Frequently Asked Questions

Liposculpture is a refinement in the technique of liposuction. Firstly, liposculpture is performed under local anaesthetic which makes it easier to achieve a regular, more even result, by assessing the patient at a later stage of the procedure. This is because it is possible to move into different positions and to stand up toward the end of the procedure which allows the effect of gravity to be seen on the areas that had liposculpture. This enables a much more predictable result to be achieved as more liposculpture is done to refine the areas and try to establish symmetry. 

Secondly, as no general anaesthetic is needed for liposculpture, the inherent risks associated with a general anaesthetic are avoided. 

Thirdly, liposculpture involves the injection of fluid into the fatty tissues before the procedure is performed. This fluid contains the local anaesthetic (lignocaine) and also a medication which effectively constricts blood vessels (adrenaline). Adrenaline vastly decreases the amount of bruising that occurs with liposculpture while the local anaesthetic produces effective relief of discomfort during the procedure and for up to 12 hours afterwards (and longer). 

Fourthly, liposculpture is day surgery. There is usually no need for the person having liposculpture to stay overnight in hospital or to have blood transfusions. You are encouraged to remain active following the procedure, walking soon after, and often returning to work after a few days to a week. Time off work and normal or vigorous activities is usually kept to a minimum. A week off work is advisable for most individuals.  

Liposculpture takes time to achieve the desired outcomes. The average procedure lasts 4 hours, especially when liposculpture of a few areas is performed. Smaller areas may only take up to 2 hours to do. In contrast, liposuction performed under general anaesthesia must be done in a shorter time as longer anaesthetic time increases anaesthetic risks. The recovery period is usually shorter with usually less bruising and less discomfort. However, due to different procedures, different patients will heal differently, and have different pain thresholds and will therefore experience different recovery times for different activities. The subcutaneous fatty tissue is thoroughly anaesthetised (numbed) and vasoconstricted when using the tumescent local anaesthetic technique and this generally contributes to a reduction of pain after the procedure. Liposculpture is performed by many doctors from many specialties.  

Dr Heckenberg is specifically trained in liposculpture. She is dedicated and will take the necessary time to strive for the desired results and performs only liposculpture and no other cosmetic surgery procedures. It is important to have these procedures performed by doctors who do the same procedures often, as with any surgery. Allowing enough time, using microcannulas and having patience are the most important factors when performing liposculpture.  

Risks associated with liposculpture are reported in international peer reviewed medical journals. These are made available to you and may be accessed below: 

Boeni, R., & Waechter-Gniadek, P. V. (2021). Safety of Tumescent Liposuction Under Local Anesthesia in 9,002 Consecutive Patients. Dermatologic Surgery, 47(5), e184–e187.  

https://journals.lww.com/dermatologicsurgery/Abstract/2021/05000/Safety_of_Tumescent_Liposuction_Under_Local.24.aspx 

This recent 2021 study comprising of 9,000 cases, also concluded that liposuction using the tumescent local anaesthetic technique “is a reliable and safe procedure if it is performed by an experienced surgeon and the guidelines of care are strictly followed”. 

 Dixit, V., & Wagh, M. S. (2013b). Unfavourable outcomes of liposuction and their management. Indian Journal of Plastic Surgery, 46(2),377. 

 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3901919/ 

 This detailed 2013 article compiles unfavourable outcomes, possible risk factors and their management associated liposuction and the importance of appropriate training in this procedure. 

 Hanke, C. W., Bernstein, G. S., & Bullock, S. (1995b). Safety of Tumescent Liposuction in 15,336 Patients. Dermatologic Surgery, 21(5), 459–462.   

https://journals.lww.com/dermatologicsurgery/Abstract/1995/05000/Safety_of_Tumescent_Liposuction_in_15,336.17.aspx 

A landmark article in the prestigious Dermatographic Surgery Journal reported the survey results of over 15,000 cases of liposculpture performed in America between 1994 and 1995. Authors concluded that complications during the procedure were few, as were problems following the procedure, and the level of complications was much less. Bruising is minimal, but does occur in most cases. It usually lasts for 10 to 14 days. Infections may occur with any surgery, but are fortunately quite rare and antibiotics are given before and after the procedure. Local areas of numbness may occur, although these usually resolve within a few months but may take up to a year. 

