Liposuction / Lipoaspiration

Liposuction uses fine cannulas to remove fat from selected areas such as the abdomen, flanks, thighs, arms or under the chin.

Also known as lipoaspiration, the procedure targets localised fat deposits that alter the body’s proportions and persist despite diet and exercise. The aim is not weight loss but a more harmonious contour. Liposuction can be performed on its own or combined with other procedures, for example a thigh lift or brachioplasty. At Detalii Med in Baia Mare, the procedure is performed by Dr Marius Pruna and Dr Valeria Pruna, plastic surgeons.

It is intended for patients at a relatively stable weight with localised deposits that persist despite a balanced lifestyle.

Results are usually better when:

• weight is close to the desired weight and stable;
• the skin has good elasticity, allowing it to adapt to the new contour;
• general health allows the procedure;
• the patient has realistic expectations and wants an improvement in shape, not weight loss.

In people with significant excess skin, liposuction alone may accentuate laxity, and other procedures may be more suitable.

It can reshape contour but is not a weight-loss method, does not correct major skin laxity and cannot remove cellulite completely.

Liposuction can reduce deposits that do not respond to exercise, improve symmetry and better define certain areas. It does not replace a balanced diet and physical activity, and it does not treat fat inside the abdomen, around the organs. The volume that can be safely removed in a single operation is limited, and staging is sometimes preferable.

Consultation assesses fat distribution, skin elasticity, weight, medical history and thrombosis risk. Areas and a safe treatment volume are agreed.

The surgeon discusses which areas bother the patient and how they would like the contour to look, then explains what can realistically be achieved. Associated conditions, medication, smoking and any previous procedures in the area are taken into account. Tests may be recommended before surgery. The type of anaesthesia and whether the procedure can be done as a day case or with a hospital stay are also decided at this stage.

After infiltration of a specialised solution, fat is removed evenly through small incisions. Technique and extent are adapted to each region.

Before surgery, the areas to be treated are marked with the patient standing. The infiltrated solution helps reduce bleeding and discomfort. Through incisions a few millimetres long, placed as discreetly as possible, fine cannulas are inserted and fat is removed in layers, aiming for an even contour. The duration varies with the number of areas, typically from under an hour to several hours. The type of technology used is chosen at consultation according to the indication.

Local anaesthesia, sedation or general anaesthesia may be used depending on the treated surface and volume.

For small areas, such as under the chin, local anaesthesia may be sufficient. When several areas or larger volumes are treated, general anaesthesia is usually preferred. The decision is made after the pre-anaesthetic assessment.

Bruising, swelling and tightness are common. Compression garments are worn and activity resumes gradually.

• Walking is encouraged from the first day to reduce the risk of thrombosis.
• Some fluid may leak from the incisions in the first few days, which is usually normal.
• Compression garments are usually worn for several weeks.
• Light activities typically resume after a few days to one or two weeks, depending on the extent of treatment.
• Strenuous sport usually resumes after a few weeks, with the surgeon’s approval.

Follow-up appointments allow progress to be monitored and recommendations to be adapted.

Risks include contour irregularity, asymmetry, seroma, infection, sensory changes, thrombosis and complications associated with large volumes.

Bruising and swelling are common and temporary. Surface irregularities or firmer areas may persist for a while and sometimes need correction. Skin with reduced elasticity may not retract fully. When large volumes are removed, the risk of fluid imbalance and general complications increases, which is why the volume is set cautiously. Serious complications are rare, and individual risks are discussed at consultation.

Some change is visible early, but final contour is assessed after several months. Weight stability helps maintain the result.

In the first weeks, swelling hides part of the result. The contour usually becomes more defined gradually over a few months. Fat cells that have been removed do not grow back, but the remaining cells can enlarge if the patient gains weight, which may alter the result. A balanced lifestyle helps preserve the new contour.

Liposuction is a contouring method for localised fat deposits, not a weight-loss method. Results are usually better at a stable weight and with good skin elasticity. The areas, a safe volume and the type of anaesthesia are agreed individually at consultation.