Liposuction is a surgical procedure that uses a suction
technique to remove fat from specific areas of the body, such as the abdomen,
hips, thighs, buttocks, arms or neck. Liposuction also shapes (contours) these
areas. Other names for liposuction include lipoplasty and body contouring.
Liposuction isn't typically considered an overall weight-loss
method or a weight-loss alternative. If you're overweight, you're likely to
lose more weight through diet and exercise or through bariatric procedures —
such as gastric bypass surgery — than you would with liposuction.
You may be a candidate for liposuction if you have too much body
fat in specific spots but otherwise have a stable body weight.
Why it's done
Liposuction is used to remove fat from areas of the body that
haven't responded to diet and exercise, such as the:
·
Abdomen
·
Upper arms
·
Buttocks
·
Calves and ankles
·
Chest and back
·
Hips and thighs
·
Chin and neck
In addition, liposuction can sometimes be used for breast
reduction or treatment of gynecomastia.
When you gain weight, fat cells increase in size and volume. In
turn, liposuction reduces the number of fat cells in a specific area. The
amount of fat removed depends on the appearance of the area and the volume of
fat. The resulting contour changes are generally permanent — as long as your
weight remains stable.
After liposuction, the skin molds itself to the new contours of
the treated areas. If you have good skin tone and elasticity, the skin is
likely to appear smooth. If your skin is thin with poor elasticity, however,
the skin in the treated areas may appear loose.
Liposuction doesn't improve cellulite dimpling or other skin
surface irregularities. Likewise, liposuction doesn't remove stretch marks.
To be a candidate for liposuction, you must be in good health
without conditions that could complicate surgery — such as restricted blood
flow, coronary artery disease, diabetes or a weak immune system.
Risks
As with any major surgery, liposuction carries risks, such as
bleeding and a reaction to anesthesia. Possible complications specific to
liposuction include:
·
Contour irregularities. Your
skin may appear bumpy, wavy or withered due to uneven fat removal, poor skin
elasticity and unusual healing. These changes may be permanent. Damage beneath
the skin from the thin tube (cannula) that's used during liposuction may give
the skin a permanent spotted appearance.
·
Fluid accumulation. Temporary
pockets of fluid (seromas) can form under the skin. This fluid may need to be
drained with a needle.
·
Numbness. You may
feel temporary or permanent numbness in the affected area. Temporary nerve
irritation also is possible.
·
Infection. Skin
infections are rare but possible. A severe skin infection may be
life-threatening.
·
Internal puncture. Rarely,
a cannula that penetrates too deeply may puncture an internal organ. This may
require emergency surgical repair.
·
Fat embolism. Pieces
of loosened fat may break away and become trapped in a blood vessel and gather
in the lungs or travel to the brain. A fat embolism is a medical emergency.
·
Kidney and heart problems. Shifts
in fluid levels as fluids are being injected and suctioned out can cause
potentially life-threatening kidney, heart and lung problems.
·
Lidocaine toxicity. Lidocaine
is an anesthetic often administered with fluids injected during liposuction to
help manage pain. Although generally safe, in rare circumstances, lidocaine
toxicity can occur, causing serious heart and central nervous system problems.
The risk of complications increases if the surgeon is working on
larger surfaces of your body or doing multiple procedures during the same
operation. Talk to your surgeon about how these risks apply to you.
How you prepare
Food and medications
Before the procedure, discuss with your surgeon what to expect
from the surgery. Your surgeon will review your medical history, and ask about
any medical conditions you may have and any medications, supplements or herbs
you may be taking.
Your surgeon will recommend that you stop taking certain
medications, such as blood thinners or NSAIDs, at least three weeks prior to
surgery. You may also need to get certain lab tests before your procedure.
Other precautions
If your procedure requires the removal of only a small amount of
fat, the surgery may be done in an office setting. If a large amount of fat
will be removed — or if you plan to have other procedures done at the same time
— the surgery may take place in a hospital followed by an overnight stay. In
either case, arrange for someone to drive you home and stay with you for at
least the first night after the procedure.
