Liposuction, also known as Liposculpture or Suction Assisted Lipectomy (S.A.L.), is a technique to remove unwanted fat deposits. Bryan Mayou introduced the technique to the United Kingdom from France in 1982 and has always been associated with development and teaching of the technique. He was involved with development of ultrasound and mechanically assisted liposuction machines.

The unsightly distribution of body fat is usually due to an inborn tendency to deposit fat in one particular area of the body, most commonly the hips. Other areas include; the neck, arms, tummy, loins, thighs, inner side of the knees and the ankles. The growth of a benign fat tumour (lipoma) can also be a disfigurement, and in men fatty swellings can develop under the nipples to look like breasts (gynaecomastia).

Bryan Mayou has treated over 17,000 areas of liposuction in 4500 patients.

The areas highlighted in blue on the images above illustrate examples of operations that Bryan Mayou has completed.

What can be done?

If you have a localised area of fat it is possible to reduce its bulk by an operation called Liposuction. A narrow metal tube is inserted through a small incision in the nearby skin. It is attached to a strong vacuum pump which is drawn back and forth within the area of excess fat. The process removes tunnels of fat leaving the small blood vessels and nerves intact.
The skin will then retract.

There are some variants in the techniques. Some surgeons inject the area to be treated with solutions (wet or tumescent technique) others do not. Suction is usually applied with a powerful vacuum machine, but it is some-times perfectly adequate to use a simple syringe for small areas. Ultrasound and mechanically assisted lipectomy are other variants. Bryan Mayou uses all these techniques where appropriate but is mindful that the hand crafted and now traditional techniques are probably the most sensitive and that the mechanically assisted techniques of all types have their own complications.

BodyJet Liposuction

BodyJet liposuction is an intriguing new technique from Germany. The local anaesthetic adrenalin and saline is pumped ahead of the cannulae loosening the fat and providing the anaesthesia at the same time. This makes the whole procedure more effective and less traumatic for the patient. All procedures can be carried out simply under this local anaesthetic and recovery is quicker.

What are the consequences?

You can expect considerable bruising which may be uncomfortable and rarely painful.
The larger the area treated the greater it will be. Some people bruise more easily than others. The discoloration of this bruising will usually last for about a month, but the lumpiness and swelling of deep bruising can take up to six months to disappear, particularly when the abdomen or ankles have been treated.

As swelling can take a long time to settle you may not see the full benefit of the operation for up to six months. Rarely, a greyish stripe can discolour the skin for several months and is more commonly seen when the ankles have been treated. If you have a tendency to be anaemic, or if you were to have a large area treated, you may need to take iron tablets for a month. You can expect some numbness in the treated skin which lasts for several months.

You will have small scars 1.0 to 2.0 centimetres long at the sight of insertion of the suction cannulae. There is a small risk in some people that these scars may stay red for a while but they are usually sighted in less obvious areas.

If you are having treatment to your legs you may find that your ankles are swollen for a few weeks and if your ankles themselves have been treated, they may stay swollen for a few months.

Will it last?

Fat cells are thought not to be regenerated in adult life. Therefore their removal by liposuction will give a permanent change in contour and be independent of any changes in your body weight.

What are the limitations?

It is important for you to understand that liposuction is not a treatment for obesity. The amount of fat that can be removed from a localised area is limited by what is safe (maximum of 3 litres) and a natural limitation when no further fat can be removed. Therefore it may not be possible to slim down an area as much as you might like. Further treatments may be carried out in the same area after six months. In certain situations the skin is inelastic and loose. Liposuction in these areas will then tend to leave the skin more loose and it may be recommended that a skin excision be carried out to correct this, either at the same time as the liposuction, or as a second procedure. This is most likely in the abdomen, after pregnancy or weight loss, the buttocks or the neck. Dimples and wrinkles of the skin, sometimes called cellulite will not be improved by liposuction.

What should you expect at the time of your operation?

Modern BodyJet liposuction is normally carried out under local anaesthesia, often with a little sedation. General anaesthesia can be given if the patient prefers and if the treatment is extensive. Occasionally the patients prefer an epidural.

You may need simple pain killers for a day or so after the operation and you will probably be asked to return a week after surgery to check the result. A snug pressure garment or corset is usually advised around the lower part of the body. This is used to reduce bruising but can be taken off to wash, quickly dried and put back on. You can take this opportunity to bathe yourself. The corset is usually worn for two to three weeks. Mr Mayou does not believe that massage, endermologie or similar techniques have any benefit in producing a better result.

You will only need to take a few days off work if only small areas are treated. You may feel able to attend work the next day if only small areas are treated. When the treatment is more extensive and the patient is anaemic, 7 days off work would be realistic. I recommend that patients who are anaemic should take iron for two weeks prior to large treatments and for two weeks afterwards. You are welcome to sunbathe but remember that discoloration of bruising will last about a month and you will not achieve your best appearance for three to six months.

What should you do before the operation?

You should avoid aspirin, anti-inflammatory drugs, any herbal remedies, vitamins or tonics for 2 weeks before the operation as these tend to cause increased bruising. You should take iron if you are anaemic.

Liposuction - Hips
click image to enlarge click image to enlarge Pop up test Pop up test
Before 3 months after Before 3 months after
Liposuction - Inner thighs and knees
click image to enlarge click image to enlarge click image to enlarge click image to enlarge
Before 3 months after Before 3 months after
Liposuction - Abdominals
click image to enlarge click image to enlarge    
Before 3 months after    
Liposuction - Arms
click image to enlarge click image to enlarge    
Before 3 months after    
Liposuction - Chin
click image to enlarge click image to enlarge    
Before 3 months after    
Liposuction - Ankle
click image to enlarge click image to enlarge    
Before 3 months after    

A narrow metal tube
is inserted through a
small incision in the
nearby skin

A snug pressure
garment is worn after
surgery around the
lower part of the body
to help reduce swelling