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Liposuction is the removal of excess body fat by a surgeon using special suction surgical equipment. Liposuction is a popular type of cosmetic surgery to remove unwanted deposits of excess fat, that helps to improve body appearance and to smooth irregular or distorted body shapes. Liposuction may be useful for contouring under the chin, neck, cheeks, upper arms, breasts, abdomen, buttocks, hips, thighs, knees, calves and ankle areas.
Several different liposuction procedures exist:
▣ Tumescent liposuction (fluid injection) is the most common type of liposuction. It involves injecting a large amount of medicated solution into the areas before the fat is removed (sometimes, the solution may be up to three times the volume of fat to be removed). The fluid is a mixture of local anesthetic (lidocaine), a drug that contracts the blood vessels (epinephrine) and an intravenous (IV) salt solution. The lidocaine in the mixture helps to numb the area during and after surgery and may be the only anesthesia needed for the procedure. The epinephrine in the solution helps reduce the loss of blood, the amount of bruising and the amount of swelling from the surgery. The IV solution helps remove the fat more easily and it is suctioned out along with the fat.
▣ This type of liposuction generally takes longer than other types
The super-wet technique is similar to tumescent liposuction. The difference is that not as much fluid is used during the surgery. The amount of fluid injected is equal to the amount of fat to be removed. This technique takes less time, but it often requires sedation with an IV or general anesthesia
▣ Ultrasound-assisted liposuction (UAL) is a fairly new technique, used in the U.S. since 1996. During this technique, ultrasonic vibrations are used to liquefy fat cells. After the cells are liquefied, they can be vacuumed out. UAL can be done in two ways, external (above the surface of the skin with a special emitter) or internal (below the surface of the skin with a small, heated cannula). This technique may help remove fat from dense, fiber-filled (fibrous) areas of the body such as the upper back or enlarged male breast tissue. UAL is often used together with the tumescent technique, in follow-up (secondary) procedures or for greater precision.
In general, this procedure takes longer than the super-wet technique
Before the day of surgery you may have blood drawn and be asked to provide a urine sample. This allows the health care provider to rule out potential complications. If you are not hospitalized, you will need a ride home after the surgery.
A liposuction machine and special instruments are used for this surgery. The surgical team first preps the operative site and administers either local or general anesthesia. Through a small skin incision, a suction tube with a sharp end is inserted into the fat pockets and swept through the area where fat is to be removed. The dislodged fat is "vacuumed" away through the suction tube. A vacuum pump or a large syringe provides the suction action. Several skin punctures may be needed to treat large areas.
After the fat is removed, small drainage tubes may be inserted into the defatted areas to remove blood and fluid that gather during the first few days after surgery. If you lose a lot of fluid or blood during the surgery, you may need fluid replacement (intravenously) or a blood transfusion.
After the surgery, bandages are applied to keep pressure on the area and stop any bleeding, as well as to help maintain shape. Bandages are usually kept in place for at least 2 weeks. Your doctor may call you from time to time to check on your health and to monitor your healing. A visit back to the surgeon after 5-7 days is often recommended. Sometimes people gain weight after liposuction. This is due to the increased fluid from surgery.
This procedure may or may not require a stay at the hospital and depends on the location and extent of surgery. Liposuction can be done in an office-based facility, a surgery center on an outpatient basis or in a hospital. Liposuction of smaller volumes is done as an outpatient for reasons of cost and convenience.
The following are some of the uses for liposuction:
▣ Cosmetic reasons, including "love handles", fat bulges or an abnormal chin line
▣ To improve sexual function by reducing abnormal fat deposits on the inner thighs, thus allowing easier access to the vagina
▣ Body shaping for people who are bothered by fatty bulges or irregularities that cannot be removed by diet and/or exercise
Liposuction is generally NOT appropriate for these uses:
As a substitute for exercise and diet or as a cure for general obesity. However, it may be used to remove fat from isolated areas at different points in time
As a treatment for cellulite (the uneven, dimpled appearance of skin over hips, thighs and buttocks)
In certain areas of the body, such as the fat on the sides of the breasts, because the breast is a common site for cancer
Many alternatives to liposuction exist, including a tummy tuck (abdominoplasty), removal of fatty tumors (lipomas), breast reduction (reduction mammaplasty) or a combination of plastic surgery approaches.
There are also risks associated with liposuction, including:
▣ Shock (usually when not enough fluid is replaced during the surgery)
▣ Fluid overload (usually from the procedure)
▣ Infections (strep, staph)
▣ Bleeding, blood clot
▣ Tiny globules of fat in the bloodstream that block blood flow to tissue (fat embolism)
▣ Nerve, skin, tissue or organ damage or burns from the heat or instruments used in liposuction
▣ Uneven fat removal (asymmetry)
▣ Drug reactions or overdose from the lidocaine used in the procedure
▣ Scarring (skin surface may be irregular, asymmetric or even "baggy" especially in older people)
The liposuctioned area may appear larger than before surgery because of swelling. You must wear a tight stocking, girdle or snug elastic dressing over the treated area to reduce swelling and bleeding and to help shrink the skin to fit the new contour. You should wear this garment continuously for 2 to 3 weeks.
You are most likely to have swelling, bruising, numbness and pain, but it can be managed with medications. The stitches will be removed in 5 to 10 days. Antibiotics may be prescribed to prevent infection.
You may feel sensations such as numbness or tingling, as well as pain, for weeks after the surgery. Walk as soon as possible after surgery to help prevent blood clots from forming in your legs. Avoid more strenuous exercise for about a month after the surgery.
You will start to feel better after about 1 or 2 weeks following liposuction surgery. You may return to work within a few days of the surgery. Bruising and swelling usually go away within three weeks. However, you may still have some swelling several months later. Your new body shape will begin to emerge in the first couple of weeks, but the improvement won't become more visible until about 4 to 6 weeks after surgery. By exercising regularly and eating a healthy diet, you can help maintain your new shape.
