LIPOSUCTION

Some problem areas are so stubborn that all measures fail. The superfluous fat pads on the chin, stomach, hips, or thighs really cling on, reacting neither to targeted nutrition nor to exercise. Linguistically, they make themselves known as love handles, life rings, fir trees or riding pants - and the reason for their appearance in certain parts of the body unites them: The individual distribution of fat cells is genetically programmed. The eating habits between the ages of 4 and 11 are decisive in determining whether additional fat cells are formed on top of the constitutional fat cells, which can later become a problem. After puberty, the number of fat cells hardly changes. If the body then constantly receives more food than it can process, some fat cells go into passive mode. They store and retain fat and only respond sluggishly to a diet or workout when the active fat cells are completely emptied. What's more, no matter how calorie-conscious your diet or how hard you work out, the number of fat cells always remains the same. And as soon as a diet or fitness program is relaxed, the pads of the problem zones fill up again.

LIPOSUCTION AS A SOLUTION FOR ALL PROBLEM AREAS?

Liposuction can reduce the number of fat cells in a targeted and permanent way. Afterwards, the problem zones are - almost - no longer a problem. Nevertheless: "Liposuction is not an alternative to losing weight. We perform it almost exclusively to remove localized fat deposits in normal-weight patients," says Dr. Cornelius Grüber, plastic aesthetic surgeon and liposuction specialist in Hamburg. The reason: "The amount we can suction out during liposuction is limited to 4 to 5 liters of fat and is not suitable for reducing severe obesity." Liposuction for lipedema is an exception.

Suitable body areas for liposuction: 

• Abdomen
• Hips
• Back (fir trees, back fat)
• Thighs (riding breeches, thigh lift)
• Upper arms (upper arm lift)
• Buttocks
• Double chin
• Ankles
• Knee
• Male breast (gynecomastia)

LIPOSUCTION WITH THE TUMESCENCE METHOD

If only a small amount of fat needs to be suctioned, e.g., to remove the double chin, the specialists for liposuction in Hamburg use the vibration method in combination with the tumescence technique. It is performed under local anesthesia, is particularly gentle on the tissue and is considered by experts to be one of the safest methods of liposuction. In order to remove the fat, tumescent fluid is injected into the subcutaneous tissue. It consists of a sterile saline solution, a local anesthetic, adrenaline, and cortisone. After a waiting time of about 30 minutes, the liquid has distributed itself in the fatty tissue and unfolds its effect there: it ensures a reliable anesthesia of the body part to be treated, so that a general anesthesia is not necessary in most cases.

During this waiting time, the fat cells become saturated with the fluid, the tissue softens and the affected part of the body, e.g., below the chin, swells considerably. This is how the name is derived: tumescere = Latin for swell. The fat cells are then released from the connective tissue and suctioned out with a fine, special cannula. Plastic surgeon Dr. Cornelius Grüber explains the advantages: "The injected solution causes the excess fatty tissue to loosen very well. This makes it possible to suction out the fat without damaging the surrounding tissue with vessels, veins, and nerves. The anesthetic contained is distributed throughout the body and has a long-lasting effect, therefore the patient can turn or sit up during the surgical procedure, so the modeling is visible from different perspectives, and I can also remove remaining fatty tissue. This leads to an even result without dents and asymmetries."

LIPOSUCTION WITH WAL, THE WATERJET-ASSISTED LIPOSUCTION METHOD

Liposuction with the WAL method begins with a small incision of 0.5 to 1 centimeter length in an inconspicuous area. Then the fat cells are loosened from the tissue with an ultra-thin, high-energy water jet and simultaneously suctioned out with fine cannulas. The advantage: there is no need to inject large amounts of fluid before liposuction and the result is already visible during the treatment, which significantly minimizes irregularities. Also, hardly any fluid accumulation remains in the body, which is gentle on the organism and makes the suction of larger amounts of fat possible. The WAL method is applicable to many different body regions and is mostly used for liposuction of the abdomen, legs, thighs, hips, buttocks, arms, or the lateral so-called riding breeches. Patients are in a light twilight sleep during this procedure.

For both water jet assisted liposuction and the tumescent method, a detailed, personal consultation is held, during which the costs and risks are also discussed. On the day of the procedure, final questions are clarified, and then the aesthetic plastic surgeons mark the pads to be removed with lines on the skin before the liposuction.

LIPOSUCTION FOR LIPEDEMA

Lipedema is a pathological, painful symmetrical accumulation of fat on the legs or arms, which is often hereditary. First signs usually appear after hormonal changes such as after puberty, pregnancy and rarely after menopause. In the advanced stage, the fat distribution disorder is easily recognizable: Legs and arms are very voluminous, while the middle of the body as well as hands and feet remain slim. In leg lipedema, the fat proliferation ends at the ankles, for example, so that the fatty tissue overlaps the ankle joint in the advanced stage. Physical discomfort occurs during prolonged standing or sitting and in the evening. The arms and legs feel heavy due to fluid retention and feelings of tension are clearly noticeable. Affected persons react very sensitively to pressure and touch and quickly develop bruises.

CONSERVATIVE THERAPIES FOR LIPEDEMA

Diets are recommended, but they are unlikely to reduce fat in the affected areas. Manual lymphatic drainage and custom-made compression stockings are also recommended. With lymphatic drainage, the physiotherapist decongests the arms and legs by gentle hand movements and the swelling under the skin is reduced. However, physical decongestive therapy rarely produces satisfactory results. At best, the disease can be delayed, but a cure is unfortunately not possible. A lasting improvement is brought by liposuction, which relieves patients of their burden and provides lasting help to those affected.

THE MEANS OF CHOICE: WATERJET-ASSISTED LIPOSUCTION.

"Because the fat cells are pathologically altered, lipedema requires more challenging liposuction to achieve an even result. Sometimes, multiple procedures are necessary," says plastic aesthetic surgeon Dr. Sonja Tomschik.

Waterjet-assisted liposuction is a safe, low-complication and effective method of treating lipedema. It can reduce the increased pain and swelling tendency, prevent secondary diseases such as joint damage, and improve appearance and quality of life. There should be a time interval of at least four weeks between the suctioning of two areas.