Liposuction, usually shortened as just ‘lipo’, is one of the commonest cosmetic procedures performed by plastic surgeons world-wide.

It is basically a procedure to remove or reduce fat under the skin in different body parts with the aim of improving the natural body shape and contouring. 

Previously, procedures such as liposuction, among other cosmetic procedures, weren’t commonly performed in our settings for various factors such as limited expertise as well as limited equipment. People that wished to have such procedures had to spend a lot of money and time to have these done abroad, at very high costs.

In Rwanda today, with the availability of plastic surgery experts and high technology medical equipment, procedures such as liposuction are done. Rwandans, as well as people from neighboring countries come for such cosmetic procedures in Rwanda.

In our daily clinical practice as well as out of hospital, questions such as "what is a liposuction? Do you do lipos? , how is it done? Can I come for a lipo? What will a lipo change on me?” frequently come up. 

With liposuction, a plastic surgeon introduces a tube under the skin through a very small cut on the skin. The tube is connected to a machine that will help in introducing a liquid that eases the fat, as well as sucking out the fat in the targeted body areas. A surgeon determines how much fat to remove for the best final appearance. This can be done under local anesthesia or when completely put to sleep depending on how much liposuction is to be done, or patient and surgeon preferences. The patient usually goes back home same day of surgery, though may need overnight hospital stay in some cases. 

First and foremost, one needs to understand that liposuction is mainly aimed at improving the body shape and contour, and not a method of treating obesity or obesity related health conditions. It is not an alternate to the other methods of weight loss, and will in fact not be indicated if one is generally very obese. With lipo, fat is removed from specific targeted fat areas of the body and not the whole body. Usually liposuction is done after one has tried exercise, diet modification and has obtained a stable weight for at least six months, but has some areas where fat has persisted despite those. These areas of liposuction on the body may include the tummy, back, chest, under the chin, arms, thighs, etc. 

It is also important to know that liposuction will not treat the excess redundant skin that one has developed after weight gain, hence, these skin folds will require to be removed with an extra surgery, with or without liposuction. In fact, liposuction is commonly combined with surgery to reduce the excess skin that results after the fat loss. 

Liposuction will generally give one a more beautiful, appealing body shape and contour if it is done for the best candidate and by a well-trained surgeon. It is, however, important that one has realistic expectations from the procedure and not expect to attain the shape that they want, rather the shape that they can possibly attain. 

Liposuction will also require one to be patient and committed for the best final results since it will depend not only on the procedure, but on how the person complies with the instructions after.  Usually the person will experience some pain despite pain medications, bruising over the skin for some days, and will need to wear some kind of compressive garments for four to six weeks after the procedure.  Much more adverse complications from the operation such as blood clots are rare, but have been reported. The final results of a liposuction may also take up to six months to show, hence, the need for patience all throughout. These results are also not permanent and can change if one later generally gains more weight. 

Liposuction can also be done multiple times, either for the same body areas in case of fat residues or fat recurrences, or at different body sites. 

Dr. Ian Shyaka Resident, Plastic Surgery Rwanda Military Hospital 

iangashugi@gmail.com