These localized fat deposits may sometimes be inherited and typically do not respond to dieting or exercise. Liposuction is often the only way to improve them.
Liposuction can be done alone or with other plastic surgery procedures such as breast reduction or tummy tuck (abdominoplasty). In addition, liposuction can be performed on several areas of the body at once.
Other names for liposuction are lipoplasty, suction-assisted lipectomy, ultrasound-assisted liposuction or lipoplasty, laser-assisted liposuction or lipoplasty and power-assisted liposuction or lipoplasty.
How Many People Undergo Liposuction?
Liposuction was the number one surgical cosmetic procedure performed on men and women in 2007, according to statistics compiled by the American Society for Aesthetic Plastic Surgery (ASAPS).
Specifically, 456,828 liposuction procedures were performed on men and women that year. And these numbers have increased by a whopping 158.3 percent since 1997, when ASAPS first started tracking cosmetic surgery trends and figures.
How Liposuction Is Performed
Step One: Marking your territory. Using a magic marker, your surgeon will literally mark the areas of your body where he or she will remove unwanted fat. Such markings before surgery help your plastic surgeon plan the liposuction procedure.
Step Two: Anesthesia awareness. Liposuction is typically performed under general anesthesia, but in some cases local anesthesia can be used. Other options include intravenous sedation or epidural block. The decision involves both you and your doctor. It takes into account how much time the surgery will take, as well as where on the body the liposuction will be performed and how much fat will be removed.
Step Three: Wetting solution savvy. Wetting solutions are infused into the area before fat is removed. The fluid contains saline (salt water) and epinephrine (which constricts blood vessels to minimize any blood loss in the aspirate) and a local anesthetic. The reason that surgeons use a wetting solution is simple: they want to minimize blood loss, to increase the safety of liposuction. Various types of wetting solutions are used in liposuction. The main difference among them is the amount of fluid used.
- The "dry" technique. Before wetting solutions came along, surgeons went in dry. This resulted in blood loss and bruising. In fact, about 45 percent of what was suctioned out was blood (not fat!), so it has fallen out of favor.
- The "wet" technique. The surgeon will infuse 100-300 milliliters of fluid (with or without epinephrine) into each treatment site. With the wet technique, about 20-25 percent of what is suctioned out is blood.
- The "super-wet" technique. As its name implies, the super-wet technique involves the infusion of greater amounts of fluid than with the wet technique. It is about a 1:1 or 1:1.5 ratio, meaning that the amount of fluid is approximately equal to the amount of fat to be removed. With the super-wet technique, less than 1 percent of what is suctioned out is blood.
- The tumescent technique. This involves even much more fluid than is used in the super-wet technique. Basically the surgeon will infuse three to six times as much fluid as the volume of the aspirate to be removed. Proponents say the tumescent technique swells the tissues, which aids in fat removal; but detractors say it interferes with the surgeon's ability to sculpt, and it is unsafe because of potential fluid overload and an overdose of anesthetic (which is used in the solution). Learn more about tumescent liposuction.
Step Four: Fat removal. There are many different ways to vacuum out the fat during liposuction.
- Traditional suction-assisted liposuction. This involves inserting a cannula (a long, thin tube) through a tiny incision to vacuum the fat cells. The surgeon moves the cannula back and forth through the fat layer to break it up, and then suction out, the excess fat.
- Ultrasound-assisted liposuction. Here the surgeon inserts a special cannula through small "access" incisions. The cannula emits sound waves to help break up the fat, presumably making it easier to vacuum. Vaser-assisted liposuction is the cutting-edge, third-generation version of ultrasound liposuction technology. In a nutshell, the cannula used for Vaser-assisted liposuction emits gentler sound waves to break up and then remove fat. These do not disturb blood vessels, nerves and connective tissue, resulting in less bruising, swelling and pain than traditional suction-assisted liposuction.
- Power-assisted liposuction. This uses a motorized cannula to break up fatty tissue that will then be vacuumed out. It is inserted through the same tiny incisions.
- Laser-assisted liposuction. This involves a small incision and the insertion of a laser fiber probe that produces a burst of energy to liquefy the fat before it is removed. (Two of the brand names you may see are SmartLipo and CoolLipo.) Proponents say that laser-assisted liposuction is the latest and greatest and may also tighten skin. But detractors say it adds nothing to the results of liposuction except for expense and for making the procedure more cumbersome for both the patient and surgeon. And, they say, it can add many hundreds of dollars to the cost of liposuction without proven extra benefit.
- Body-jet liposuction. Using a thin, fan-shaped jet that pulsates water, your surgeon loosens fat cells from connective tissue, while simultaneously vacuuming them out. It is sometimes called water-jet assisted liposuction or water-assisted liposuction. While other liposuction techniques destroy or break apart the fat cells before suctioning them out of the body, the new water-assisted technique may loosen the fat cells first. As a result, water-assisted liposuction may be less traumatic than traditional liposuction methods. There may also be a shorter recovery time if the technique is proven to be gentler. Body-Jet liposuction does not use as much fluid as tumescent liposuction. What's more, the fluid is infused while the procedure is being performed, not beforehand as it is with other types of liposuction. The water is then immediately sucked back out with the fat; which may make it easier for your surgeon to determine if any areas need additional suctioning. Water-assisted liposuction flushes the fat instead of destroying it, so there may be an opportunity to harvest fat for fat transfer to other parts of the body where it is needed to restore plumpness. Water-assisted liposuction may be performed under local anesthesia, but general anesthesia will likely be needed for larger areas of fat removal. The bottom line is that more research is needed to determine the exact benefits and risks of water-assisted liposuction.
