# Liposuction (Lipoplasty)

> **Liposuction** is a surgical procedure that removes excess fat deposits from specific areas of the body to address contours and proportions.

- Canonical page: https://doctormaresky.co.za/procedure/liposuction
- Category: [Body Contouring](https://doctormaresky.co.za/procedure-category/body-contouring)
- Procedure directory: https://doctormaresky.co.za/procedures.md
- Medical disclaimer: https://doctormaresky.co.za/medical-disclaimer


## Overview

**Liposuction** (also called lipoplasty or suction-assisted lipectomy) is a surgical technique that removes excess fat deposits from specific areas of the body to improve body contours and proportions. It is **not a weight loss solution** but rather a body contouring procedure for individuals close to their ideal weight who have stubborn fat deposits resistant to diet and exercise.

**Dr Maresky** performs liposuction on various body areas including:

**Common Treatment Areas**:
- **Abdomen** (upper and lower belly)
- **Flanks** (love handles)
- **Thighs** (inner, outer, front, back)
- **Hips** and buttocks
- **Arms** (upper arms, "bat wings")
- **Back** (bra rolls, lower back)
- **Chest** (male breast reduction, gynecomastia)
- **Chin and neck** (double chin, jowls)
- **Knees** (inner knees)
- **Calves and ankles**

Liposuction may be considered for localized fat deposits that do not respond to lifestyle measures. It is not a weight-loss procedure, and suitability depends on assessment of skin quality, anatomy, and health history.

**Dr Maresky** uses techniques such as **tumescent liposuction** and **VASER (ultrasound-assisted) liposuction** when appropriate for the patient's anatomy and treatment goals.

## The procedure

- **Duration:** **1-4 hours** depending on number of areas treated and amount of fat removed

- **Anaesthesia:** **General anesthesia** or **IV sedation with local anesthesia** (tumescent technique) depending on extent of procedure

- **Location:** **Christiaan Barnard Memorial Hospital** - private hospital facility

### Procedure steps

- **Anesthesia**: You're given general anesthesia or IV sedation for comfort
- **Marking**: **Dr Maresky** marks treatment areas while you're standing
- **Tumescent solution**: A solution containing saline, lidocaine (anesthetic), and epinephrine (to minimize bleeding) is injected into treatment areas
- **Incisions**: Small incisions (3-5mm) are made in inconspicuous locations
- **Fat removal**: A thin cannula (hollow tube) is inserted through incisions and moved back and forth to break up fat, which is suctioned out using a surgical vacuum
- **Contouring**: **Dr Maresky** sculpts the area for smooth, natural-looking contours
- **Closure**: Incisions are closed with sutures or left open to drain
- **Compression garment**: A compression garment is applied to reduce swelling and support healing

- **Technique:** **Dr Maresky** uses advanced liposuction techniques:

**Tumescent Liposuction**: The gold standard technique using tumescent solution to minimize bleeding, reduce pain, and improve fat removal.

**VASER Liposuction** (Vibration Amplification of Sound Energy at Resonance): Ultrasound energy liquefies fat before removal, allowing for:
- More precise fat removal
- Better skin tightening
- Reduced bruising and swelling
- Faster recovery
- Ability to treat fibrous areas (male chest, back)

**Power-Assisted Liposuction (PAL)**: Mechanically vibrating cannula for easier fat removal in dense areas.

## Candidate information

- Adults **within 30% of ideal body weight** with good skin elasticity
- Individuals with **localized fat deposits** resistant to diet and exercise
- Non-smokers or those willing to **quit smoking 4 weeks** before and after surgery
- Those with **realistic expectations** about results
- Individuals in **good overall health** without serious medical conditions
- Patients with **good skin tone** (skin that can contract after fat removal)
- Those committed to **maintaining results** through healthy lifestyle
- Non-pregnant, non-breastfeeding individuals

## Preparation

- **Timeline:** **2-4 weeks** before surgery

### Medical tests

- **Complete blood count (CBC)**
- **ECG if over 40 years old**
- **Chest X-ray if indicated**
- **COVID-19 test if required**
- **Pregnancy test** for women of childbearing age

### Medications

#### Medications to discuss stopping

- **Stop** aspirin and blood thinners **2 weeks** prior
- **Stop** NSAIDs (ibuprofen, naproxen) **1 week** prior
- **Stop** herbal supplements (ginkgo, garlic, ginseng) **2 weeks** prior
- **Stop** vitamin E supplements **1 week** prior
- **Discontinue** oral contraceptives if advised by **Dr Maresky**

