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In conversation with Plastic Surgeon Wouter van der Pot about Liposuction

Written by Lindsay van der Looij– founding partner of KNAP, skin specialist and diet guru.

I often get the question from clients who did liposuction what the best treatments are to optimize the result to speed up the recovery process.
I also get questions about liposuction itself and what is achievable in fat reduction.
That is why I started a conversation with Plastic Surgeon Wouter van der Pot and asked him everything about Liposuction and the recovery process.
Wouter works at Blooming Plastic Surgery in Haarlem.

1. Introducing, who is Wouter?

That’s me! I am Wouter van der Pot.
I am a plastic surgeon at Blooming Plastic Surgery in Haarlem where I perform many cosmetic operations; from breast augmentation to facelifts, eyelid surgery, abdominal wall surgery and liposuction.

2. Liposuction: what is it exactly?

Lipo = fat, suction = suck.
So simply said liposuction involves the suction of fat.
We use a hollow tube (cannula) with a blunt tip that you can slide under the skin through a small hole (for example, through your navel).
There is a suction hose attached to that tube and if you move the cannula back and forth you can remove fat in certain places.
It is the trick to do this as smoothly as possible, so that you do not get any irregularities or dents.
It is also important not to sit too superficially, because then you run the risk of unevenness.
Furthermore, you must of course be careful that you do not go to places where you do not want to be, such as blood vessels, nerves, organs, etc.

There are all kinds of different cannulas; different sizes, shapes, different shapes of holes in it, all for different purposes.
So there is much more to do with it than people think.
For example, nowadays the removed fat can also be used to fill elsewhere in the body (for example in the breasts and buttocks). For now, the High Definition Lipo Sculpture is on the rise; This allows you to “etch” a six-pack in the fat of the abdomen, also known as “abdominal etching”.
In short; everything happens in the world of liposculpture.

3.How many zones can be treated in 1 operation and how much fat can be removed in total?

You must realize that although only a few incisions are visible on the outside, there is a huge wound bed under the skin with extensive liposuctions.
Except that your fur and blue can be (and very tired because your body has to do some wound healing), you can’t just keep removing endless fat.

At first, the area has to be treated (even if you are under anesthesia) must be infiltrated with anesthetic fluid (dissolved in salt water).
If you inject extreme amounts, you can get electrolyte disorders. Secondly, the chance of complications increases if you treat very large areas.

In terms of zones, it is just what you call a zone.
You can easily do lower abdomen, upper abdomen, flanks and love handles.
That would be 4 zones.
You could do the upper legs, but to also do the poor, the recovery will be very tough.
So I would say that generally speaking, 5-6 zones is usually the maximum.
Regarding the total amount of fat, that also depends on the regions and the patient, but I would not easily remove more than 7 liters and I usually stay well below that.
Safety first!

4. In the case of liposuction, can you also opt for certain ‘contours’ as a client?
Yes and no.
Yes, because you can indicate which zones you want to treat more than others. You can use this to change the contour.

No, because your contour is not only determined by your fat. After all, your muscle and bone structure also determine your contours and we do not change that with a liposuction.

5.Which zones are the most requested zones?

Belly, flanks, upper legs (inside and outside) and the lower chin.

6. Do you also implement the buttock enlargement (BBL) technique?

Yes, we also do that at Blooming Plastic Surgery. I don’t do this with extreme amounts, as is common in South America and Miami. This beacouse of the increasing risk of fat emboli (pieces of fat that end up in the bloodstream) with larger quantities. But I do indeed do the buttocks with lipofilling. Lipofilling of the breasts more often than of buttocks, by the way.

7. When do you undergo liposuction under local anesthesia and when under general anesthesia?

We are with our cosmetic private clinic within the walls of the Spaarne Gasthuis. I also operate my patients there (or at the Rode kruis Hospital in Beverwijk). So I have an operating room and very good anesthetists. That is why we can easily provide anesthesia. If you are going to treat larger areas, it is very difficult to do this under local anesthesia; it just remains very uncomfortable for both the doctor and the patient. And the people who come to me usually have a request to treat larger areas.

I always find it very annoying when people experience a lot of pain during a treatment. Then I notice that a large part of my attention goes to the discomfort of the patient, instead of the operation. I therefore stop earlier, while I actually wanted to get some more away. In short; for good liposculpture you should, just as for me, go under general anesthesia, then you will get a better result. A small area around the belly button or lower chin, or only the inside of the upper legs could be done under local anesthesia. But as mentioned earlier, I usually do a lot more like 95% under general anesthesia.

8. What is the downtime of liposuction?

You shouldn’t underestimate it.
I always say “Prepare for the worst, hope for the best”.
It is difficult to predict beacouse one person really has little trouble and does everything very quickly, the other person is really bright and blue and crippled and stumbles the first 2 weeks. If you are prepared for the worst, it can only be better than expected. I advise people to wear a pressure suit for 4 to 6 weeks (we measure this and order in advance). The first 2 weeks it is nice if you have no important (work) agreements.

