedure(s) do not carry the guarantee applicable to surgery originating from this hospital.  This type of surgery is usually difficult and unpredictable and may require several procedures.  If you hold medical insurance, it may well be that the cost, either in full, or part, will be met by your insurers.  The Hospital will assist with the necessary forms.  An ever-increasing amount of surgery carried out at this Hospital is for corrective purposes.

Everyone is different and the same operation will have different results.  Some take longer to heal than others, some skins produce raised scars and other, hardly any at all.  This is due to differing natural healing responses, which cannot be evaluated prior to surgery.  You must remember this.  Minor revision surgery may be required because in major or complex procedures it is more likely that all the factors of shaping and healing, will fail to give a perfect result first time.  Some revision surgery becomes necessary, because a patient fails to transmit his or her true requirements to the surgeon.  If you have a passive personality (absolutely nothing wrong with that) and during your consultation say, you contribute little, you are most likely to end up with the surgical result which reflects your surgeons aesthetic tastes as opposed to your own.  As previously mentioned, if your requirements are specific in any way, they must be made known to your surgeon during consultation.  During your consultation, your surgeon will listen carefully to what you say, noting down your requirements in your personal records.  These notes will be of great value to him, both when planning your treatment and carrying it out.  If you are accepted for treatment, please do not make a definite appointment for your surgery to be carried out unless you are sure you can keep it.  The Nottingham Center for Cosmetic Surgery required a fee equivalent to 10% of the total fee payable before booking a surgical appointment and this fee is non-refundable in most circumstances.  Please discuss this point with administration.

Anaesthetics

Wherever possible, we avoid the use of general anaesthetics, preferring instead to use sedation therapy, Twilight, as it is sometimes known is a natural method of anaesthesia, which allows you to sleep naturally throughout your Lipoplasty/Liposuction (Fat Removal) operation.  Many patients say that in effect they were not really asleep but in a “twilight condition” which they enjoyed.  The advantages of this type of anaesthesia are enormous both to patient and surgeon alike.  You will benefit in that when you awake you will not feel sick, will not have a sore throat and will be able to drink almost immediately.  Anaesthesia should not cause you concern.

Hospital Administration

Patient Information Managers are appointed by to ensure that every patient is fully aware of the consequences of electing surgery.  PIM’s as they are known, are the people who will book your operation should you elect Lipoplasty/Liposuction (Fat Removal) surgery.  However, before they do so they will need to know that you are confident of your decision and that you are aware of all aspects of your treatment and its effects upon you.  You may feel that the Lipoplasty/Liposuction (Fat Removal) information you are given is more than necessary or, unduly pedantic.  We do not believe this to be the case, rather that well-informed patients make better patients.  The future for cosmetic surgery is too bright to leave patients in the dark.

Lipoplasty/Liposuction (Fat Removal)

The skin surrounding the surface of the body has great elasticity and contractibility as demonstrated by weight fluctuation and pregnancy.  This characteristic is greatly influenced by subcutaneous body fat.  Body fat is a source of nutrition and energy storage and it serves as insulation.  In addition, body fat moulds the external appearance of the body around the muscles and skeleton.  As the body ages, muscle mass is replaced by fat deposition.  It is in the fat cell that morphological changes take place with obesity and where genetic predisposition results in localised deformities.  The number and size of fat cells influence the appearance of the body silhouette.  Too much fat deposition results in obesity; too little fat results in cachetic appearance (thin – weak).  The numbers of fat cells remain constant with individual cells increasing in size, as with moderate obesity, or the total number can increase and become excessive as with massive obesity.  Moderate obesity may be defined as body weight more than 120% and less than 170% of the reference body weight.  Body weight of more than 170% of the reference weight is considered morbid obesity.

Skin is attached to the deeper structures by fibrous septa.  These can be described as being the body’s “Velcro”, holding the skin to the body.  Between the septa are globules of fat.  The principle of Lipoplasty is to remove the fat, and do as little damage as possible to the septa, which contain blood vessels, nerves and lymph vessel.  For this fat to be removed without serious damage requires an excellent knowledge of the anatomy, an appreciation of body proportions and of course, surgical and mental fitness.

