Liposuction

Written by Debra Stang | Published on July 23, 2012
Medically Reviewed by George Krucik, MD

What Is Liposuction?

Liposuction is a cosmetic surgical procedure that removes excess fat from one or more areas of the body. It can be used for small areas, such as the space under the chin. It may also be used for larger areas, including the thighs or buttocks.

Liposuction is also referred to as lipoplasty, suction lipectomy, or body contouring.

Liposuction is usually performed by a plastic surgeon. It may take place in a doctor’s office, clinic, day surgery center, or hospital, depending on the size of the area being targeted.

Who Is a Candidate for Liposuction?

Liposuction works well for those whose weight is stable but who continue to have stubborn pockets of fat that do not respond to diet or exercise. It is most useful in healthy young adults with elastic skin that can shape itself around the body’s new contours.

A slightly modified procedure called laser-assisted liposuction uses lasers to further reduce the water content of the fat after the initial liposuction procedure. This works best for adults over the age of 45, because in addition to liquefying fat, it also helps to tighten skin.

Who Is Not a Candidate for Liposuction?

Liposuction is not a substitute for diet and exercise, and generally produces poor results for people who are 20 percent or more over their ideal body weight.

It is also not intended to treat cellulite (skin dimpling).

Liposuction is not performed on individuals who have chronic medical problems, including:

  • restricted blood flow
  • diabetes
  • heart problems
  • a weakened immune system

Types of Liposuction

There are two basic kinds of liposuction, and they are generally used in combination to achieve the maximum benefit.

Tumescent Liposuction

In this type of liposuction, sometimes known as fluid injection liposuction, the doctor injects a large amount of fluid into the area where the surgery will be performed. The fluid contains lidocaine, a local anesthetic, epinephrine (which causes the blood vessels to temporarily get smaller), and saline solution to help break up the fat cells.

Ultrasound-Assisted Liposuction

This type of liposuction has only been available in the United States since 1996. It involves using ultrasound vibrations to liquefy the fat in the area of the body being worked on. The high-frequency sound waves can be delivered either to the outside of the skin (externally) or beneath the skin (internally).

How Liposuction Is Performed

Depending on the type of anesthetic you are receiving, your doctor may ask you not to eat or drink anything after midnight on the day of the surgery. This is usually the case if you are having general anesthetic (which puts you to sleep) or deep sedation.

You will check in at the facility where the procedure is being performed. A nurse or technician will give you a gown to put on. He or she will also start an IV in your hand, wrist, or arm. The IV allows your doctor to give you medicine and fluids before, during, and after surgery.

Your plastic surgeon will then inject a combination of three medications into the area to be operated on. Your plastic surgeon may use an ultrasound or a laser to help break up fat cells as well.

When it is time for the operation to begin, the surgeon will sterilize and drape the area being operated on. You will receive either general anesthetic or local anesthetic, which numbs only the area being worked on. Your doctor may also give you a sedative to make you feel calm and sleepy.

When the surgical site has been prepared and the anesthetic has taken effect, the doctor will make a small incision and insert a device attached to a suction tube into one of the fat pockets. Each pocket of excess fat is vacuumed out, one at a time. If the surgeon is working on a large area, such as your abdomen, he or she may need to make more than one incision. Surgery can take several hours depending upon the number and size of the areas being worked on.

After surgery, you will go to the recovery room so that the hospital staff can monitor your vital signs and make sure you are pain-free and stable. After some time in the recovery room, you may be discharged to go home, or you may spend a night or two in the hospital recovering.

Aftercare

If you are sent home, you will probably have tiny surgical drains at each incision site. These drains prevent fluid buildup and promote healing. You may also be given prescriptions for antibiotics to avoid infection and painkillers to ease discomfort.

You will need to wear a tight compression garment over the surgical area. Your doctor will encourage you to take regular, short walks. However, you should avoid strenuous activities.

You will see your doctor again in a few days. At this point, he or she will probably remove the surgical drains and tell you how much longer you should wear the compression garment. Your doctor can also tell you when you can go back to work and when you can resume normal activities.

Most people feel better in one to two weeks. Bruising around the surgical site may be visible for up to three weeks. Swelling from excess fluids can last for as long as a month. It will probably take four to six weeks before you notice any improvement in your body contours.

Outlook for Liposuction

Most people who undergo liposuction report being happy about their decision. Fat deposits usually do not return as long as your weight remains stable.

Liposuction carries some risks, uncluding:

  • scarring
  • dehydration (if too many fluids are vacuumed out of a large area)
  • over-hydration (if doctors try to replace fluids too quickly)
  • allergic reaction to the general or local anesthesia (rare)
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