#### Medications to continue

- **Continue** essential medications as advised by **Dr Maresky**
- **Inform Dr Maresky** of all current medications during consultation

### Lifestyle

- **Smoking:** **Quit** smoking at least **4 weeks** before surgery to promote proper healing and reduce complications

- **Alcohol:** **Avoid** alcohol **48 hours** before surgery

- **Fasting:** No food or drink after midnight the night before surgery (**NPO after midnight**)

- **Exercise:** Maintain healthy weight - liposuction is not a weight loss solution

### Arrangements

- **Arrange** transportation home after surgery - you cannot drive
- **Arrange** for a responsible adult to stay with you for the first **24-48 hours**
- **Prepare** recovery area at home with pillows, medications, and entertainment
- **Purchase** compression garments as recommended by **Dr Maresky**
- **Stock** easy-to-prepare meals and plenty of fluids
- **Plan** time off work (**1-2 weeks** depending on extent of procedure)

## Recovery and aftercare

### Timeline

- **Immediate:** Compression garment applied; mild to moderate discomfort managed with pain medication

- **24 48hours:** Drain tubes removed (if used); continue wearing compression garment

- **1week:** Sutures removed; most swelling and bruising present; return to light activities

- **2weeks:** Significant improvement in swelling; return to work (desk job); continue compression garment

- **4 6weeks:** Most swelling resolved; return to exercise gradually; may still wear compression garment

- **3months:** **90% of swelling resolved**; results becoming apparent

- **6months:** **Final results** visible; all swelling resolved; scars fading

- **1year:** Scars mature and fade to thin, barely visible lines

### Restrictions

#### First 24 hours

- **Bed rest** with assistance for bathroom
- **No** driving
- **Keep** compression garment on at all times
- **Take** prescribed pain medication as directed

#### First 2 weeks

- **Avoid** strenuous activities, heavy lifting, and exercise
- **No** swimming or soaking in water (showers okay after 48 hours)
- **Wear** compression garment **23 hours/day** (remove only for showering)
- **Sleep** with head and torso elevated
- **Walk** regularly to prevent blood clots
- **Avoid** alcohol and smoking

#### 2 6weeks

- **Gradually** resume exercise as approved by **Dr Maresky**
- **Continue** wearing compression garment during day
- **Avoid** sun exposure to incision sites
- **Attend** all follow-up appointments

#### Long term

- **Maintain** stable weight through healthy diet and exercise
- **Protect** skin from sun damage
- **Stay** hydrated and maintain healthy lifestyle

- **Pain management:** **Moderate discomfort** for first few days, managed with prescribed pain medication. Most patients describe it as muscle soreness similar to intense workout. Pain significantly improves after first week.

- **Scarring:** **Minimal scarring** - incisions are very small (3-5mm) and placed in natural skin creases or inconspicuous areas. Scars fade to thin, barely visible lines within 6-12 months.

## Expected results

- **Timeline:** **Initial improvement**: 2-4 weeks
**Significant improvement**: 3 months
**Final results**: 6-12 months (after all swelling resolves)
**Permanence**: Fat cells removed are gone permanently, but remaining fat cells can enlarge with weight gain

- **Expectations:** **What Liposuction CAN do**:
- Remove stubborn fat deposits resistant to diet and exercise
- Improve body contours and proportions
- Address localized contour concerns
- Refine selected treatment areas when skin quality is suitable
- Support longer-term contour changes when weight remains stable
- Treat multiple areas in one procedure

**What Liposuction CANNOT do**:
- Replace healthy diet and exercise
- Remove cellulite or stretch marks
- Tighten loose, sagging skin (may need skin removal surgery)
- Treat obesity or serve as weight loss solution
- Prevent future weight gain
- Guarantee perfect symmetry (bodies are naturally asymmetric)

- **Satisfaction:** Liposuction outcomes depend on skin quality, anatomy, weight stability, and post-operative care. Dr Maresky discusses realistic goals, limitations, and recovery during consultation.

