Liposuction Health Article

Definition

Liposuction is the removal of excess body fat by suction using special surgical equipment. A plastic surgeon typically does the surgery.

Alternative Names

Fat removal - suctioning

Description

Liposuction is a popular type of cosmetic surgery. It removes unwanted deposits of excess fat, to improve body appearance and to smooth irregular or distorted body shapes. The procedure is sometimes called body contouring.

Liposuction may be useful for contouring under the chin, neck, cheeks, upper arms, breasts, abdomen, buttocks, hips, thighs, knees, calves, and ankle areas.

However, liposuction is a serious surgical procedure and may involve a painful recovery. Because liposuction can have serious or occasionally fatal complications, you should carefully think about your decision to have this surgery.

Before your surgery, you will have an initial patient consultation, which will include a history, physical exam, and a psychological evaluation. You may need to bring someone (such as your spouse) with you during the visit. You may need a second consultation to give you time to think over the surgery.

You should feel free to ask questions, and to feel satisfied with the answers to those questions. A properly informed person makes a better patient. You must understand fully the pre-operative preparations, the liposuction procedure, and the post-operative care. Understand that liposuction may enhance your appearance and self-confidence, but it will probably not give you your ideal body.

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; however, 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 meed 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.

Liposuction may or may not require a hospital stay, depending on the location and extent of surgery. Liposuction can be done in an office-based facility, in a surgery center on an outpatient basis, or in a hospital. For reasons of cost and convenience, liposuction of smaller volumes is usually done as an outpatient. You may need to stay in a hospital if a larger volume of fat is being removed, or if you are having other procedures done at the same time.