Most patients interested in Lipoplasty/Liposuction (FatRemoval) know that fat is removed through tubes known as cannulae.  It is through these tubes the fat has to travel when leaving the body.  They come in varying sizes and shapes, can be disposable or reusable, made of plastic or metal (stainless steel) and have single of multiple holes at the tip.  Despite the many varieties of cannulae available to surgeons, all cannulae share a common requirement: they must be non-cutting, i.e. free of sharp openings or small burrs which are damaging to the fibrous septa, blood vessels and nerves.  Almost all-superficial body fat is accessible to the surgeon’s cannulae.  This fat is to be found as a layer between the skin and the underlying fascia.  Small cannulae are used for the face and extremities, and larger ones are used for the trunk and thighs.  Many different types and styles of cannulae are available, but only a few are really effective.  Possibly the most effective of all cannulae are the Grams – Grazer Mercedes type preferred by us.

Patients usually want to know the long-term effect on the body when fat cells are removed by suction.  After almost 14 years of experience, surgeons all over the world are agreed that localised fat deformities that have been removed do not fully recur, ever, in the patient who gains weight.  The amount of fat that can be removed safely is determined by body size and the amount of subcutaneous fatty tissue.  When these notes were first produced, the general consensus of opinion among liposuction surgeons was that 2 to 3 litres of fat was a much as could be removed safely in 1 treatment.  Today, we know that we can take as much fat as is required providing the formulae for fluid loss and replacement are observed.  With Mega liposculpture, some surgeons have reported removing in excess of 50 litres of fat during a single operation.  Fluid replacement and blood loss replacement are prime considerations for your surgeon when assessing your safety.  It was once believed that patients for Lipoplasty/Liposuction (Fat Removal) should be at or near target weight.  Today surgeons realise that Lipoplasty/Liposuction (Fat Removal) can be a valuable aid in reducing fat in patients who’s weight is such to compromise their health.

Not only are diabetic patients not excluded from Lipoplasty/Liposuction (Fat Removal) but weight reduction can profoundly influence insulin requirements in adult-type diabetes, and some patients require no further treatment.  The answer to the question “Can surgical reduction of fat cells have any influence on the diabetic patient?” is definitely yes, to a limited extent.  Case histories of diabetic patients have shown that insulin requirements have been reduced after aspiration of as little as 1 litre of abdominal fat cells.

In an ideal world patients for Lipoplasty/Liposuction (Fat Removal) should meet 3 criteria: The area they require treating should be a localised deformity. They should be enjoying good physical and mental health and normal body weight.  However as Lipoplasty/Liposuction (Fat Removal) has now been recognised as a medical as well as a cosmetic treatment, surgeons are able to treat most patients who for a variety of reasons need to have fat safely removed.  However, you are more likely to be acceptable for treatment if you conform to the above criteria.  A poor candidate for Lipoplasty/Liposuction (Fat Removal) would be a patient who has undergone massive weight loss, is not in good health, or has unrealistic expectation and/or history of psychological instability.  Loss of tissue turgo, elasticity of the skin and contractibility are contraindications to the procedure.

Excessive body fat compromises general health, leads to increased heart risk and digestive disorders, and is probably related to malignancy.  If you are in this category your surgeon will routinely advise you to loose weight and under certain circumstances may postpone your Lipoplasty/Liposuction (Fat Removal) surgery for a short period before allowing you to undergo treatment.  You may feel good reason exists to follow his advice.

If you are a smoker and interested in undergoing Lipoplasty/Liposuction (Fat Removal) there may be barriers to obtaining treatment.  A history of heavy smoking, which may already have seriously compromised your health, may cause further problems in that postoperative pulmonary complications occur more often in heavy smokers who undergo general anaesthesia.  Worse, there is an increased incidence of skin slough (parts of the skin die in the treated area) as a result of the toxic substance in tobacco e.g. Cyanides, nicotinic acid, nitric acid and other substances.  Smoking is not popular with Plastic Surgeons, or anaesthetists, either of whom requires you to stop smoking for a fortnight or so before your treatment.

Prior to any fat being suctioned, your surgeon will administer a solution of buffered salt, adrenaline and a long acting anaesthetic to the area to be treated.  This procedure is know as the wet technique and adds considerably to efficiency of the treatment.  Bleeding and bruising are reduced by about 90% over conventional liposuction and pain post operatively, is rare.  The solution is delivered by a special cannula, which is carefully worked through to the area to be suctioned.  As well as delivering the solution to the exact area where it is required, it also breaks up the fat allowing it to be vacuumed away.

