A flat stomach, well-formed posterior as well as tight arms and legs are considered by many to be essential components of a beautiful body.

Unfortunately, in many cases, pounds of fat stand in the way of this ideal, and a trip to the surgeon for some liposuction appears tempting, even if it brings with it some risks.

Liposuction is one of the most popular elective procedures chosen by people looking to trim some weight off. In Germany for example, 19,000 such operations were carried out in 2009.

However, liposuction should not be used as an alternative to normal weight loss methods, says Joachim Graf von Finckenstein of the German Institute for Aesthetic and Plastic Surgery.

"Those who think they will lose lots of kilos as the result of an operation are mistaken," he says.

People with a Body Mass Index (BMI) above 25 should begin with exercise and a change of diet to lose excess weight.

"Diet and activity work on the whole body. Liposuction only targets certain problem zones," Graf von Finckenstein explains.

There are also clear borders when it comes to using the procedure for beautification purposes.

"Too much fat shouldn't be removed because otherwise the skin becomes wrinkled or flabby, making tightening necessary," says Professor Dennis von Heimburg, a plastic surgery specialist in Frankfurt.

A maximum of two liters of fat can be sucked away by removing excess fat from deposits located between the skin and muscle on an outpatient basis.

"More can be achieved with larger interventions," Graf von Finckenstein adds.

It's important that the fat removal is even and gentle to prevent unwanted side effects, such as bumps and wrinkles. A small deposit of fat between the skin and muscle must remain.

"Otherwise, there is a threat of adhesions," Von Heimburg warns.

Even if the fat deposits removed don't return, patients can still put on weight in the same place.

"The remaining fat layer can still expand somewhat," says Graf von Finckenstein, although this isn't always a problem.

"It's important that liposuction takes place in harmony with the body's contours. Otherwise, the result doesn't look good."

A visit to a doctor is necessary for those looking to get to grips with any cosmetic problems with the help of liposuction, although the standard of treatment can vary greatly, especially in countries with poor medical regulations.

Patients who travel abroad for treatment can find the costs mounting quickly, especially when there are complications that require further corrective treatment at home.

Anybody undergoing liposuction needs to be put under observation and receive post-operative care, something that isn't possible in the time frame of a weeklong foreign holiday, Von Heimburg believes.

It's better that any patient suffering bruising, swelling or serious pain be in a position to see their treating doctor so they can make a diagnosis. Liposuction is often presented as a fast and harmless cosmetic procedure, but such a view underestimates the dangers of the process.

"Every year, people die from the risks and side effects of liposuction," Von Heimburg says.

One reason is an underestimation of the risks among patients suffering from heart problems, allergies or impaired healing.

However, poor hygienic standards or the lack of a thrombosis prophylaxis on the part of the treating doctor can have serious consequences.

"Patients should ensure they are fully informed about their doctor's qualifications and not simply take up the first best offer," Von Heimburg says.

German Press Agency

(China Daily 02/09/2011 page19)