Cannula Counts, Too
Regardless of the type of liposuction you and your doctor choose, the size of the cannula is also important. The cannula is a long, hollow instrument that is connected to the fat suctioning device. The cannula enables the plastic surgeon to suction out the fat.
Today, cannulas are about 3 millimeters or finer in diameter, while in the past they were as large as 10 to 12 millimeters in diameter. The smaller diameter causes less trauma to surrounding tissues and blood vessels. So smaller cannulas mean less bruising. Consider asking your doctor what his or her cannula choice is.
Putting It All Together
Based on your surgeon's experience and expertise and your particular case, he or she will choose a method of anesthetic, the appropriate wetting solution and a method of liposuction.
For anything but very small removals, most plastic surgeons select general, and at times epidural, anesthesia, the super-wet technique for wetting solutions, and aspiration with the traditional technique, using ideal cannula types for the body area they are treating. When ultrasound is used, Vaser is the latest development.
The time in surgery varies, depending on the size of the area being treated. It can span from 30 minutes to five hours. If you choose to have multiple areas treated at once, the procedure will take longer.
Who Is a Candidate for Liposuction?
The first step toward determining your candidacy for liposuction is choosing a competent surgeon for your initial consultation.
During this appointment or series of appointments, the plastic surgeon should take a thorough medical history, which includes a list of the medications you are taking, your weight, whether your weight has significantly fluctuated and whether you plan to lose weight before the liposuction. He or she will also talk with you about your expectations to make sure they are realistic.
In general, the ideal candidates for liposuction are men and women who are of relatively normal weight, but have isolated pockets of fat that do not respond to an adequate diet and exercise program. Think love handles or muffin tops.
You should have firm and elastic skin tone and have excessive fatty deposits in certain body areas. Keep in mind that liposuction removes fat, not loose skin.
Age is not a deciding factor, but many older patients have less elastic skin, so they may not get optimal results.
Preparing for Liposuction
Your surgeon will give you a list of instructions on what to do and what not to do in the days before you undergo liposuction. This may include guidelines on eating and drinking. He or she will also discuss the importance of quitting smoking at least 30 days before liposuction. Smoking greatly increases the risks of any surgery, and liposuction is no exception.
Certain medications, such as aspirin and nonsteroidal anti-inflammatory drugs, may promote bleeding and should be discontinued before surgery. Your surgeon will advise you on which medications you should stop taking before liposuction. Never stop taking prescribed medications without first talking with your surgeon and with the doctor who prescribed them.
What to Expect After Liposuction
The suctioned areas will be swollen and uncomfortable for several days after liposuction. In some cases, the small incisions are left open temporarily so that fluids and residual fatty deposits can empty through an inserted drain. Your surgeon may prescribe an antibiotic to reduce the risk of infection.
Usually the treatment area is wrapped with elastic bandage. Support hosiery or a girdle may be worn over this, to help compress tissue and control swelling and bruising. Your surgeon may want you to wear the bandage and/or garment for several days or weeks.
It is recommended for you to move soon after surgery, as this will decrease the risk of blood clots that can occur from long periods of being sedentary. You will be allowed to return to work or your normal activities in a few days. Some patients can return sooner, especially if conservative amounts of fat were removed. Strenuous activity, however, is a no-no for at least three weeks.
Be patient. The final results may not be evident for up to six months, but they are permanent (assuming that your weight remains stable). Depending on how gently the procedure was performed, you may see some preliminary results as early as one week.
Liposuction Risks
All surgeries have risks, and liposuction is no exception. They include:
- Infection
- Fluid imbalance. A lot of liquid exists in fat tissue, which is removed during liposuction. What's more, especially during tumescent liposuction, your surgeon may inject large amounts of fluids during liposuction. This can result in a fluid imbalance, which can lead to heart problems, excess fluid collecting in the lungs or kidney problems as your kidneys try to maintain fluid balance.
- Shock
- Blood clots in the lung (pulmonary emboli)
- Hematoma (a collection of blood in the areas suctioned)
- Temporary numbness or discoloration in the treated area
- Asymmetry, dimpling, wrinkling, unevenness and surface irregularities over the treated area
- Perforation wounds in surrounding tissue or organs
- Anesthesia reactions
- Swelling
- Burns (from ultrasound-assisted and laser-assisted liposuction)
- Death
These risks are higher in people with underlying medical conditions such as heart or lung disease, poor circulation or diabetes. In addition, individuals who have recently had another surgery in the same area where they want liposuction are at higher risk for complications. These factors should all be addressed during your initial consultation with a plastic surgeon.
To ensure maximum safety, consult a board-certified plastic surgeon who has extensive experience with liposuction, including in the area you wish to have treated.
Advantages of Liposuction
Liposuction's advantages include:
- It's permanent.
- In competent hands, it has an extremely high safety record.
- Scars are small and inconspicuous.
Liposuction Cost
The average cost of liposuction performed on one area of the body is up to $4,000; in three areas it is $6,000 to $8,000; and in five areas it is $8,000 to $11,000.
Liposuction cost is higher for larger body areas. For example, the average cost for the abdomen is $4,000 to $8,000, but for the outer thigh is about half as much.
As a general rule, insurance companies do not cover liposuction.
Great information provided by Liposuction.com and Vaser.com
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