Cosmetic Surgery Q&A: Mr Baljit Dheansa

Q1. When is liposuction performed on its own?

Liposuction is a technique that we can use either on its own, or we can use it in combination with other surgical procedures. When you use it on its own, it's usually to improve the contour of a body part, so it may be the hips, the abdomen, or the arms. But it can also be used to try and even out areas that have got uneven texture or have had previous injuries. When we do use it for that particular technique, it's really important that we have good quality skin elasticity so that then the skin can shrink back. If there's quite a lot of loose skin or a lot of stretch marks, liposuction may not be the best technique to use here.

Q2. When is liposuction used alongside other procedures?

When liposuction is used in combination with other procedures, it's often used to try and improve the contour so that we can not only remove excess tissue but try and improve the contour as well. A good example would be with tummy tucks, where the upper part of the abdomen or the sides of the abdomen may have liposuction, and the lower part of the abdomen has the tissue removed.

The other examples that you can use liposuction for include the sides of the chest when having breast uplift surgery or breast reduction surgery, and sometimes when you're doing an arm lift, you may want to do some liposuction to try and improve the contour and make it easier to do the surgical procedure itself.

Q3. Who is suitable for fat transfer?

Lipofilling, or fat transfer, is something that plastic surgeons are doing more often, having had experience in the reconstructive field after using it in breast reconstruction. We tend to use it quite a lot for filling in small defects, and that might be around the breast after some surgery, or it may be as part of a much more comprehensive approach when we can try and augment breasts to give much more volume, instead of using breast implants.

We also use it for cosmetic procedures around the face, which gives a more permanent but natural appearance rather than using fillers.

Q4. When is the right time to have surgery?

One of the important things about cosmetic surgery especially, is understanding the benefits or the disadvantages of doing surgery. The timing of surgery is always important, so I'll often have a long discussion with patients about what to do before and afterwards to make sure that they're safe for the procedure itself. I won't perform surgery on someone who's coming back from a long-haul flight within four weeks or is planning to go on a long-haul flight, because their risk of complications is much higher.

More importantly, there are patients who we may choose not to do surgery because they have significant medical problems, or they may be on a weight loss journey or a fitness journey, which means that they may be unstable in terms of their weight or their body appearance. And we want to do surgery to get the best result by performing it when the body shape is in the most stable position that it's going to be.