- Treatment duration30 minutes to 3 hours
- AftercareCompression garment for 4 to 6 weeks
- Anesthesiadepending on the procedure: local anesthesia, twilight sleep, general anesthesia
- Downtime5 to 7 days
- HospitalizationOutpatient surgery, in case of major surgery one night inpatient stay
- Costsfrom 2000 Euro incl. VAT after GOÄ
The reasons for 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:
- Back (fir trees, back fat)
- Thighs (riding breeches, thigh lift)
- Upper arms (upper arm lift)
- Double chin
- Male breast (gynecomastia)
METHODS FOR LIPOSUCTION IN HAMBURG
The most suitable areas for liposuction are troublesome fatty tissue on the outer thighs (saddlebags), the inner thighs and on the abdomen and hips. However, smaller areas on the ankles, knees, upper arms, chin and neck, or back can also be removed by liposuction. With great sensitivity and experience, the experts at the HANSEATICUM in Hamburg bring the body into top shape.
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: STEP BY STEP
Before the operation, the current condition is documented with photos and the procedure is carefully planned.
A pencil is used to mark the area of the body where the fat is to be suctioned off.
The procedure is performed on an outpatient basis under local anesthesia, if desired under twilight anesthesia, rarely under general anesthesia.
The attending specialist makes minimal incisions to insert the cannula and sucks out the fat.
After the minimally invasive surgery, the incisions are closed with small plasters, in most cases it is not necessary to stitch the small wounds.
Afterwards, compression garments are applied, or a pressure bandage is applied after the double chin liposuction.
The compression garments support the regeneration and prevent dents and should be worn consistently for several weeks or months to guarantee the best possible result.
The procedure lasts between 1 and 3 hours, depending on the effort required.
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.
Liposuction prices are as individual as the patient. The cost depends on how many zones are treated and what method is used for liposuction. A small procedure such as on the chin costs from 1500 euros. However, if you want additional tightening, the surgery is more complex and therefore more expensive. Likewise, the cost of liposuction is higher if it is performed under twilight sleep (local anesthesia with additional administration of sleeping pills and monitoring by an anesthesiologist) instead of local anesthesia. In a personal consultation in Hamburg, you can clarify all details about liposuction with the plastic aesthetic surgeons Dr. Cornelius Grüber and Dr. Sonja Tomschik.
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.
FREQUENTLY ASKED QUESTIONS
WHAT ARE THE RISKS?
Bruising, asymmetry, or slight irregularities are possible. Medical complications such as thromboses and embolisms, severe infections, large bruises or dying tissue are extremely rare and almost impossible when liposuction methods are used safely by an experienced treating physician. Mild pain, comparable to sore muscles, may last up to 2 to 3 weeks. Bruising may be visible for 6 to 10 weeks, depending on predisposition.
WHAT HAPPENS AFTER THE PROCEDURE?
You can return to your normal daily routine after a few days. You should wait at least 2 weeks before exercising. Depending on the indication, you should wear the compression garments for 4 to 8 weeks - the micro-movements between the skin and the compression garments lead to increased lymphatic drainage.
WHEN IS THE FINAL RESULT?
The result of the procedure can be seen after about 6 months, bruises may be visible for up to 2 months, dark discoloration of the skin may persist for several months.
WHY IS LIPEDEMA A SPECIAL CASE?
Liposuction is often the only treatment option for lipedema to stop the progression of the disease.
WHEN IS LIPOSUCTION NOT SUITABLE?
Liposuction is not suitable for people who are very overweight. They should first reduce the weight with other methods. Liposuction is risky for patients with health problems such as diabetes, heart or lung diseases, circulatory insufficiency, tumor diseases or open wounds and eczema.
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