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Leg liposuction and lipedema

Summary of surgery

TIME

3 - 5h

ANESTHESIA

General

HOSPITALIZATION

1 Night

RECOVERY

15 Days

Video subtitled in English

In this section, leg liposuction, two topics that Clínica Sanza Barcelona performs are discussed, they are closely related but they are not the same, do not confuse them:

1 – Leg liposuction surgery

It is the most common, something that one does for aesthetics, to look better, not out of necessity or health. It consists of removing the adipocytes or cells containing the subcutaneous fat located in the area of the thighs, knees, calves and ankles, or in some of these areas in particular through various methods.

The combination of conventional liposuction, lipolaser, lipovibrosuction and lipolaser with ultrasound allows us to achieve the results we are going to show you below in high definition. It is the most perfect technique that currently exists to achieve the best body reshaping.

2 – Lipedema Treatment

Lipedema is a progressive disease of the fatty tissue that usually affects women. Fat accumulates in an exaggerated manner in the arms and legs.

It is not a surgery that one does for aesthetics but for a real problem that needs to be solved before it gets worse.

The solution to this problem is exactly the same: Perform liposuction to remove those cells that accumulate fat in the legs and ankles.

Lipedema can be of different degrees, depending on the involvement:

  • Grade I: The skin surface is regular, although soft, but small fat nodules can be palpated.
  • Grade II: The skin surface is irregular, as well as hard, due to increased fat nodules.
  • Grade III: The skin surface is adipose, especially on the hips and ankles, where nodules of different sizes abound.

Degrees of Lipedema

Causes leading to lipedema formation

The true origin of lipedema is still unknown. The majority opinion is that its main cause is an unhealthy lifestyle (poor diet and sedentary lifestyle) that favors the accumulation of fatty tissue, but this is NOT the case. Although the causes are not clear, most experts believe that it is closely related to hormonal disorders.

This is because its manifestation and worsening occurs after puberty, pregnancy, menopause or taking the pill. Likewise, it has been proven that there is a genetic component that affects the predisposition to lipedema.

Since there is no obvious origin, this makes it difficult to diagnose the disease. Many patients are frustrated when they go to a specialist and receive assessments such as “tired legs”, “poor circulation” or “obesity”.

What is fat and how is it removed forever with liposuction?

Body fat is a cellular tissue of the body that: protects organs, covers joints, controls temperature, stores vitamins, and is a source of energy for the body.

It is in a semi-liquid state and is composed mainly of triglycerides. It is generated by the excess calories we eat and do not use.

Adipocytes
Adipocytes

The body is prepared to store what is left over in cells called adipocytes. I present them to you, you can see them in the photo below. Do you see everything that is yellowish in tone? Well, all that is the fat they accumulate, and the bad news is that there are millions and millions of it in your body (and mine).

And on top of that they reproduce … unless you get them out of there … and here’s the thing.

  • Video subtitled in English

What happens to the skin that is left over after fat reduction with liposuction?

In the vast majority of cases the skin retracts on its own and does not need anything else. It will put itself in place and you won’t be left dangling. Only in cases of poor skin quality may the skin not retract on its own. We are talking about maybe 5% of the cases.

Look at this photo below, the skin retracts, no stretching.

How the skin looks before and after liposuction

It is not a matter of taking out too much or too little fat that causes it to retract, it is a matter of skin quality. The doctor will see this before doing anything, before paying anything, and will advise you. But that of stretching the skin in extreme cases is done later. This type of intervention is called ABDOMINOPLASTY and you can click here for more details and to see what it is all about.

https://www.clinicasanza.com/operacion-abdomen-y-espalda-barcelona/abdominoplastia/

  • Video subtitled in English

How to mark the musculature with liposuction?

  • Video subtitled in English

How to eliminate cellulite definitively with liposuction?

  • Video subtitled in English

WHERE DO WE OPERATE?

At Clínica Sanza we rely on the Sagrat Cor Hospital, part of the Quirónsalud group, to perform our surgical procedures.
Its prestige, facilities, medical and healthcare staff, as well as its technology are a guarantee.

BARCELONA: A HEALTH HUB

Do you want to know why it is worth coming to Barcelona for plastic surgery and why so many people come from abroad?

WE ORGANIZE EVERYTHING FOR YOU

Your trip, your flight, your operation, your transfer and your hotel with our support agency. We work with the best travel agencies worldwide.

calendario azul

Book a visit

You can do it in 3 ways:

Free on-site visit: Call +34 932066540 from Monday to Thursday from 9:00 am to 6:00 pm and Friday from 9:00 am to 3:00 pm.