The size of the cannula and its corresponding openings, plus the amount of vacuum applied and the velocity of the stoke of the cannula, directly affect the amount of fat removed.  In other words, the large the cannula, the higher the vacuum and the fat removed.  Lipoplasty/Liposuction (Fat Removal) is not for the faint-hearted surgeon if it is to be carried out well.  Vacuum is obtained in 2 ways: by pump, driven by an electric motor or from a syringe if the surgeon is carrying out lipoplasty on a smaller area.  Syringe lipectomy, as its known in the States is also known as Liposculpture.  Regardless of the method employed to remove fat, the amount removed will be carefully monitored so as to ensure that an imbalance of removed fat will not occur, as could happen for example in the case of fat removal to the thighs, hips, knees, ankles etc.

Consultation pre-operatively accomplishes several objectives.  Your surgeon must determine if you are an acceptable candidate for the surgery you desire, whether it is a Lipoplasty/Liposuction (Fat Removal)  procedure, a traditional skin tissue reduction, or a combination of the two.  He will wish to ensure that you are well informed about the surgery you are seeking and will almost certainly cover the following points:

• Status of your health
• Your psychological well-being
• If your expectations of the results you are seeking are realistic

Your surgeon will probably begin with a thorough medical history and appropriate physical examination.  You will already have completed a patient medical history information document prior to your consultation appointment.  Medical history is essential to determine your prior medical treatments (if any) and health patterns.  With many patients routinely taking some form of medication or dietary supplement, a careful review determines which medications need to be discontinued and which additional ones will be required prior to surgery.  It is important to determine if prescribed or over-the-counter-drugs can alter or affect the clotting mechanism and to be aware of food additives or agent such as fish oils that decrease clotting.  Garlic is an example of a food that encourages bleeding.

Following your surgery you may be required to wear a pressure garment for between 1 and 6 weeks, depending upon the amount of fat removed.  Specific instructions will be given to you in order that you may safely manage yourself following surgery, you will be encouraged to take gently exercise, but to limit swelling and bleeding, such exercise should be confined at first to simply walking.  Vigorous activity such as tennis, squash, etc, should be avoided for the month following surgery.

Fullness may be taken out of one area and re-deposited into another, for a more pleasing resolution of the silhouette.  However, if advertisements for Lipoplasty/Liposuction (Fat Removal) are to be believed, many people can be forgiven for thinking that this particular aesthetic plastic surgery procedure is the answer to all problems.  There have been major problems with this procedure, which is not as simple as some would have people believe.

A major problem facing Lipoplasty/Liposuction (Fat Removal) today is the need to correct the results of over suctioning and irregular contouring in patients.  Patients who find themselves in situation where over suctioning has occurred have usually contributed to their predicament by failing to ascertain the experience and competence of the surgeon they initially approached to carry out their surgery.  Lipoplasty/Liposuction (Fat Removal) is the most sought after anaesthetic surgery procedure in both the United States and Great Britain.  It has shown itself to be particularly safe (but not without risk as with all surgery) and effective in removing areas of fat, which could not have been removed by another technique.

The procedure is most effective in patients with good skin elasticity, as the skin will contract after the fat has been removed.  Where abnormal collections of fat have developed, Lipoplasty/Liposuction (Fat Removal) has been beneficial in recontouring the body of the trochanteric area, abdomen, hips, lateral thighs, inner thighs, knees, ankles and creating or emphasising a buttock fold.  Older patients and other patients with poor tissue elasticity may also benefit from Lipoplasty/Liposuction (Fat Removal)  in conjunction with traditional surgical body contour methods such as facelift, abdominoplasty and thighplasty (thigh lift).  Where Lipoplasty (Mega Liposculpture) is used for massive weight reduction, patients should be aware that further surgery may be required to deal with the problem of slack skin.

Policy

The Hospital has a policy of disclosing all information on any subject, which may affect its patients.  The complications statement that follows is in accordance with this policy.

