Liposuction Health Article

Definition

Liposuction, also known as lipoplasty or suction-assisted lipectomy, is cosmetic surgery performed to remove unwanted deposits of fat from under the skin. The surgeon sculpts and re-contours a person's body by removing excess fat deposits that have been resistant to reduction by diet or exercise. The fat is permanently removed from under the skin with a suction device.

Purpose

Liposuction is intended to reduce and smooth the contours of the body and improve a person's appearance. Its goal is cosmetic improvement. It is the most commonly performed cosmetic procedure in the United States.

Liposuction does not remove large quantities of fat and is not intended as a weight reduction technique. The average amount of fat removed is about a quart (liter). Although liposuction is not intended to remove cellulite (lumpy fat), some doctors believe that it improves the appearance of areas that contain cellulite, including thighs, hips, buttocks, abdomen, and chin. A new technique called liposhaving shows more promise at reducing cellulite.

Demographics

Liposuction is the most commonly performed cosmetic procedure in the United States. In 2002, there were 372,831 liposuction procedures performed in the United States, approximately 13% of all plastic surgical procedures.

Description

Most liposuction procedures are performed under local anesthesia (loss of sensation without loss of consciousness) by the tumescent, or wet, technique. In this technique, large volumes of very dilute local anesthetic (a substance that produces anesthesia) are injected under the person's skin, making the tissue swollen and firm. Epinephrine is added to the solution to reduce bleeding, which allows the removal of larger amounts of fat.

The physician first numbs the skin with an injection of local anesthetic. After the skin is desensitized, the doctor makes a series of tiny incisions, usually 0.12–0.25 in (3–6 mm) in length. Flooding the area with a larger amount of local anesthetic, fat is then extracted with suction through a long, blunt hollow tube called a cannula. The doctor repeatedly pushes the cannula through the fat layers in a radiating pattern creating tunnels, thus removing fat and recontouring the area. Large quantities of intravenous fluid (IV) are given during the procedure to replace lost body fluid. Blood transfusions might be necessary.

Some newer modifications to the procedure include the use of a cutting cannula called a liposhaver and the use of ultrasound to help break up the fat deposits. The person is awake and comfortable during these procedures.

The length of time required to perform the procedure varies with the amount of fat that is to be removed and the number of areas to be treated. Most operations take from 30 minutes up to two hours, but extensive procedures can take longer. The length of time required also varies with the manner in which the anesthetic is injected.

The cost of liposuction can vary depending upon the standardized fees in the region of the country where it is performed, the extent of the area being treated, and the person performing the procedure. Generally, small areas such as the chin or knees can be done for as little as $500, while more extensive treatment such as when hips, thighs, and abdomen are done simultaneously can cost as much as $10,000. These procedures are cosmetic and are not covered by most insurance policies.

Diagnosis/Preparation

Liposuction is most successful when performed on persons who have firm, elastic skin and concentrated pockets of fat in areas that are characterized by cellulite. To get good results after fat removal, the skin must contract to conform to the new contours without sagging. Older persons have less elastic skin and, consequently, may not be good candidates for this procedure. People with generalized fat distribution, rather than localized pockets, are not good candidates. People with poor circulation or who have had recent surgery at the intended site of fat reduction are not good candidates.

Candidates should be in good general health and free of heart or lung disease.

The doctor will conduct a physical examination and may order blood work to determine clotting time and hemoglobin level for transfusions, in case the need should arise. The person may be placed on antibiotics immediately prior to surgery to ward off potential infection.