Plastic Surgery

In 2007, the most popular surgical cosmetic procedure was liposuction; the most popular non-surgical cosmetic procedure was Botox injection. 

Liposuction

Overview

Liposuction

Liposuction is a cosmetic procedure that can enhance the shape of the body by removing excess fat deposits. Other terms for liposuction are lipoplasty, suction lipectomy, liposculpture, or fat suction. While liposuction may be performed alone, in many cases it is done in conjunction with other cosmetic surgery procedures, such as a tummy tuck, breast reduction, or facelift. Overall, it is one of the most popular types of cosmetic surgery for both men and women in the United States.

Although the purpose of liposuction is to get rid of unwanted fat in the body, it is not a weight loss procedure and should not be thought of as an alternative to healthy eating and exercise. Many individuals who are healthy and in good physical condition may still have small pockets of unsightly fatty tissue that remain in certain body areas, often due to genetics.

For individuals who are healthy and interested in sculpting their body's contours into a more desirable proportions, liposuction is an option to consider.

Patient Criteria

The ideal candidates for liposuction:

  • Over 18 years of age
  • Have firm, elastic skin and good muscle tone
  • Healthy individuals, who do not have a serious illness or medical condition which would impair healing, such as diabetes
  • Should not be on antibiotics or anticoagulants
  • Non-smokers

About the Liposuction Procedure

Liposuction is a surgical procedure that should only be performed by a plastic surgeon who has received special training and is experienced in liposuction techniques. Choosing a qualified and skilled surgeon not only increases your safety, but improves the likelihood of a successful outcome. The procedure may be performed in an outpatient surgical center or hospital.

During the liposuction procedure, fat is removed from the body through small incisions (less than 1") using a thin hollow tube, called a cannula. In order to confirm with the patient which areas will be treated, the surgeon will have the patient stand and will mark the relevant body locations before going into surgery.

Liposuction may be used to remove excess fat deposits in most body areas, including:

  • Cheeks, chin, and neck
  • Chest and back
  • Upper arms
  • Abdomen and waist
  • Thighs, hips, and buttocks
  • Inner knee, calves, and ankles

Before the procedure begins, the patient is given medication to help control pain and discomfort. In all types of liposuction, either a local anesthesia or general anesthesia is used. The most common anesthetic used is lidocaine. The patient may be hooked up to an IV fluid line in order to replace body fluids which are lost with fat removal and monitoring devices may be attached that keep track of blood pressure, heart rate, and blood oxygen level.

To begin, the skin is treated with a sterile solution at the treatment sites and small incisions are made for inserting the cannula. A saline water solution is injected into the space between the muscle and fat tissue, in order to separate them.

Then, to loosen the excess fat, the surgeon inserts the cannula through an incision and moving it back and forth with controlled motions. Once the fat is loosened, a suction device is attached to the cannula and the excess fat is vacuumed out. During the procedure, it may be possible for the patient to feel a scraping sensation from the cannula movement.

When the procedure is finished, compression garments or elastic bandages are placed over the treatment areas. They are used to keep swelling down and compress the skin to the new body contours.

Liposuction Techniques

Liposuction may be performed in any one of several various options. Different techniques have evolved over the years as doctor’s have worked on developing safer procedures and better results. The techniques differ by the amount of fluid injected into the treatment site and the method of loosening the fatty tissue before it is removed from the body. In all methods, the liquefied fat is suctioned out by a vacuum pump.

Some of the newest and most common techniques are tumescent liposuction, super-wet liposuction, and ultrasound-assisted liposuction (also called ultrasonic liposuction). During a consultation, the surgeon will determine which technique is best for a patient based on the individual’s personal situation.