Complications

Complications with Lipoplasty/Liposuction (Fat Removal) are quite rare when the procedure is carried out by a competent surgeon but as with any operation, certain problems can occur and it is important that you are aware of them.  Although far from the norm, complications that have been noted with this procedure include thickened and unattractive scars at the site of the small incisions used to introduce the suction device: irregularity of contour of the area treated: possibility of skin loss, which may result in permanent scarring of the area or the need for skin grafting, wrinkling or sagging of the skin: numbness in the area treated: prolonged swelling of the lower extremities when the thighs, buttocks or saddle bags are treated: and accumulation of blood or serum under the skin, requiring removal.  The immediate post operative risk involved in this procedure may be asymmetry, infection, haematoma, pain and pulmonary embolism (1) blood clot to lungs (rare), pulmonary fat syndrome (fat in the lungs – extremely rare).  This is also the possibility that you may not look better from this operation, and it is conceivable that you may even look worse, should complications occur.  The potential exists for personality changes such as profound depression after this, or any other operation.  The risks associated with this procedure are directly related to the amount suctioned and the age of the patient.

Prior to Lipoplasty/Liposuction (Fat Removal) being carried out, patients are advised to cease smoking for 14 days before admission.  If you can’t stop smoking at least try to reduce the amount you smoke.

You should also avoid taking wheat germ oil, cod liver oil or salmon oil capsules for the same period of time.  Also to be avoided is garlic capsules.  Drugs to avoid are Disprins, Codis, Analgen and Veganin or any other product containing Aspirin.  Your surgeon will advise you during your consultation of any other requirements he may have for you, any of which are in order to ensure your treatment is as safe as it can possibly be.

General Anaesthetic

After you have discussed your operation with the surgeon, it will be necessary for you to consider your anaesthetic requirements.  In order for the operation to be performed painlessly, it will be necessary for you to have an anaesthetic of one type or another.  Although we try and avoid the use of full-blown general anaesthetics wherever possible, in many cases, for reasons of your absolute comfort and safety they are required.  Modern general anaesthetics are safe.  You need not fear them.  They are even safe for the type of patient seeking elective surgery because of their fitness levels.

If a GA has been selected as being appropriate in your case you will meet your anaesthetist before the operation but, because your operation is not urgent in a medical sense, it is sensible for you to be as fit and healthy as possible, prior to the anaesthetic.

In order to avoid unnecessary disappointment, this leaflet has been prepared describing some common problems, which can result in the operation being postponed.   If you are in any doubt, please contact the hospital prior to leaving home.  If it is essential to postpone your operation you will then be spared the journey, when a new date can be arranged.

Most people have never had an anaesthetic.  The latter part of these notes describes what will happen before, during and after your anaesthetic.  The description is quite detailed, in the hope that it will take away some of your anxieties.  Your anaesthetist will be taking care of your all through the Lipoplasty/Liposuction (Fat Removal) operation, although you will only be aware of his presence before and after the operation.

Coughs, sore throats, colds and influenza, or any infection in the breathing passages, can be made much worse by a GA.  For this reason you should be symptom free for at least two weeks before an anaesthetic.  Important symptoms include a fever, sore throats, runny nose or cough.

It is very important that your stomach is empty before you have a GA.  For this reason you should not eat, or drink anything, for at least 6 hours prior to your operation.  This will be advised to you on the day of booking your operation with the Patient Information Officer.

Most medical conditions do not cause difficulties for your anaesthetic, providing that they have been adequately treated beforehand.  If you have a problem such as diabetes, chronic bronchitis, or asthma, which deteriorates from time to time, it is best to have your anaesthetic during a good period.

If you are worried that you may not be fit enough for an anaesthetic, ask yourself this question: “while I have suffered from this problem, have I ever been fitter?”  If the answer is yes, please phone the hospital before leaving home, so that we can advise you on the desirability of having an anaesthetic at that particular time.  It may be necessary to delay your operation for a few weeks so that your medical condition can be improved.  This may be a disappointment at the time, but is done for your comfort and safety.

If you suffer from high blood pressure, you may like to ask your GP to check it for a few weeks before your operation.  If your blood pressure is unacceptably high, your GP will be able to read it before your have your operation.  You will appreciate that your GP will already have cared for you during your medical illness.  He is, therefore, in the best position to advise on treatment, which will return you rapidly to full fitness.