At Be Sculptured, Dr Heckenberg is trained specifically in liposculpture and she has a medical fellowship from The Australasian College of Cosmetic Surgery and Medicine (ACCSM) and a Lipoplasty Fellowship. Dr Heckenberg is dedicated to the procedure of liposculpture. It is the only cosmetic procedure she performs. Performing the same procedure often is necessary to acquire appropriate skills for any procedure. Dr Heckenberg has Specialist Registration in General Practice after gaining her Fellowship in 1997 (FRACGP) and a Diploma in Obstetrics and Gynaecology in 1996 (DRANZCOG) and has been performing contraceptive and reproductive out-patient gynaecological procedures since 1998. Her medical registration number is MED0001158434.  

Liposculpture is a body changing tool. Liposculpture is performed using Dr Klein’s “tumescent local anaesthetic” with micro-cannulas. The administration of the tumescent local anaesthetic makes it possible for the patient to stand up at the later stage of the procedure, allowing the effect of gravity to be visualised. Patients are also able to move themselves into the appropriate positions to adequately remove the fat from specific areas to change the body shape. It is this ability to visualise the patient’s body that provide a more predictable/favourable results.  

As no general anaesthetic is needed, risks associated with a general anaesthetic are avoided. Sedation has its risks, such as excessive drowsiness, or inadvertent and unexpected deeper levels of sedation, but recommended dosing and monitoring during the procedure reduces these risks. 

Liposculpture involves the injection of fluid into the fatty tissues before the procedure is performed. This saline solution contains the local anaesthetic drug (lignocaine) and also a medication which constricts blood vessels (adrenaline). Adrenaline decreases the amount of bleeding and bruising while the local anaesthetic reduces discomfort during the procedure and for up to 12 hours afterwards. These effects may last longer in some individuals. 

Slow absorption of lignocaine from the fatty tissue is the answer. There are several reasons for the slow absorption of lignocaine. These are: 

1. Subcutaneous (under the skin) fat has a low volume of blood flow,

2. Lignocaine is lipophilic (is attracted to fat) and is easily sequestered in (moves into) fat.

3.Diluted adrenaline in the saline solution ensures vasoconstriction (constriction of blood vessels), thus minimising systemic absorption and bleeding.

4.The large volume of tumescent solution itself compresses blood vessels by hydrostatic pressure (the pressure from the large volume of saline solution compresses the blood vessels).

5.The very low dilution (more saline solution compared to the dose of the drug) of lignocaine in Dr Klein’s solution does not achieve the gradient required for systemic absorption.

6. Most of the solution is removed during aspiration (suction), minimising the duration available for absorption.  

Liposculpture is performed as a day procedure. There is rarely a need for the person having liposculpture to stay overnight in hospital, or to have blood transfusions. A half to ¾ of a day is required to perform the procedure and to stay in the hospital recovery. You are encouraged to remain active following the procedure, gentle walking soon after, and often returning to work after 1 week or possibly after a few days. Time off work and normal activities is usually kept to a minimum. More vigorous exercise may be resumed 3- 4 weeks after the procedure.  

YES. Liposuction / liposculpture has been extensively researched. Study findings on liposuction / liposculpture are reported in international peer reviewed medical journals. Landmark publications are made available to you and may be accessed below: 

 Boeni, R., & Waechter-Gniadek, P. V. (2021). Safety of Tumescent Liposuction Under Local Anesthesia in 9,002 Consecutive Patients. Dermatologic Surgery, 47(5), e184–e187.  

https://journals.lww.com/dermatologicsurgery/Abstract/2021/05000/Safety_of_Tumescent_Liposuction_Under_Local.24.aspx 

 Hanke, C. W., Bernstein, G. S., & Bullock, S. (1995b). Safety of Tumescent Liposuction in 15,336 Patients. Dermatologic Surgery, 21(5), 459–462.   

https://journals.lww.com/dermatologicsurgery/Abstract/1995/05000/Safety_of_Tumescent_Liposuction_in_15,336.17.aspx 

 In these studies, involving a large number of patients, it was concluded that complications during the procedure were few, as were problems following the procedure, and the level of complications was less than for conventional liposuction surgery which is performed under general anaesthesia.  