Free on-site visit with IMMEDIATE booking: For booking outside office hours. We charge 60 € on your card to avoid false bookings. It is refunded on the day you come to the consultation.

ONLINE Visit: Video conference using whatsapp or Zoom. Cost of 60 € non-refundable. When booking indicate in the comments that you want videoconferencing and not on-site.

calendario azul

Book a visit

You can do it in 3 ways:

Free on-site visit: Call +34 932066540 from Monday to Thursday from 9:00 am to 6:00 pm and Friday from 9:00 am to 3:00 pm.

Free on-site visit with IMMEDIATE booking: For booking outside office hours. We charge 60 € on your card to avoid false bookings. It is refunded on the day you come to the consultation.

ONLINE Visit: Video conference using whatsapp or Zoom. Cost of 60 € non-refundable. When booking indicate in the comments that you want videoconferencing and not on-site.

PATIENT PROFILE

More frequent in women than in men.

Patients who wish to improve their legs, whether in volume, shape or cellulite.

Patients who, in spite of taking care of themselves with diet and sports, present an accumulation of fatty tissue in: cartridge cases, inner face, knees, calves, ankles, or all legs in general.

Patients who genetically develop more fatty tissue in the legs with respect to the constitution of the shoulders, arms, back and abdomen.

PROCEDURE

It is performed by the aforementioned methods in the operating room.

It can be a simple procedure, when small lumps accumulate and we have to remove less than 1 kilo of fat tissue.

Sometimes it can be more complex when we have to remove 6 or 10 kilos of fat tissue. In all cases they do not leave scars, barely visible, since fine cannulas are used, either laser or ultrasound.

It is one of the most variable surgeries, since it is not the same to reduce an area, than to make complete legs and lower several dress sizes.

DURATION OF THE INTERVENTION

  • From 1 to 5 hours

PROTOCOL

Preoperative

  • Evaluate the areas to be treated to determine the adequacy of the treatment.
  • Follow the specific guidelines determined by the Doctor
  • CBC, cardiac and respiratory status tests if needed

Anesthesia

  • Local and sedation, epidural or general sedation if preferred

Hospitalization

  • Ambulatory or admission from 24h to 48h depending on the volume to be extracted

Postoperative

  • Wear a compression garment that will be given to you at Clínica Sanza.
  • Take medication if required
  • Mandatory postoperative check-ups to avoid complications
  • Remove stitches after 10 days, if necessary.

Convalescence

  • 1 to 7 days of rest, depending on the case.
  • Removal of girdles after 15 to 30 days
  • We recommend lymphatic drainage to accelerate the recovery process.
  • Heavy physical activity, such as sports, 1 month

RESULTS

  • Highly effective and durable
  • Rejuvenated and greatly improved appearance
  • Loss of one to several clothing sizes
  • Improved self-esteem, self-confidence and security

DEGREE OF DIFFICULTY

  • Simple-complex intervention

LEVEL OF RISK

  • Low-medium
  • Risks inherent to surgery: bleeding, hematomas, infection. Infrequent
  • Risks of the operation: possibility of an irregularity requiring a touch-up, which is also rare.

BEFORE/AFTER PHOTOS

Previously Then
Previously Then
Previously Then
Previously Then

Whatever your case may be, do not hesitate to contact us.
Sanza Clinic in Barcelona, quality of service

Frequently asked questions about leg surgery

When there is an accumulation of fat in a certain place of the body such as the thighs, knees, calves or ankles, liposuction or liposculpture, also called body remodeling, is indicated. These minimally invasive surgical alternatives, that is, without leaving residual scars, are the best options to achieve the best body contouring.
The surgery is performed through small incisions, through which a cannula is introduced to extract the excess fat, thus shaping the area to be treated. Depending on the extension of the area, it will be performed under local, epidural or general anesthesia. Lipolaser or lipovaser can be used if desired or necessary.
In most cases the postoperative period is 24 hours, and the initial discomfort is perfectly controllable with a mild analgesic. After the operation and during the first month, a compression garment should be worn and the treated area should be massaged to optimize recovery for 1 to 2 weeks. They can lead a normal life depending on the discomfort of each patient and the number of liters of fat removed. (1- 15 liters)
When we perform liposuction we extract the excess fat tissue, but when we want to perform in addition to the extraction of fat some skin retraction we can use the technique of laser liposuction, followed or not by classic liposuction depending on each case.
If there is little fat tissue it can improve contouring and cellulite. If there is a lot of fatty tissue it can go down up to 5 dress sizes.
This surgical procedure improves the shape of the calf muscles of the legs by inserting an implant that is placed through the posterior crease of the knee. Implants add definition and substantially improve the appearance of the legs. They can be short and mark only the calves or they can be long and reach the ankles.
People who generally seek this surgery are those who want to show off more developed muscles in their legs, who often despite exercise have not managed to increase the muscle volume in this area, as well as those patients who have decreased their calf muscles as a result of congenital or pathological conditions.
The implant used in calf surgery is a kind of anatomically shaped pouch, with an external surface and filled with high-density silicone, with a smooth surface, specifically designed for this area of the body. The shell of these implants is highly resistant, similar to breast prostheses but more cohesive and shaped like a twin or full leg.

