Your liposuction in Sindelfingen
Being aware of your own body, keeping it in shape through a healthy diet and physical activity and staying fit are important pillars of our modern lifestyle. Despite regular exercise and a conscious diet, however, bothersome fat pads can remain that are practically impossible to influence with these approaches. These regions, also known as problem areas, affect women and men equally and follow very individual and gender-specific patterns.
Typical affected regions in women are the waist and lower abdomen, the outer thighs (so-called saddlebags) or the calves; in men, usually the lateral and rear flanks, the entire abdominal region or the chest. Smaller regions for which liposuction is very well suited include, for example, the chin/neck region (in the case of a double chin) or the mons pubis.
Such localized fat accumulations usually lead to an unfavorable overall appearance of the body or make the body silhouette look disproportionate. This can result in discomfort but also restrictions, up to reduced self-esteem. Liposuction certainly cannot replace a healthy lifestyle or weight reduction, but it does offer the possibility of removing stubborn fat pads effectively and permanently.
In addition, liposuction can model or refine existing contours to match your personal ideal figure (so-called high-definition liposuction or liposculpture).
Among specialists, in the absence of a medical indication (necessity), we speak of aesthetically motivated liposuction, whose results can be further perfected by state-of-the-art medical procedures such as additional plasma skin tightening. In addition to the desired volume reduction through liposuction, this leads to targeted skin tightening and stimulation of collagen production.
A medical indication for surgical fat tissue reduction, on the other hand, exists in the presence of a pathological fat distribution disorder (lipedema). This condition affects women almost exclusively.
In addition to hereditary factors (familial clustering), outbreaks of the disease are also repeatedly seen during pregnancy and menopause, which is why hormonal factors are also discussed as a cause.
At the onset of the disease, however, it is usually women between the ages of 20 and 30 who are affected.
In lipedema, different distribution patterns are distinguished. In most cases, the lower half of the body, i.e. the hip, buttock and leg region, is affected, and the disease usually also affects the arms. The disease occurs in both overweight and normal-weight women, although the distribution patterns described and the associated disproportions are usually easier to recognize in women of normal weight than in the case of general obesity.
Those affected usually suffer from severe feelings of tightness up to pain and bruise easily, which results from the high tissue pressure within the tissue and on the fine subcutaneous vessels. The disease often shows a progressive and sometimes episodic course.
Lipedema can and should be diagnosed as early as possible on the basis of typical features, characteristics and course. Ideally, this is first done by a vein specialist (phlebologist), who uses clinical tests and, if necessary, further examinations to assess the blood and lymph vessels to at least raise the suspicion or make the diagnosis, classifies the lipedema into different stages (stage I–III) according to its appearance or severity, and then recommends or refers you to the plastic surgeon.
Even though the diagnosis can of course be made by an experienced specialist in plastic and aesthetic surgery on the basis of clinical criteria, it is advisable to see a colleague specializing in phlebology beforehand, as the examination methods used in each specialty further substantiate the diagnosis of lipedema.
Through a joint assessment and taking into account your expectations, wishes and concerns as an affected woman, the best possible treatment concept for you can thus be developed and implemented.
Once the diagnosis has been made correctly, a stage-appropriate treatment concept must follow, which always includes at least accompanying conservative treatment approaches (above all decongestion or compression treatment, long-term weight control, regular exercise and sport…).
In the treatment of lipedema, depending on the stage, symptoms and level of distress, essentially two therapeutic approaches can be considered:
On the one hand, there is so-called “complex decongestive therapy, CDT for short”, which primarily aims to relieve symptoms, slow the progression of lipedema and prevent an additional lymphedema component (lipo-lymphedema). The CDT treatment approach therefore has a clear justification and necessity at the onset of the disease, throughout its course and usually also after surgical liposuction.
In my experience and in everyday practice, however, it is all too often the case that affected women only receive a correct diagnosis late and the necessary treatment accordingly also starts late. This in turn means that by the time the diagnosis is made or a specialist is consulted, there are already pronounced and disproportionate fat accumulations that can only be reduced effectively and permanently by professionally performed liposuction!
Liposuction, combined with consistent decongestive therapy and an adapted, healthy lifestyle, can make a significant contribution to relieving symptoms and improving the well-being of women affected by lipedema.