Bruising is usually minimal but does occur in most cases. It lasts for 10 to 14 days, sometimes longer. Infections theoretically can occur but are rare and antibiotics are given before and after the procedure. Local areas of numbness can occur in the areas of liposculpture, although these usually resolve within a few weeks to a few months, but may take longer.  

This is a very broad question. Many people may be suitable for liposculpture, and a wide spectrum of Australians are interested in the technique. However, careful patient selection is necessary. It is not to be considered a weight loss tool. The number of people having this procedure performed in the USA and Australia is increasing and it is the most commonly performed cosmetic procedure. It is only recently that liposculpture using the tumescent technique is being understood by the general public, although the method has been utilised for decades (since the late 1980’s). 

Some common examples of people who have had the procedure done are: 

•  Women who have had children and are concerned by the unwanted accumulations of fat as a result of childbearing – outer thighs (saddlebags), full thighs, hips (flanks), and accumulations of fat in other areas, eg. abdomen, arms, breasts, knees, which may be resistant to the most rigorous gym workouts and diet regimes.
•  Men who have developed fat above the hips (flanks) or accumulations of abdominal fat (fat that exists between the skin and the muscle), not necessarily related to lack of exercise, but often due to natural decline in the production of growth hormone, which occurs with age. Genetics may determine many of these fat deposits as the tendency to deposit fat in some areas is genetically pre-determined.
•  Women and men who wish to modify their proportions. For such people the removal of small amounts of fat from localised areas may facilitate change in their body shape and proportions, eg. neck / chin liposculpture. 
•  People who have been significantly overweight, have lost weight and are now near their goal, but still have problems with local persistent accumulations that will not budge despite diet and exercise. Excess skin laxity may preclude some individuals.
•  Men who have unwanted accumulations of fat over the breasts as a result of hereditary or other factors, such as medications.

Liposculpture isn’t suitable for everyone. Only patients with a Body Mass Index (BMI) of under 35 will be considered but only after they have been properly assessed during the consultation. Your BMI can be checked using the following online calculator   

Smoking increases the level of carbon monoxide in the blood, which deprives tissues of oxygen. Blood supply is a major concern during any surgical procedure. Combining smoking and cosmetic surgery can categorically result in increased pain, loss of skin, infections, death of tissue or fat cells, delayed healing, thick scarring, permanent vessel damage, or blood clots. Smokers should cease smoking 6 weeks prior to the procedure or consider to not have the procedure at all. 

Patients with Body Dysmorphia Disorder (BDD) are inappropriate for liposuction / liposculpture or any type of cosmetic surgery or procedure. BDD is a mental illness. People who have this illness constantly worry about the way they look. They may believe an inconspicuous or non-existent physical attribute is a serious defect. They respond to this by performing repetitive acts such as mirror checking or comparing their appearance with others. The severity of BDD varies. For example, some people know their feelings and / or perceptions aren’t rational or justified, while others are almost delusional in their conviction. BDD causes severe emotional distress. It is not just vanity and is not something a person can just ‘forget about’ or ‘get over’. The preoccupation of their appearance can be so extreme that the affected person has trouble functioning at work, school or in social situations. People who suffer from BDD can target any part of the body. They may seek out numerous cosmetic procedures to try to “fix” the perceived flaw. Afterward, they may feel temporary satisfaction or a reduction in distress, but often the anxiety returns and the search for other flaws resumes. Along with ways to “fix” them. Treatment of BDD may include cognitive behavioural therapy and medication after an assessment by a psychiatrist. 

The skin is a remarkable organ. Liposuction / Liposculpture itself “de-weights” the skin by removing many of the underlying fat cells and therefore an element of skin retraction or shrinkage will occur. Skin will contract in areas treated by liposculpture and excision of any skin in most selected cases is usually not necessary but that is dependent on the individual and patients need to be thoroughly assessed during the initial consultation, including a skin quality assessment and patients asked of their expectations. 