Liposuction and lipolaser frequently asked questions

Body fat is a cellular tissue of the body that: protects organs, covers joints, controls temperature, stores vitamins, and is a source of energy for the body.

It is in a semi-liquid state and is composed mainly of triglycerides. It is generated by the excess calories we eat and do not use.

The body is prepared to store what is left over in cells called adipocytes. I present them to you, you can see them in the photo below. Do you see everything that is yellowish in tone? Well, all that is the fat they accumulate, and the bad news is that there are millions and millions of it in your body (and mine).

And on top of that they reproduce … unless you get them out of there … and here’s the thing.



YouTube video


In the vast majority of cases the skin retracts on its own and does not need anything else. It will put itself in place and you won’t be left dangling. Only in cases of poor skin quality may the skin not retract on its own. We are talking about maybe 5% of the cases.

Look at this photo below, the skin retracts, no stretching.

How the skin looks before and after liposuction

It is not a matter of taking out too much or too little fat that causes it to retract, it is a matter of skin quality. The doctor will see this before doing anything, before paying anything, and will advise you. But that of stretching the skin in extreme cases is done later. This type of intervention is called ABDOMINOPLASTY and you can click here for more details and to see what it is all about.

https://www.clinicasanza.com/operacion-abdomen-y-espalda-barcelona/abdominoplastia/



YouTube video


The fat in our body accumulates in 3 areas:

Subcutaneous fat: If I tell you that these are the “love handles” or “love handles” you will surely understand me. It is the fat that accumulates just under the skin and before the muscles that really interests us in this case and is so noticeable. This type of fat can usually be lost more easily through exercise. Attention! it does not work the same and does not accumulate in the same areas for everyone. Depending on our genetic inheritance and our hormones, fat can accumulate more in some areas than in others. For men it usually accumulates in the belly and torso, but for women it accumulates in the hips and thighs.

Where is the body fat

Visceral fat: It is more internalized in our organism. It is around the organs, which is dangerous if it accumulates in excess. Normally an excess of visceral fat is preceded by an excess of subcutaneous fat, hence the importance for our health to avoid developing a protruding belly or excessively wide hips and thighs. If you don’t have fat like love handles, love handles or cellulite, you hardly have it around your organs.

visceral fat

Intramuscular fat: It is usually very little and stays inside the muscles. Like the fat you can see in acorn-fed ham. Nothing to do with the other two types of fat. Obese people who have fat in their muscles can develop diabetes because we become insulin resistant. But this is another topic …

Intramuscular fat

In short, right now we are talking about how to eliminate subcutaneous fat, that of love handles, love handles and cellulite, in the area you are interested in.

And this is where the magic word begins: HIGH DEFINITION LIPOSUCTION.

Liposuction can be used to remove excess fat from different areas of the body. These are the different areas we can treat:

  • Liposuction of the face and neck
  • Liposuction of the pectorals (gynecomastia)
  • Liposuction of arms and armpits
  • Liposuction of abdomen and back
  • Liposuction of male or female pubis
  • Liposuction of the buttocks
  • Liposuction of the legs

To perform liposuction it is only necessary to make a cut of between 3 and 5 millimeters in each area to be treated, nothing more. The size depends on the size of the tube (called a cannula) used to aspirate the fat. This means that if it is on the pectorals there will be this cut on each pectoral. If it is on the arms there will be one on each arm, if it is on the buttocks one on each buttock, if they are larger areas such as the abdomen there may be two cuts, one on each side.

Photo of a liposuction scar

This small mark remains almost invisible afterwards. It’s like what you would be left with after removing a freckle from your skin, a wart or something like that.

In the example we can see in the photo on the right a small dot of the scar that with time will be practically erased. It is very small: 3 to 5 millimeters.

Well, yes, I really do! and also definitive if you do it right.

Let me tell you: If you diet by eating less or doing sports, what you are actually doing is removing the fat accumulated in those cells, called adipocytes. What you achieve is to deflate them, to leave them empty. As if they were inflated or deflated balloons. But they are still there, waiting for you to come back to accumulate excess energy. With liposuction what we are doing is eliminating the fat cells, we are removing them from where they were. This means that you will not be able to put on weight in this area unless your excesses are really exaggerated. But to put weight back on in that area you have to eat in a very exaggerated way. If you eat a lot but not too much, what will happen is that you will put on weight in other areas of the body, but not in that one.