## Risks and considerations

### Common

- **Bruising and swelling** (expected, resolves over weeks)
- **Temporary numbness** in treated areas (resolves in weeks to months)
- **Fluid drainage** from incisions (normal for first few days)
- **Soreness and discomfort** (managed with pain medication)
- **Temporary skin irregularities** (usually smooth out over time)

### Rare

- **Contour irregularities** (lumps, bumps, asymmetry) - may require revision
- **Seroma** (fluid accumulation) - may need drainage
- **Infection** (rare with proper antibiotic use)
- **Skin discoloration** or pigmentation changes (usually temporary)
- **Prolonged swelling** in some patients
- **Scarring** (hypertrophic or keloid scars in predisposed individuals)

### Serious

- **Deep vein thrombosis (DVT)** or pulmonary embolism (rare, prevented with early mobilization)
- **Fat embolism** (extremely rare, serious complication)
- **Excessive bleeding** requiring transfusion (very rare)
- **Skin necrosis** (death of skin tissue) - rare with proper technique
- **Perforation of organs** (extremely rare with experienced surgeon)
- **Anesthesia complications** (minimized by experienced anesthesiologist)
- **Lidocaine toxicity** (rare with tumescent technique, monitored carefully)

- **Prevention:** Appropriate specialist assessment, careful patient selection, surgical technique, and post-operative care are essential for managing risk.

## Frequently asked questions

### Is liposuction a weight loss procedure?

**No**, liposuction is **not a weight loss solution**. It's a body contouring procedure for individuals close to their ideal weight who have localized fat deposits. You should be within **30% of your ideal weight** before considering liposuction.

### How much fat can be safely removed?

For safety, **Dr Maresky** typically removes **up to 5 liters (11 pounds) of fat** in a single session. Larger volumes increase risks. If more fat removal is needed, it may be staged over multiple procedures.

### Will the fat come back?

Fat cells removed are **gone permanently**. However, remaining fat cells can enlarge if you gain weight. Maintaining a stable weight through healthy diet and exercise preserves your results long-term.

### Can liposuction remove cellulite?

**No**, liposuction does **not remove cellulite**. In fact, it may make cellulite more noticeable if skin elasticity is poor. Other treatments (laser therapy, subcision) may be better for cellulite.

### Will I have loose skin after liposuction?

If you have **good skin elasticity**, skin will contract after fat removal. If you have **poor skin elasticity** or significant fat removal, you may have loose skin requiring skin removal surgery (tummy tuck, arm lift, etc.). **Dr Maresky** assesses this during consultation.

### How long until I see results?

You'll see **initial improvement in 2-4 weeks** as swelling decreases. **Significant improvement** appears at **3 months**, with **final results** visible at **6-12 months** after all swelling resolves.

### Can I combine liposuction with other procedures?

**Yes!** Liposuction is commonly combined with **tummy tuck**, **breast procedures**, **facelift**, or other surgeries. Combining procedures saves time and cost. **Dr Maresky** will discuss safe combinations during consultation.

### What's the difference between liposuction and tummy tuck?

**Liposuction** removes fat only. **Tummy tuck** removes excess skin and fat, tightens abdominal muscles, and repositions belly button. If you have loose skin or muscle separation, tummy tuck is better. They're often combined.

### How painful is liposuction recovery?

Most patients describe **moderate soreness** similar to intense workout. Pain is managed with prescribed medication and significantly improves after the first week. Compression garments help reduce discomfort.

### When can I return to work?

Most patients return to **desk work in 1-2 weeks**. Physical jobs may require **2-4 weeks** off. **Dr Maresky** provides personalized recommendations based on your procedure extent and job requirements.

### When can I exercise after liposuction?

**Light walking** immediately (encouraged to prevent blood clots). **Light exercise** at **2 weeks**. **Full exercise** at **4-6 weeks** as approved by **Dr Maresky**. Gradual return prevents complications.

### What is VASER liposuction?

**VASER** uses ultrasound energy to liquefy fat before removal, allowing for more precise contouring, better skin tightening, less bruising, and faster recovery compared to traditional liposuction. It's ideal for fibrous areas like male chest and back.

## Indicative pricing

- Estimate: R55,000 to R90,000 ZAR
- Cost factor: Number of areas treated
- Cost factor: Technique add-on
- Detailed cost page: https://doctormaresky.co.za/cost/liposuction
- Final pricing is confirmed after an individual consultation.

## Consultation and contact

- Consultation: https://doctormaresky.co.za/procedure/general-consultation
- Contact: https://doctormaresky.co.za/contact