During the initial consultation, you will be assessed for suitability for the procedure and you must be in good health. You will be assessed for Body Dysmorphia Disorder (BDD). You will be provided written pre-operative instructions. You will require a second consultation (either in person or via video) prior to any procedure that may be booked (at least 7 days prior to surgery). You will require a referral from a general practitioner (not involved in any cosmetic medicine or surgery practice) from 1st July 2023. It is important that aspirin and anti-inflammatory medications (Nurofen, Naprogesic, Feldene, Voltaren etc.) and multi-vitamins not be taken for two weeks before the procedure. These medications decrease the effect of platelets in the blood and can increase the amount of bruising and risk of bleeding. An anti-bacterial soap should be used for two days prior to the procedure. Antibiotic tablets are started the night before the procedure to reduce the risk of infection. Patients should not smoke as that increases complications, including infection, fat necrosis, blood clots, increased pain, and thick scars. After the procedure, a Lycra garment is worn over areas treated for one to two weeks (sometimes longer). The garment is quite a light, comfortable garment and may be worn under normal but usually looser clothing. 

After the saline solution is introduced into the tissues through small incisions (3-5mm) in the skin, and the local anaesthetic in the fluid has had enough time to work, small blunt tubes (cannulae) are introduced into the fatty layers (located under the skin and on top of the muscles). Suction is applied to the cannula while it is moved back and forth through the tissues and the unwanted fat is removed in a progressive fashion. Most cannulae used are 2mm to 3mm or less in diameter (sometimes 4mm) and are substantially narrower than the cannulae used in older liposuction methods. The movement of the cannula through the fatty tissue will “strip” the fat cells away from the connective tissue and the suction merely takes the fat cell away from the site of disruption. This fat is not removed “like a vacuum cleaner” as each fat cell removed needs to be parted from its supportive tissue. This is the reason it can take quite a few hours to perform.  

Bruising, seen as skin discolouration or black and blue areas, are expected, and this usually persists for a few weeks.  Occasionally there may be excessive bruising under the skin, or there may be an accumulation of fluid in the areas. This may take a few days to a few weeks to resolve and the procedure is planned to accelerate the drainage of this fluid and so reduce bruising and facilitate healing.  

Severe discomfort is less likely. There is usually some discomfort mild to moderate discomfort for a few days to a few weeks after the procedure.  Discomfort is usually described as soreness and stiffness which may or may not require paracetamol.  Some patients may require stronger pain relief. This varies with each individual depending on the extent of the procedure, the patient’s personal pain tolerance and if any complications should occur.  Persistent soreness or pain should be reported to the doctor.  If undue pain is experienced it may be the sign of an impending complication and the doctor must be notified immediately.  

Numbness can also occur after the procedure which may take a few weeks to many months to resolve, sometimes up to a year.  It is possible but quite rare, to have persistent numbness in an area. The instruments used in liposculpture are blunt and therefore do not cut tissue in the same way as a surgical cut. Numbness is less likely to be permanent.  

Texture irregularities or lumpy areas on the skin may occur and may take a several months to resolve, sometimes up to a year.  These are usually normal healing reactions and represent “remodelling” of the tissue. Initially swelling occurs where the procedure has been carried out, with the most swelling occurring in the lowermost parts of the body because of the effects of gravity. Ankle swelling may occur and can last for several months, even up to a year. This is the reason when liposculpture is performed on the lower legs, a fitted stocking is required for 4 weeks or more. Itchiness is a normal post-operative side effect and may last a month or so. It is the result of the nerve endings in the skin starting to heal and regenerate. However, texture or contour irregularities may however persist indefinitely where patients may need reassessment.  

Scars may develop over the incision sites (3-5mm) and may become darker or lighter in colour, become enlarged, known as hypertrophic scars or more rarely keloid. They generally tend to become less obvious with time. Sutures are not required for most incisions and the incision sites act as drainage points post operatively for the excess anaesthetic fluid to drain out.  

Infection is a possible complication of any surgical procedure. Infection may require additional antibiotics, incisions for drainage or admission to hospital.  Very rarely does a life-threatening infection occur after liposculpture using the tumescent local anaesthetic technique. Although very rare, fatal infections have been reported as well as necrotising fasciitis, which is a serious bacterial infection that destroys tissue under the skin.  

Allergic reactions may occur with any medications the doctor uses or prescribes.  It is important to present to Emergency at your nearest hospital if you experience any breathing difficulty or swelling of lips, tongue. This is important because you may be suffering from a general reaction to the medication which may become worse (called anaphylaxis) which, if not treated, can be life threatening.  

