The operation

Preparation before the operation

Preparation before the operation - Dr. med. Daniel Münch

Shower before you arrive, but please do not use body lotion or cream, as this will prevent the felt marker from adhering well. We recommend a light meal prior to the procedure. You should bring suitable clothes (e.g. dark, loose fitting sweat pants), because after the procedure there may be leaking fluids for around 24 hours. We will provide you with a plastic sheet which you can place between the bed sheets and mattress, and you will also get sufficient absorbent material.

First, I will discuss the process with you once more and answer any questions you may still have. During the process I will explain every step – and you can ask questions at any time.

Preparation before the operation - Dr. med. Daniel Münch

After this we monitor blood pressure as well as vital blood values. Next you receive Atropine (as a pre-medication to stabilize the circulation), an antibiotic to prevent infection and, if desired, 1 Dormicum 7.5mg tablet (has a calming effect). Of course, these drugs are adapted for allergies or intolerances.

The areas to be treated are precisely marked with a green marker while in a standing position, much like the “altitude lines” on a map. Thus, you can express your wishes with regard to the extent of the areas agreed on for treatment and see in mirror that exactly the right areas are marked and nothing is forgotten. Then a photo documentation is made, a copy of which you receive to take home. Photos from three sides (no face) are helpful to plan and execute the operation and are a part of the confidential files within the patient’s history. The photos are also the basis of the “before and after” used as a quality control.

Preparation before the operation - Dr. med. Daniel Münch

As you lie on  the pre-warmed operating table, the areas to be treated are extensively disinfected and the rest of the body is covered with sterile towels as per hygienic stipulations. During the procedure, oxygen saturation of the blood and the pulse are continuously monitored, and depending on the situation, we also create an infusion, monitor heart rate and regularly measure blood pressure.

The procedure

The procedure - Dr. med. Daniel Münch

The designated incision places for the thin infiltration cannulae are desensitized, and then small skin incisions are made in these places, each 3-4 mm long. Using a thin infusion cannula, the anesthetic fluid is then evenly injected into the fat layer. The preheated solution emerges from the cannula tip in a fan shaped fine spray and distributes into the fat layer under the skin in a tissue protecting manner. Depending on the size and number of the areas to be treated, this stage takes from 10-20 minutes.

After this infiltration stage the suctioning follows. Now a cannula is used, which further loosens the fat cells using an anesthetic spray stream, and at the same time also sucks the fat cells through side openings. The cannula follows the jet stream gently and without force through the fat tissue, thus protecting the tissue and generally, the suction is quite tolerable, even for sensitive patients. So that all areas can be uniformly treated with the fan shape from different directions, additional skin incisions are made, usually two per treated zone. These skin incisions are intentionally placed parallel to the skin tension lines and if possible in concealed areas. The motion of the cannula is even, multilayer, and constantly changing directions using regular, manual control with the surgeon’s hand held flat. In certain areas (e.g. inner thighs and upper arms) the cannula must be turned to the longitudinal body axis in order to protect the lymph vessels. At the beginning of the operation, the deeper fat layers are worked on, and then the upper surfaces are formed.

An “over-liposuction” or a “skeletization” must absolutely be avoided for aesthetic reasons: in any case, a remaining subcutaneous fat layer of at least 1-1.5cm must be left in addition, to avoid irregularities and circulation disturbances. The zones in the areas of bone protrusions are particularly delicate in this regard. During the operation, the patient must often shift position or turn.  Using different positions, the “criss-cross” technique and the various injections enables all areas to be reached evenly from different directions, so that a uniform result ensues. The goal is to shape harmonious body contours with smooth transitions to the untreated zones.

The procedure - Dr. med. Daniel Münch

Depending on the size and number of the areas to be treated, the entire liposuction lasts between one half up to a maximum of two hours. The skin incisions are left open, so that the fluids can flow out on their own. This is somewhat uncomfortable, but the flushing out effect protects against possible bleeding and helps prevent infections.  Immediately after the procedure, the compression garment is put on as a bandage. We have a large selection of these in supply and they are of a very good quality, so that we can provide you with an item suitable for you.

After the operation

After the operation - Dr. med. Daniel Münch

After the operation, there is an approximately one hour recovery stage, in which your entire body is “dried” by means of a warm air device and, if desired, is warmed. You may also listen to music, read or drink something. My practice assistant and I then explain exactly the course of action for the next days and weeks. In the brochure "After the Operation" we provide this information in writing for you to take home. 

Before you return home, we “wrap” you with sufficient absorbent layers that no fluids will drain into your clothes. The fluids may appear slightly pinkish, but this is normal and should not concern you: even with minimal blood there will be the coloration.

After an outpatient liposculpture you are immediately mobile and - if you have received no sedating drugs - you may even drive. If you can arrange for a ride home, this is of course the preferable alternative.

At home, you should take it easy for the next day or so, but definitely regularly move about (rule of thumb: 1 hour prone with slightly elevated legs, ½ hour moving). Prolonged sitting or standing should be avoided. In the first 24 hours after the procedure, some of the injected fluids may still leak from the incisions.

You will receive pills for the pain and to prevent swelling for 2-3 days. In addition, we provide preventative antibiotics for 5 days. After the first day, you may walk as much as you wish and also perform light physical activities. You may also shower on the day following the operation, for which you should keep on the bodysuit (like a bathing suit, the fabric dries quickly).

After the operation - Dr. med. Daniel Münch

The compression suiting should be worn continuously both during the day and at at night for the first 7 days, after which it should be worn during the day only for an additional 4-5 weeks. Be careful that the bodysuit does not cut into the skin. You may remove the bodysuit to shower and also for approximately 1 hour, and it can be washed at low temperatures (30°c) (do not tumble dry). On the day following the operation, you may also apply the vein gel we provided you to the treated areas, and later switch to the vein cream. These ointments should be applied for a minimum of 3-4 weeks. After 4-5 days you may begin with light gymnastics, after around 10 days you may gently apply a body lotion to the affected areas, and after 4 weeks, the use of a skin-tightening cellulite cream is allowed.  You may apply the scar cream to the areas of the small incisions after the third week. If you wish, a professional lymph draining is permissible after about 2 weeks.

After the operation - Dr. med. Daniel Münch

The treated areas of the body may sometimes turn somewhat blue over the course of a few days (bruising); also a swelling may occur over2-3 weeks. Body weight sometimes goes up slightly over the course of a few days, and sometimes during this time there is an increased tendency for leg swelling. Over a few weeks, zones may appear in the treated areas that are more sensitive to pressure or touch, and at the same time the sensitivity or touch sensitivity might be reduced. Some areas (particularly the abdominal area) may feel hardened for 1-2 months. Bruising, swelling, hardening, increased touch sensitivity or decreased sensitivity will all return to normal. With large amounts of fat removed from the abdominal area, the skin sometimes needs a longer recovery time, of up to a year. The incision scars can sometimes stay reddish for several months. After 1-2 months, you may use a solarium or sauna again. Depending on the physical activities required at work and the extent of the procedure, you may return to work after 1-3 days.

After the operation - Dr. med. Daniel Münch

Beyond the often described bruise-like pain, any complaints, temperature increases, redness or adverse effects to general well-being should be reported to us—but these occur very rarely.

If you wish, we can arrange a follow-up appointment for 5-7 days after the operation. The final examination is usually after 6 months. Of course, we are always available for any questions or problems by telephone, and outside office hours I am best reached via cell phone at (079 215 86 86). (0)32 636 25 25