Key facts about liposuction
| Duration of surgery: | 1–4 hours |
|---|---|
| Special features: | state-of-the-art & gentle technique (water-jet method), extensive expertise in lipedema, can be combined with lifts |
| Type of anesthesia: | local anesthesia (tumescent anesthesia), general anesthesia if necessary (for large suction volumes, e.g. lipedema, or combined operations) |
| Hospital stay: | outpatient, 1 overnight stay if needed (for large-volume liposuction or combined surgery) |
| Aftercare: | Physical rest for approx. 1–2 weeks, compression garment for at least 6 weeks, scar care, sun protection, regular follow-up appointments for 1 year, |
| Suture removal: | none, usually not necessary as the sutures are self-dissolving |
| Back to social life: | after 2–7 days depending on the course of healing and the region |
| Back to work: | after approx. 1 week for light office work, after approx. 2 weeks for heavy work |
| Sports activities: | after 1–6 weeks (depending on the sport) |
| Treatment costs: | from €1,500 (depending on location, extent and number of regions) |
Frequently asked questions (FAQs) about liposuction
Who is suitable for liposuction?
Surgical liposuction is suitable for the targeted reduction or removal of localized fat pads that do not respond to conservative methods such as weight reduction and targeted exercise, and aims to improve the body contour.
Furthermore, liposuction is the only form of treatment that can effectively and permanently reduce the amount of fatty tissue in chronic fat distribution disorders such as lipedema and fat deposits after pregnancy.
In addition, liposuction is suitable for targeted modeling of individual body areas, for example to emphasize certain muscle groups or to adapt existing contours to your personal ideal of beauty (high-definition liposuction).
However, liposuction cannot replace necessary weight reduction, for example in the case of obesity, and in that case it leads to increased surgical risks.
Which areas are suitable for liposuction?
In principle, liposuction can be used on all regions of the body. The most frequently treated areas are the abdomen, the waist, the hips, the outer thighs (saddlebags), the inner thighs, the knee region, the upper arms, the chin and the male chest, e.g. in the case of gynecomastia/pseudogynecomastia. The former is an enlargement of the male mammary glands, which can lead to increased breast volume and feminization of the chest, including the areolas.
In pseudogynecomastia, various factors and influences cause a localized increase in fatty tissue, which can also lead to feminization of the male chest. In many cases, there are mixed forms of the types described, which can be treated very well with liposuction.
Less frequent but also possible is liposuction of the calves, buttocks or back.
What liposuction procedures are there?
There are now various established techniques for liposuction. Almost all of them have in common the use of a special fluid (Klein's solution), which is injected into the tissue before or during the actual treatment in order to anesthetize the tissue, loosen it and prepare it for suction. Various procedures are used for the subsequent liposuction: power-assisted liposuction (PAL),
water-assisted liposuction (WAL) or ultrasound-assisted liposuction (UAL). Other techniques use laser technology (LAL) or radiofrequency (RFAL).
Which procedure do we use?
Depending on the location, volume and circumstances, I use different techniques to remove the fatty tissue effectively and gently. For large areas such as the abdomen, waist, hips and thighs, I use the so-called water-jet technique (Body-Jet), water-assisted liposuction (WAL). Unlike other procedures, this method requires less volume and exposure time of the previously injected fluid that prepares the tissue for liposuction. In the Body-Jet procedure, the fat cells are detached from the surrounding tissue by a fan-shaped water jet and suctioned off simultaneously with an atraumatic suction cannula. The advantages are that the surrounding tissue, especially the blood and lymph vessels and the nerves, is particularly well protected, while suction is very effective at the same time.
In experienced hands, the procedure therefore has very few complications, which is why it is also of great importance in our practice for the treatment of lipedema (chronic fat distribution disorder).
For very small areas such as the chin region (in the case of a double chin), the manual suction technique is suitable, in which, after the previously injected fluid has taken effect, the fatty tissue is reduced in a controlled manner with very narrow, atraumatic cannulas by gently sliding them back and forth.
Especially in circumscribed and small areas such as the chin and neck region (e.g. in the case of a double chin), fat-dissolving injections (lipolysis) may be a sensible, non-surgical alternative to surgical liposuction.
I will be happy to advise you in detail on the various procedures.
What is the procedure for the operation / liposuction?
Before the operation, I mark the areas to be treated and calmly explain the entire procedure to you once again. You are then prepared for the operation. This means that I inject a special fluid (tumescent solution / Klein's solution) into the treatment areas, causing the tissue to swell. The main components of this fluid are saline solution and an anesthetic, supplemented by medications that greatly reduce the risk of bleeding. After an exposure time of about 30 minutes, the liposuction is performed, which can take between 1 and 3 hours depending on the number of regions, location and volume. Unlike smaller liposuctions, which can be carried out under local anesthesia and twilight sedation, general anesthesia is recommended for time-consuming large-volume liposuction or combined procedures so that you can relax completely. The liposuction itself is carried out with constant checks for symmetry and with the aim of achieving the most harmonious transitions possible to neighboring regions. At the end of the operation, the incisions, which are only a few millimeters long, are sutured with absorbable stitches if necessary. The small wounds are covered with sterile plasters and the compression garment is put on. You can then recover from the procedure. We pay attention to sensible positioning, freedom from pain and rapid mobilization, with recommendations that are very helpful for the time at home.