All major blood vessels and nerves are located at a deeper plane. Small cutaneous (skin) nerve fibres are located directly under the skin and are temporarily damaged which causes the expected numbness. It is very uncommon to get permanent numbness or permanent disability from damage to deeper nerves. Liposuction instruments are blunt, so unable to “cut” a nerve. 

Occasionally, a fluid collection (seroma) or blood collection (haematoma) may persist and may require drainage with a needle and syringe. This is less likely when micro-cannulas are used, which are the chosen cannula type, but may still occur. 

Post operative fibrosis (or hardening of the subcutaneous tissue) may occur if the body develops an extreme reaction to the trauma created by liposculpture. Collagen is the protein found abundantly in the human body. Its development in excess or its accumulation during tissue repair generates fibrosis. This may delay recovery, cause hardening or scarring of the tissue and may require steroid injections periodically to help soften the tissue, or may be permanent.  

With the older technique of liposuction, a small area of sloughing (skin loss) has been reported in the medical literature, in rare cases. Fortunately, this is infrequent with liposculpture performed under local anaesthesia with micro-cannulas but may still occur.  “Erythema Ab Lipoaspiration” is a permanent blotchy (net-like pattern) pink-brown discolouration of the skin resulting from rasping the under-surface of the skin during superficial liposuction.  

A rare complication is a Deep Vein Thrombosis (DVT).  This is rarer when liposuction is performed under local anaesthetic, where the patient frequently moves into different positions during the procedure. With the techniques utilised, whereby most normal daily activities are resumed post-operatively, it is fortunately rare. However, if any clots develop in your deep leg veins, these may travel to your lungs. A pulmonary embolus can be serious and life threatening. It can occur after any type of surgery or during or after long haul flights.  

Visceral or bowel perforation during abdominal or chest liposuction is very rare, especially when the procedure is performed under local anaesthetic and by an experienced liposuction proceduralist. The proceduralist’s non-dominant hand should be constantly following the tip of the cannula over the skin to avoid the cannula inadvertently taking an unwanted direction.  

Lignocaine is the numbing local anaesthetic drug of the fatty tissue. During the initial consultation with the doctor, liposculpture areas will be determined that may be performed in the one operative session. This is determined by the maximum dose of lignocaine that may be injected into the subcutaneous (under skin and on top of the muscle) fatty tissue. It is important not to exceed the recommended dose as the lignocaine may become toxic to the heart and brain (and even cause death) if excessive doses are given. Safe and recommended dosages of lignocaine are determined during the consultation and may limit what areas of liposculpture may be performed at the same time.  

If sedation drugs are used excessively there is a risk of damage to lung/ heart/ brain and even death, but this is extremely rare. It is important that you are adequately fasted before the procedure under sedation of any kind. No food or milk products for 6 hours before the procedure. Only water may be consumed up to 2 hours prior to the procedure. If you are not properly fasted, your procedure will be cancelled. You will be required to have a carer pick you up and take you home afterwards as you cannot drive and cannot go home unaccompanied. 

The above information mentions most of the side effects and complications that may occur from a liposculpture / liposuction procedure. Should there still be any questions, seek the answers and ask the doctor before undertaking the procedure.  The patient who is well informed about the benefits and risks is then realistic in their expectations of the liposculpture procedures and what can be achieved. Patients who would be satisfied with a 50% change and not expect perfection would likely be appropriate candidates for liposuction/ liposculpture. Diet and exercise are integral in maintaining results after liposuction/ liposculpture. Be aware and mindful that cosmetic surgery is invasive and carries risk. You have the option of choosing not to go ahead as liposuction/ liposculpture is a purely elective procedure. Cosmetic surgery may be a very positive experience for many individuals but is not the only option for those who are unhappy with their appearance.  

NO, but liposculpture can be used in people who are slightly overweight to reduce localised problems, eg. abdomen, arms, etc. Many such people may describe the liposculpture as a ‘kick start’ and go on to continue to lose weight, especially when central abdominal fat cells are removed, but that is dependent on the motivation of the individual. Liposculpture is really not suitable for those with BMI >35. BMI is calculated by your weight divided by your height squared (eg. 70kg / 1.7m squared = 24.2) Your BMI can be calculated using the online calculator  on the BDMI section of each individual treatment page.