What you can expect
Before the procedure
Tumescent
liposuction procedure Enlarge image
Before your liposuction procedure, the surgeon may mark circles
and lines on the areas of your body to be treated. Photos also may be taken so
that before and after images can be compared.
How your liposuction procedure is done depends on the specific
technique that's used. Your surgeon will select the appropriate technique based
on your treatment goals, the area of your body to be treated, and whether you
have had other liposuction procedures in the past.
·
Tumescent liposuction. This is
the most common type of liposuction. The surgeon injects a sterile solution — a
mixture of salt water, which aids fat removal, an anesthetic (lidocaine) to
relieve pain and a drug (epinephrine) that causes the blood vessels to
constrict — into the area that's being treated. The fluid mixture causes the
affected area to swell and stiffen.
The surgeon then makes small
cuts into your skin and inserts a thin tube called a cannula under your skin.
The cannula is connected to a vacuum that suctions fat and fluids from your
body. Your body fluid may be replenished through an intravenous (IV) line.
·
Ultrasound-assisted liposuction
(UAL). This type of liposuction is sometimes used in conjunction
with traditional liposuction. During UAL, the surgeon inserts a metal rod
that emits ultrasonic energy under your skin. This ruptures the fat-cell walls
and breaks down the fat for easier removal. A new generation of UAL called
VASER-assisted liposuction uses a device that may improve skin contouring and
reduce the chance of skin injuries.
·
Laser-assisted liposuction
(LAL). This technique uses high-intensity laser light to break
down fat for removal. During LAL, the surgeon inserts a laser fiber
through a small incision in the skin and emulsifies fat deposits. The fat is
then removed via a cannula.
·
Power-assisted liposuction
(PAL). This type of liposuction uses a cannula that moves in a
rapid back-and-forth motion. This vibration allows the surgeon to pull out
tough fat more easily and faster. PAL may sometimes cause less pain
and swelling and can allow the surgeon to remove fat with more precision. Your
surgeon may select this technique if large volumes of fat need to be removed or
if you've had a previous liposuction procedure.
During the procedure
Some liposuction procedures may require only local or regional
anesthesia — anesthesia limited to a specific area of your body. Other
procedures may require general anesthesia, which induces a temporary state of
unconsciousness. You may be given a sedative, typically through
an IV injection, to help you remain calm and relaxed.
The surgical team will monitor your heart rate, blood pressure
and blood oxygen level throughout the procedure. If you are given local
anesthesia and feel pain during the procedure, tell your surgeon. The
medication or motions may need adjustment.
The procedure may last up to several hours, depending on the
extent of fat removal.
If you've had general anesthesia, you'll wake in a recovery
room. You'll typically spend at least a few hours in the hospital or clinic so
that medical personnel can monitor your recovery. If you're in a hospital, you
may stay overnight to make sure that you're not dehydrated or in shock from fluid
loss.
After the procedure
Expect some pain, swelling and bruising after the procedure.
Your surgeon may prescribe medication to help control the pain and antibiotics
to reduce the risk of infection.
After the procedure, the surgeon may leave your incisions open
and place temporary drains to promote fluid drainage. You usually need to wear
tight compression garments, which help reduce swelling, for a few weeks.
You may need to wait a few days before returning to work and a
few weeks before resuming your normal activities — including exercise.
During this time, expect some contour irregularities as the
remaining fat settles into position.
Results
After liposuction, swelling typically subsides within a few
weeks. By this time, the treated area should look less bulky. Within several
months, expect the treated area to have a leaner appearance.
It's natural for skin to lose some firmness with aging, but liposuction results are generally long lasting as long as you maintain your weight. If you gain weight after liposuction, your fat distribution may change. For example, you may accumulate fat around your abdomen regardless of what areas were originally treated.