YES, and in fact it is the norm. Our patients usually have liposuction of several areas taking advantage of the operating room, anesthesia, etc. at one time. It ends up being a significant money saver. If you plan to do so, take advantage of it, you will pay for only one operating room, only one anesthesiologist …

It is clear that, if we are talking about a large liposuction, we are limited to the number of hours needed to perform it and the amount of anesthesia that this implies. We do not perform liposuction for more than 4 or 5 hours. If this is the case, it would have to be done by zones on different days, but this is not very common.

Liposuction is the conventional technique where a small cannula is used to remove fat accumulations from certain areas of the body. The lipolaser requires a special fiber optic device that transmits laser energy, this energy produces a destruction of the fat. The fat is converted into a liquid emulsion that is left for the body to reabsorb (if the amount is not too large) or can be removed by aspiration through a cannula. In addition to fat removal, the laser causes coagulation of the small vessels of the adipose tissue and stimulates the reorganization of collagen in the superficial dermis causing an immediate skin tightening or firming effect.

Liposuction, like any cosmetic surgery procedure, can be performed at any time of the year. The only consideration to take into account is the need to wear a pressotherapy girdle in the operated area for a month after the intervention, which prevents the patient from going to the swimming pool or the beach.

Not if it is well done. Once puberty has passed, fat cells take a long time to reproduce, but they maintain the capacity to “grow”, which is why once we eliminate the number of fat cells (adipocytes) these accumulations cannot develop, as long as we have a healthy diet without excesses.

The time of the bath will mark the moment when the girdle can be removed and repositioned without causing discomfort and that the swelling begins to subside, this may be after 2 or 3 days of the intervention.

The result of a liposuction is brutal, people leave delighted because you can see the result NOW. Your clothes will fit big, a pleasure for your eyes. What is certain is that the first week after the operation you will have a hard time, it would be absurd to say otherwise. From there it depends on the pain threshold of each individual. We consider it essential to be quiet, to stay at home and not go to work. It’s going to be a bad week, but you’ll get over it. It’s the usual, when you see the result you forget the bad time of this first week.

From the second week onwards, things get much better. You won’t be well, but it will be something else. From our experience we can say that you can usually return to work after 10 days. But it depends a bit on the person and especially on the type of work. It is not the same as an office job that you can sit quietly and go about doing, or a physical job in the construction industry, standing in a store or if you have to carry weights.

Yes, very much so. Cellulite or orange peel skin is a skin problem that manifests itself as very frequent small depressions in the buttocks, legs and hips. Liposuction cures and improves cellulite by reducing the volume of certain areas. Partially eliminates fibrous septa and promotes better lymphatic drainage.

At Clínica Sanza Barcelona, we are specialists in liposuction. Let’s say it’s our main course, after more than 30 years dedicated to this. It allows us to perform large liposuctions that other centers are not prepared for.

Dr. Sanza has taught many plastic surgeons around the world his techniques for performing major liposuction, and thanks to him his methodology is now practiced in more clinics worldwide.

Patients with little fat can remove from 100 grams to 1 liter of fat, while larger patients can be talking about up to 20 liters of fat in one go. Imagine what a great result. Suddenly they find themselves with 4 or 6 pant sizes less, very strong!

Do you know what happens? Fat weighs much less than muscle and that is why when you take out many liters the volume you reduce is brutal.

Yes, of course, just remember that liposuction is not a method to lose weight but to lose volume. Clinica Sanza has a very extensive and protocolized casuistry for liposuction of large volumes (from 10 to 15 liters), a technique that we have published in different specialized magazines and that we have presented in multiple national and international medical congresses.

Bruising (hematomas) and swelling may appear in the area for a few days, even weeks. Bruising usually disappears after 7 to 14 days and the most evident swelling after one to two weeks. Subsequently, there is some residual swelling that is not very noticeable and that can be maintained for a month or two after the intervention.

Basically, you must follow the case-specific instructions given to you by your surgeon. On the other hand, compression garments must be worn for a period of 3 to 5 weeks (depending on the evolution of each patient). We suggest lymphatic drainage to eliminate edema, swelling and accelerate the disappearance of bruises.

Once the acute inflammation has passed, the initial results can be seen after 3 weeks to 2 months depending on the extent of the intervention, although the definitive results may take 6 to 9 months.

It is due to poor technique of the surgeon. If done correctly it is impossible for it to re-form, even if you become pregnant and after delivery you keep the weight after liposuction the result remains as we had left it.

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