YES. Lipoedema is an abnormal build-up of fat in your legs and sometimes arms. It can be painful and affect daily life. It is more common in women and usually affects both sides equally. Compression therapy can sometimes help manage lipoedema. As well as changing diet possibly, massage therapy and water-based activities may improve the condition. Liposculpture, which also changes the body shape by removing the excess fat cells, but compression is also necessary after liposculpture/ liposuction procedures.  

There is no theoretic age limit for the performance of liposculpture provided there are no significant health problems that may interfere with the medications used or recovery. At the initial consultation with Dr Heckenberg, it is important to be honest about medication you are taking as the local anaesthetic drug (lignocaine) can have interactions with some drugs and may increase risk of toxicity, which could affect the heart or brain or even cause death. This is one of the reasons why excessive liposculpture or liposuction cannot be done in a single procedure. At our clinic, only patients over the age of 18 are accepted.  

As the cannulae used in this technique are very narrow, the incisions used can often be concealed in some of the natural creases of the body. Scars may develop over the incision sites (3-5mm) or become darker or lighter in colour or become enlarged but generally they tend to become less obvious with time. Sutures are not required for most incisions and the incision sites act as drainage points post operatively to allow the excess anaesthetic fluid to drain out.  

NO. Cellulite (localised dimpling of the skin especially over the thighs and buttocks) is due to the distribution of fibrous bands within fatty tissue. Attempts to divide these fibrous bands have been tried, but the level of success is variable, so at present no technique can reliably treat this problem, although in situations where excess fatty tissue is also a problem, removal of the fatty tissue may make specific dimples less obvious. However, this is very variable amongst individuals. 

NO. Viewing “before” and “after” photographs of patients having liposuction / liposculpture are only relevant for that particular patient and do not necessarily reflect the results other patients may experience, as results may vary due to these factors including the individual’s genetics, diet and exercise.

NO. Different patients will heal differently, and have different pain thresholds and will therefore experience different recovery times for different activities.  

YES. You may raise your concerns directly with the doctor, you may contact the clinic or facility, make a complaint to the Health Care Complaints Commission (HCCC), or call the Cosmetic Surgery Hotline on 1300 361 041. 

For people who live busy lives the timing of their procedure is paramount. At Be Sculptured we realise that you may only have a window of time to have your procedure. Coordinating the hospital and the anaesthetist may limit what day is available, so it is best to plan ahead. Procedures can usually be performed within 6 weeks of the consultation but this timing may be variable. The Australian Medical Board, in October 2016, advised a mandatory 7-day cooling-off period from the time of consultation to the time of cosmetic surgical procedures. You can consult online for possible times but a face-to-face consultation is necessary at least 7 days prior to the procedure.  

1. All patients seeking cosmetic surgery must have a referral, preferably from their usual general practitioner or if that is not possible, from another general practitioner or other specialist medical practitioner. The referring medical practitioner must work independently of the medical practitioner who will perform the surgery and must not perform cosmetic surgery or non-surgical cosmetic procedures themselves.  

2. You must be assessed for underlying psychological conditions such as Body Dysmorphic Disorder (BDD) using a validated psychological screening tool for BDD. This screening tool will be in the form of a validated questionnaire and that is mandatory requirement for anyone considering cosmetic surgery.  Please view our BDD PDF here.

3. You must have at least 2 pre-operative consultations. The first consultation must be with the medical practitioner who will perform the surgery, or another health practitioner, eg. registered nurse, who works with the medical practitioner, who will perform the surgery. At least one of the 2 consultations must be in person with the medical practitioner who will perform the surgery. Other consultations can be in person or by video.  

4. There must be a cooling-off period of at least 7 days AFTER the patient has had 2 consultations before the surgery can be booked, performed or a deposit paid.  

5. A separate consent form is required for photography. You can view our Photography consent form here.

The cost of this procedure varies according to the areas requested. The hospital theatre fee is time based as is the anaesthetist’s fee.  

Liposuction / liposculpture is NOT covered by Medicare or Private Health Insurance. For an accurate costing, please use the online consultation or make an appointment by phoning 0484898977.