LAHORE: Like many other countries, Pakistan too has become a victim of growing obesity and weight problems.

Fast foods – fallout of a busy lifestyle -- are usually low in nutrition and high in fat are becoming more and more popular. That, coupled with a relatively inactive lifestyle such as more desk work has also resulted in a rise in obesity.

Like many aspects of life are becoming more and more ‘instant’, many misperceive weight loss to also become more instant, and more convenient. Instead of sweating it out to lose excess weight, many believe that there are easier ways to reach the perfect body weight, and some of these include medical procedures.

Liposuction is one of these procedures about which people have a misconception, especially regarding weight loss.

Most people believe it to be an expensive procedure which helps someone to shed excess pounds.

While it is expensive and doctors who do the procedure admit that it is mostly meant or done by people who can afford it, the process is mostly meant for cosmetic changes.

“There are two types of people who come in for liposuction,” says Dr Moazzam Tarar who is a plastic surgeon in the Jinnah Hospital.

“One are those who come in for body contouring. They are not overweight as such but they want to distribute their body fat uniformly and also feel that they could reduce a little fat but from various parts of their bodies. The other kind are those who are grossly overweight or obese. This kind of patients we must refuse because lipo for them is not an option.”

Dr Tarar explains that only seven litres of fat can be taken out of the body at one time and for those who are grossly overweight, this amount will make little difference but increasing this amount can prove to be very risky for them.

“If your body mass index (BMI) is approaching 40 then there are serious risks involved in getting this procedure done.

“There can be blood loss – because the same percentage of blood as the percentage of fat is lost. There is fluid loss, clots can occur and so can infections. Not to forget that the skin will also end up sagging badly. There is also a rare instance of fat embolism,” he says.

This also means that depending on which area is being operated upon, a skin tuck may also be needed.

“For women who have been pregnant and have a lot of lose skin on their belly, a lipo procedure on their bellies will definitely need a tummy tuck. Usually for thighs and back, we do not need tucks but for arms there is a 50pc chance that it may be needed. Saggy skin looks worse,” says Dr Tarar.

Other doctors have given an even longer list of risks attached to liposuction.

“Any type of major surgery carries a risk of bleeding, infection and an adverse reaction to anaesthesia,” says Dr Fareed Aslam, a plastic surgeon running a private clinic.

“Bad bruising is one big effect of lipo- this is especially the case if patients have been taking anti-inflammatory medications or aspirin. Patients with a tendency to bleed are also at higher risk of bad bruising. Inflammation is yet another big effect and swelling can take up to six months to settle. Sometimes fluid may continue to ooze from the incisions.”

He also counts in thrombophlebitis (a blood clot forms in a vein, causing inflammation of that vein) and contour irregularities (patients with poor skin elasticity who heal in an unusual way, or fat removal has been uneven, the skin may appear withered, wavy or bumpy). These undesirable results may be permanent, he says.

Other noted risks are the cannula may cause damage that makes the skin appear spotted. Seromas may form under the skin (temporary pockets of fluid), which may need to be drained. Temporary numbness and skin infections may occur after liposuction surgery.

Sometimes this needs to be treated surgically, with the risk of scarring; a rare case of internal organ punctures; kidney or heart problems; pulmonary embolism which can be life-threatening.

In very extreme cases death is also a possibility.

“For this very reason I always tell my patients that liposuction should only be carried out after a lot of thought,” says Dr Aslam.

“Results are never dramatic – contrary to what they expect; they are subtle.”

Interviews with various plastic surgeons reveal that treatments done commonly are on the abdomen, back, buttocks, chest, inner knees, hips, flanks, neckline as well as the area under the chin followed lastly by thigh and upper arms. Women most popularly go for the thigh and abdomen area while men for the flanks and abdomen.

Dr Farah, who has a liposuction and laser therapy clinic, says liposuction should only be done in relatively small areas of the body and it is in no way a treatment for obesity or long-term weight loss.

“Liposuction is sometimes used to treat certain conditions, including lymphedema - a chronic condition in which excess fluid collects in tissues, causing edema, which commonly occurs in the arms or legs. Liposuction is sometimes used to reduce swelling, discomfort and pain. However, doctors tend only to use liposuction with patients who have severe symptoms. After the operation patients have to wear a compression bandage for several months, sometimes up to a year after the operation. Gynecomastia is another condition, where it may used.”

Published in Dawn, June 21th, 2016