Many people do not want their GPs to know that they are having a cosmetic operation.  This is because they believe that he will be unsympathetic.  This is very rarely the case.  We prefer to involve your GP in any treatment, prior to your operation, as his advice can be immensely helpful. 

We will always ask your permission before contacting him and will only do so if you agree.  We hope that you will agree for the reasons just given.

It is important that you bring with you all pills and medications that you are currently taking.  It is important that your anaesthetist knows what you are taking before Lipoplasty/Liposuction (Fat Removal), so that he can give you an appropriate anaesthetic, which will not interact with your tablets.

Excessive consumption of alcohol can cause bleeding during and after the Lipoplasty/Liposuction (Fat Removal) operation.  It is better not to drink at all before the operation but if you feel the need, please do not have more than one pint of beer, or one short, on the evening before your operation is carried out.  If you smoke, you are more likely to develop a chest infection after your operation.  Any reduction in cigarette consumption is helpful.  Ideally, you should stop smoking completely from the time of your first consultation or for that period of time advised by your surgeon.  Smoking has an adverse effect on the outcome of many surgical procedures.

Your anaesthetist will ask you for details of your teeth.  What he wants to know is whether or not you have any crowns, bridges or cosmetic dentistry, which will require him to use a different technique.  Teeth can be and often are, damaged by failure of the patient in informing the anaesthetist that crowns or bridges are present.

The possibility of damage to teeth during anaesthesia is remote, if you have given full dental information prior to your anaesthetic.

Your surgeon will tell you when you can expect to go home after your operation.  If you are discharged on the day of your operation, it is dangerous for you to drive, operate appliances, or machinery.  Long journeys by public transport can be exhausting, even after a minor operation.  It is therefore advisable for you to arrange to be collected by a friend or relative.  You may also find it helpful to stay with someone overnight.  You should not drink alcohol for 48 hours after your anaesthetic or for that period of time advised by your surgeon post operatively.

Each anaesthetist uses a slightly different method.  It is not therefore possible to describe precisely, what will happen.  The following description, will however, give you some idea of what to expect:

Before your operation your anaesthetist will wish to see you.  He will discuss your medical history and will examine your heart and lungs.  A nurse will already have taken your temperature and blood pressure.  Some patients may also have a heart tracing taken (ECG).

The anaesthetist will decide whether this is necessary on the basis of your age, medical history and the examination.

Conversely so, you should not worry if your anaesthetist does not take an ECG reading.  This simply means that your obvious good health obviates its necessity.  An ECG is taken as an added precaution, and you should not assume that the anaesthetist thinks you are ill.  Before an ECG is taken, he will explain why he thinks it is necessary, and afterwards will tell you what it shows.  You will then have a chance to discuss you anaesthetic.  Many people worry unnecessarily because they have head “dreadful stories”.

Modern anaesthetics are extremely safe, and we hope that you will feel free to ask as many questions as you like so that we can set your mind at rest.  You may also be written up for some sleeping tablets, which are optional, but are often helpful the night before an operation.

Before your Lipoplasty/Liposuction (Fat Removal) peration you may be given a pre-med.  This is usually a tablet, but in certain circumstances may be an injection.  The pre-med will make you pleasantly drowsy and reduce your anxiety.  Although you will have been starving in preparation for your operation, it is perfectly in order for you to drink a small amount of water to help you swallow the tablets.  At about this time you will be asked to put on a theatre gown, and to remove all jewellery, except your wedding ring, which will be covered with tape.  You should only wear the gown and your lower undergarment.

About ten minutes before your operation, you will be asked to get onto a trolley and taken to the anaesthetic room, which is next door to the theatre.  The anaesthetic nurse will confirm with you the operation you are having, and will then put on you a blood pressure cuff, and small stickers, which will allow your anaesthetist to monitor your heart beat whilst you are sleeping.

You will then be anaesthetised.  This will involve a small injection in your hand, wrist or below.  You probably will not feel the injection at all, but if you do, it will be no worse than scratching yourself.  You will be asleep within twenty seconds after the injection.

Some people feel a little dizzy just before they fall asleep, others fall asleep instantaneously.  Each person reacts differently, but the majority of our patients do not find our anaesthetic procedure either disturbing or unpleasant.