Concerning speeding up the recovery period, I send my patients now to KNAP for lymfedrainage.
After liposuction, the client may experience lumps and bumps in the beginning.
These are often fluid accumulations because ‘trauma’ has been inflicted on the body.
By effectively massaging these accumulations, the moisture can be drained faster, which benefits the result.

Lymphdrainage is a massage technique that focuses on the lymphatic vessels.
Lymph is a fluid that flows through our body and this fluid is responsible for the removal of waste and excess moisture.
By massaging the lymphs you would stimulated and boosted the functions of them, so that the body can remove waste and moisture more effectively.
Lymphatic drainage is a special ‘pumping’ massage technique. This way of massaging feels very nice to the touch (‘stroke technique’) and is absolutely effective.
The therapist works on the body from the bottom up to effectively massage the accumulated fluid from the body.

During weeks 3 and 4 you can do a lot more, but you still have to give your body a rest.
You can really be more active in week 5 and 6.
I only recommend exercising after 6 weeks.
Everything of course also depends on how extensive the operation has been; with smaller liposuctions you can certainly do things faster.

9.How long does it take to see the final result?

I always explain that the “cannula”  that sucks away fat leaves a kind of hollow tunnel that immediately fills itself with some wound fluid and possibly some blood. So you see very little result in the beginning; the same volume is still there. With a good pressure suit and good lymphatic drainage treatments you can see quite a good new contour after about 6 weeks. Some spots can still feel a bit harsh on some, so in order not to make patients too impatient, I often say that you should really give the final result 3-6 months.

10. Which treatments do you recommend following liposuction to speed up the healing process? And why?

Lymph drainage massage as mentioned above. This technique helps to remove moisture faster and to prevent adhesions. Beside, this massage makes everything smooth and soft much faster so that the recovery process will actually speed up. I also recommend Radio Frequency, that will help also the recovery process

11. Because liposuction removes fat, the skin can become a bit more wrinkled; does this improve on its own? Are there treatments that can help the skin?

That depends on many factors. By young people, the skin is more elastic than in older people. If you have smoked, seen a lot of sunlight, dropped a lot of weight, etc., the extent to which the skin springs back can be disappointing. It is essential to properly estimate this before the operation. As a plastic surgeon, I naturally combine treatments in the most of the cases. For example: I do abdominal wall correction in combination with liposuction. Or I do liposuction of a chin in combination with a facelift. Always get detailed with information and ask the doctors all your questions.

Good non invasive recovery treatments such as lymphatic drainage and radio frequency can help to make the skin recover faster.

12. How exactly does Radiofrequency help with the healing process? Can you explain something more about that?

Radio frequency can help to tighten the skin (which will initially be looser after a liposuction) during the recovery process. At KNAP we work with the innovative MP2 technology of the Venus LegacyTM. This treatment triggers a heat reaction in the skin that helps to stimulate the skin’s natural recovery capacity. The process causes the skin to contract, leading to firming and wrinkle reduction. Ideal to help a (temporary) sagging skin after a liposuction. Beside, radio frequency also helps to boost the production of new fibroblasts (which provide collagen) and blood vessels. All this results in a nicer, more even skin texture.

13.What do you recommend with nutrition and supplements after liposuction?

I recommend a good and healthy diet, exercise and sufficient vitamin C intake for good wound healing.

Lindsay: ¨ At KNAP we recommend supplements for skin improvement and collagen production and during a course of Lymphatic drainage. Skin hydrate from Laviesage, for example, helps to balance the body’s moisture regulation. This supplement is made up of, glucosamine, vitamin C and hyaluronic acid. Hyaluronic acid can bind up to 1000 times its own weight in water: it connects the collagen and elastin present in the skin and thus provides visibly more volume in the middle skin layer. In addition, the supplement helps to optimize the cellular connections in the skin, so that the cells in the skin stays in the perfect place.Beside, the Elixir from Cellics can also be a nice addition. This product contains no less than 27 cell and skin boosters that your skin and body needs to counteract the natural loss of building blocks. The Elixir helps build and repair cells!’

14.How soon can you exercise again after a liposuction?

In principle, after 6 weeks but as mentioned earlier, this varies per person. Always discuss this with your doctor.

15. Will the removed fat stay away forever?

Yes! You have an alot numbers of fat cells in your body that are distributed in a certain way. In principle, the cells that have been removed do not return. Other cells can increase in size if you get fatter and therefore have more fat.Make sure a healthy lifestyle with pure nutrition and enough sport to prevent weight gain. In this way you can optimally enjoy the result.

16. Does it ever happen that a ‘touch up’ is necessary? For example disparity on both sides?

Of course. In some cases you sometimes have to correct something. Whether you do eyelids, breasts or liposuctions, it can always happenthat something is not yet entirely as what they hoped. Asymmetry is a good example of this. Although rare, it occurs. These are often minor post-corrections; they can usually be performed under local anesthesia.

17.Finally, how do you best maintain the result?

Staying stable in weight, no smoking and healthy living!

This client has undergone an abdominal wall correction in combination with liposuction.

Are you considering liposuction and would you like to get in touch with Wouter for a consultation?  Klik dan hier to make an appointment with him

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