What are the risks of liposuction?
In experienced hands and using the appropriate techniques, liposuction is a procedure with relatively few complications. Typical complaints are temporary swelling and bruising, feelings of tightness and numbness in the treated areas. Irregularities or slight asymmetries may also exist temporarily and are usually an expression of differing degrees of swelling or tissue irritation. Major complications such as significant secondary bleeding, serious wound healing problems or injuries to important structures, up to circulatory collapse, on the other hand, occur extremely rarely with the appropriate expertise and can largely be avoided. Compression treatment, especially when treating the legs, is of great importance, also with regard to the not insignificant risk of thrombosis/embolism (blood clot formation/migration). In addition, you should activate the “calf muscle pump” by specifically moving your feet (while lying down) and by going for walks.
What should be considered before and after liposuction?
Before the treatment, it is advisable to aim for your personal feel-good weight, which ideally corresponds to your normal weight. The reason for this is that subsequent weight gain or frequent weight fluctuations can have an unfavorable effect on your tissue and your result.
In the case of previous abdominal operations or older patients, I always ask for a medical report on an ultrasound examination of the abdominal wall, which you can have carried out by your family doctor or a radiologist. In particular, weaknesses in the abdominal wall such as an umbilical hernia or incisional hernias should be ruled out. Such pathologies, but also existing scarring after abdominal operations (e.g. after removal of the gallbladder or after previous liposuction), make (repeat) liposuction more difficult and may therefore increase the surgical risk. Depending on the circumstances, I will also ask you to provide a current blood count with coagulation values. Anticoagulant medications such as aspirin/ASA or heparin and Marcumar must be paused or switched 14 days before the operation in consultation with your family doctor. If continuous blood thinning is necessary, I may have to cancel the operation.
To minimize the already low risk of inflammation or wound infection, you should, if necessary, shave the treatment area thoroughly one day before the operation. This usually applies to men or to treatments in the intimate area, such as the mons pubis.
After the operation, some wound fluid will drain from the small skin openings for a few days, which is why we give you suitable pads to place under the compression garment. In preparation, please also obtain a sufficient number of commercially available pads, such as thicker sanitary pads, for home. The drainage of wound fluid is completely normal and the simplest way for the body to rid itself of excess fluid. For proper wound hygiene, please change damp plasters and pads regularly. From the very first day after the treatment, you may and should shower as normal, but also pay attention to adequate wound hygiene by disinfecting the wounds and applying fresh plasters and pads if necessary. You must wear the compression garment consistently around the clock for at least 6 weeks, except for your daily hygiene needs, as it above all regulates the swelling that develops, facilitates lymphatic drainage and shapes the result. To further reduce swelling, I recommend cooling the treated areas and, if necessary, taking arnica, which usually reduces the formation of bruises. These practically always occur with liposuction and disappear after about 10–14 days. Make sure you rest physically for about 1–2 weeks. Short walks alternating with rest breaks stimulate your circulation, counteract swelling and blood clot formation (thrombosis) and thus accelerate healing. You should refrain from more strenuous sporting activities for up to 6 weeks depending on the region. Nicotine consumption is known to have a negative effect on wound healing and should be stopped for a few weeks before and after the operation.
When is the result of liposuction visible?
I am repeatedly asked how much weight you will ultimately lose through liposuction. The answer is rather sobering, because after the operation you will, if anything, notice a slight weight gain. The reason is that your body will first rid itself of excess fluid retention in the first days and weeks, which is visually noticeable as swelling. In addition, fatty tissue is significantly lighter than muscle tissue. Body weight is therefore not an indicator of treatment success.
You will of course notice the effect of liposuction, i.e. the tissue reduction and improvement in shape, immediately. However, it can take 3–6 months until the last swelling subsides and the final result is visible. Consistently wearing the compression garment and following the appropriate rules of conduct have an equally positive effect on healing and on the treatment result.
How much does the treatment cost?
The treatment costs depend on the surgical technique, the number of regions to be treated (e.g. front of the abdomen, flanks, outer thighs, etc.) and thus also on the surgical effort and duration of the operation, as well as the need for anesthesia and/or an overnight stay.
They are between approx. €1,800 and €6,000. The treatment of 1–2 regions can usually be carried out very well under local anesthesia (so-called tumescent anesthesia), which means no further costs for you. Depending on the circumstances, and especially with larger suction volumes, several regions and combined procedures (e.g. intimate surgery), the operation should, however, be performed under general anesthesia. The costs of anesthesia and of any accommodation in a single room in the private clinic are invoiced to you transparently and separately.