Whilst you are asleep your anaesthetist will be looking after you all the time.  His sole duty is your safety and welfare.  Several sophisticated electronic monitoring devices are used to assist your anaesthetist.  These constantly monitor your heartbeat, blood pressure, and the quality of anaesthetic being given.

All the machines are fitted with alarms to give your anaesthetist early indication of the very rare occurrence when an abnormality may arise.  This allows the abnormality to be corrected.

When the Lipoplasty/Liposuction (Fat Removal) operation is over, your anaesthetist will wake you up.  By the time you become aware of your surroundings you will be in a special recovery room.

A nurse will be with you until you are completely awake.  You will still be having your heart rate and blood pressure measured at regular intervals by automatic machines.  When you are fully awake (usually about 15 minutes) you will be lifted back into your own bed where you may drift back into natural sleep.  Even though you will not be allowed out of the recovery room until we are confident that your anaesthetic has worn off, it is quite common not to remember anything until you wake from this natural sleep.

Most of these operations are not nearly as painful as your might imagine.  Often the pain can be relieved by simple tablets such as Paracetamol.  Stronger painkillers are always available should you need them.  The nurses will ask you at regular intervals if you are feeling discomfort, or pain, but you may ask for painkillers at any time.

Questions

Are there any risks associated with a general anaesthetic?

Every anaesthetic carries a small risk.  The risk is minimal provided that you are in the fittest possible condition at the time of your anaesthetic, you have ensured that your anaesthetist is fully aware f your medical history and current medication and that you are starved at the time of your operation.  You can help by being honest about your medical history and any previous anaesthetic difficulties.

If your anaesthetist is fully informed he can choose the best anaesthetic for your personal needs.  If there is a risk associated with your anaesthetic, you anaesthetist will discuss it fully with you.  Almost all problems can be overcome, although your operation may have to be postponed for a few weeks.  Postponement of an operation is always a disappointment for the patient.  We understand this, and would only suggest it if we felt that it would add to your safety.

Will I wake up at the end of the operation?

Yes, you will.  There are only a few reasons why patients do not wake up at the end of an anaesthetic.  Most are for medical reasons, which can be anticipated and treated, provided we know your medical history beforehand.  Very rarely does an accident occur.

Almost all accidents occur because the anaesthetist is inexperienced and fails to monitor the patient properly.  Your anaesthetic will be administered by a senior anaesthetist who has passed all the examinations and is employed as a consultant in the NHS.  The monitoring apparatus used at this hospital is all up to the minute technology.

Will I wake up in the middle of the operation?

No.  This problem nearly always occurs in ladies who are having a light anaesthetic for a Caesarean section.  Because the baby’s safety must also be considered, it is vital that the least possible anaesthetic is given.  Sometimes an anaesthetic that is suitable for the baby is too little for the mother.

When you have your operation, the anaesthetist has only you to consider and you will be given as much anaesthetic as you need.  Waking during anaesthesia does not occur often.  It is a fear you need not have at this hospital.

Some operations can, in suitable cases, be performed under local anaesthesia.  The patient is awake and only the part of the body being operated on is anaesthetised.  If this method of anaesthesia is used, you will not need to starve and your medical problems are less important.

Another type of anaesthetic we like to use is sedation therapy.  Instead of a full general anaesthetic, a local anaesthesia is used but with the addition of safe drugs which thoroughly relax you.  If you are awake during your operation, you won’t remember, or feel anything.  However, most patients doze, remembering nothing until they wake up in their own bed.

Many people do not like to be awake during an operation, or even the thought of being awake, even though they will not be able to see the operation itself.  If you feel that you are one of these people, but have been advised to have a local anaesthetic, sedation therapy is for you.  If you are given a sedative, you must be starved prior to your operation.

YOU SHOULD NOT DRIVE OR DRINK ALCOHOL FOR AT LEAST 12 HOURS AFTER THE OPERATION.

This information has been prepared to help you understand your anaesthetic.  If you are worried in any way about what you have read, please contact the hospital so that a further explanation can be given.

We hope that you will be pleased by your new appearance.  Our aim is to make your stay at the hospital as pleasant and trouble-free as possible.

We hope this Lipoplasty/Liposuction (Fat Removal) information has answered most of your questions.  If it hasn’t please jot down any concerns you may have which can be dealt with either by telephoning us on 0800 0281 329 so you can elect to take your enquiry further, during your consultation.  If you do attend for a consultation please feel free to bring along a relative or friend whose judgement you trust, if you feel their presence would support you.

Photographs

Many patients express disappointment at the fact that these notes do not contain photographs taken prior to and following surgery.  The use of photographs projecting “only favourable results” is misleading and such photographs bear no relationship to the surgical result, which can be obtained apart from the patient so depicted.

Photographs of patients show only what was possible in that particular case.  There is no guarantee that you will fare as well, or won’t do better.  If you are interested in seeing photographic examples of your surgeons work, ask for them during your consultation when he can positively ensure that no confusion is allowed to exist.

About our In-House Therapist

Suzie has studied and qualified in many therapies, among them: Psychotherapy, Hypnotherapy, Neuro-Linguistic Programming, Emotional Freedom Technique, Anatomy, Physiology and Physical Therapies.

Suzie has worked extensively on studying the effects of thoughts, life experiences and stress on individuals.  Now an Eclectic Therapist, she works with a wide range of clients at varying levels; from deep seated emotional issues to Image Consultancy.  Suzie’s extensive range of skills have been nurtured through her varied background and experience.  Having worked as a model for several years, she then moved into Theatre and TV, later training as a make-up artist.  It is hardly surprising; therefore, that Suzie is passionate about looking your best, feeling your best and being your best.  She is engaging, warm, grounded and potent individual with a wicked sense of humour. More recently, Suzie has been working as a trainer and facilitator for key corporate organisations.

Don’t miss the opportunity to work with this unique therapist and coach who is keenly aware of the thoughts and feelings of those who wish to make a change.

A quote from Suzie:-

“Many years ago I had a cosmetic procedure.  Whilst I was very pleased with the result, I realise now that I would have benefited in having a caring professional to help support me in addressing other psychological issues that were present, I did eventually seek out a therapist and coach who worked with me, enabling me to take control of my life and make the most of myself and my opportunities.  Seeing the results from people who take time to work with a therapist and coach encouraged me in the belief that what I am doing is worthwhile and valid”.

Our Methodology

Has four main influences in which our therapist and coach is fully qualified and able to support you:

Life Coaching

• Identifying goals and working towards them
• Overcoming any obstacles on the way
• Often used in conjunction with other therapies
• Promoting personal responsibility
• Understanding the techniques
• Putting into operation new ways of being

Hypnosis

• One of the most powerful tools to aid relaxation and de-stress
• Allowing positive suggestions deep into your sub-conscious
• Giving lasting results

NLP (Neuro-Linguistic Programming)

• Understanding self and others
• Using a range of techniques towards significant improvement
• Helping you communicate more effectively
• Building relationships and rapport with others
• A very powerful technique when used with hypnosis

Psychotheraphy

• Using the essence of this therapy for coaching purposes
• Supporting more deep-rooted issues which sometimes occur

What you will gain from coaching

• Clarity
• Focus to fulfil your true potential
• A new found confidence and sense of self
• You will be empowered to go out and be the best you can be!

Making the most of your for the rest of your life 

If you are considering a surgical procedure, it is quite normal to wish for an enhanced look.  Our therapist can also help you focus on the bigger picture, by discussing the psychological and emotional aspects, dealing with what is important to you: focusing on the thoughts, beliefs and feelings that run parallel to your decision.  In this way, you will gain the maximum advantage before, during and after cosmetic surgery, enabling you to make the right decision for the right reasons and with a realistic outcome.  In short, we will be concentrating not only on the “you” outside but also the “you” inside.

We have an extensive range of techniques that can guide, mentor and coach you through to:

• Personal well-being
• Making the most of yourself
• Professional success
• Understanding your strengths
• Achieving your goals
• Being the best you can
• Freeing you from guilt and limitations
• Increasing your self-confidence
• Losing weight (and keeping it off!)
• Eliminating fears and phobias
• Relieving stress

From a one-off session, discussing whether this is correct for you, to your decision to go ahead with surgery, our in-house therapist can help you from step one, supporting you through any fears and anxieties and any emotional issues.

---

"I am so glad I came to see you when I did… I can move on with my life with confidence once again." - Jenny