Tumescent Liposuction

  • Before excess fat is removed, treatment areas are injected with a diluted saline solution containing a local anesthetic (lidocaine) for numbing and a vasoconstrictor (epinephrine) for temporarily shrinking the capillaries and blood flow
  • Volume of injected solution is roughly three to four times the volume of fat to be removed
  • Large amount of solution may affect body's fluid balance
  • Does not require general anesthetic, blood products, and intravenous fluids
  • Requires more time than traditional liposuction, but can provide smoother results

Super-Wet Liposuction

  • Before excess fat is removed, treatment areas are injected with a diluted saline solution containing a local anesthetic (lidocaine) for numbing and a vasoconstrictor (epinephrine) for temporarily shrinking the capillaries and blood flow (reduces blood loss)
  • Volume of injected solution is roughly the same amount as the volume of fat to be removed
  • Preferred technique for high-volume liposuction as it better balances body's fluid levels
  • May require either intravenous sedation and local anesthetic, or general anesthesia
  • Procedure takes one to three hours, depending on the size of the treated area(s)

Ultrasound-Assisted Liposuction

  • Before excess fat is removed, a specialized cannula is used which emits ultrasonic vibrations (high frequency sound waves) that liquefies fat cells
  • Good choice for fibrous areas, such as the upper back or male breast area
  • Slightly less blood loss
  • May cause seromas (fluid pockets) which need to be drained with a needle
  • May cause necrosis (death of skin)
  • Risk of heat injury or thermal burn

Laser Liposuction (Laser Lipolysis)

  • Two technologies available, marketed as SmartLipo and CoolLipo
  • Use thermal energy to affect fat emulsification, gradual skin tightening, and preservation of delicate tissues

Recovery from Liposuction

Liposuction patients can usually get up, walk around, and go home the same day, although someone else should drive them home. If general anesthesia is used, an overnight stay may be necessary. It generally takes anywhere from several days to several weeks before a patient will be able to resume normal activity, depending on the extent of the procedure.

  • Pain - may last up to two weeks, but can be managed with medication
  • Swelling - two weeks to two months to subside
  • Bruising - few days to two weeks to fade
  • Numbness - may last for several weeks
  • Non-absorbable sutures - removed after five to ten days
  • Excess fluid - can take days or weeks to drain out
  • Compression garments or bandages - worn for two to four weeks
  • Initial Results - may be seen in as little as two weeks, as swelling subsides
  • Final Results - may take up to six weeks or six months, depending on healing progress

Before you go home, the surgeon will provide you with specific instructions for post-surgery care, including; how to care for the incisions, medications to take for pain and to prevent infection, when to schedule a follow-up appointment, and when to resume exercise and normal activity. It is important for patients to follow their surgeon's post-surgery instructions to reduce complications and ensure a successful outcome.

Risks of Liposuction

Any surgical procedure involves some degree of risk, even with a skilled surgeon under the best of circumstances. Before undergoing an elective cosmetic procedure such as liposuction, a patient should consider both the benefits and risks of surgery. Unexpected events, such as an infection or reaction to the anesthesia, are always a possibility.

Other possible complications of liposuction include:

  • Damage to nerves, blood vessels, muscles, and internal organs
  • Change in skin sensation
  • Uneven contours, rippling, or loose skin
  • Scarring and skin discoloration
  • Persistent pain or swelling
  • Bleeding (hematoma), blood clots, fat clots
  • Excessive fluid loss or fluid accumulation
  • Poor healing
  • Possibility of revisional surgery

Cost of Liposuction

Liposuction can range from $2000 up to $8000 for one liposuction session, and as much as $12,000 to $20,000 for multiple sessions. Depending on the doctor’s pricing structure, the cost may be based on volume of fat suctioned, the specific area suctioned, how many areas are suctioned, or how much time is spent suctioning the fatty tissue. As a general guideline, one can expect that the cost will go up as more fat is suctioned.

The cost of liposuction includes the following expenses; surgeon’s fee (which is determined by training, skill, experience, and geographical location), hospital or surgical facility costs, anesthesia, medications, compression garments, medical tests, follow-up appointments, and revisions.

Results

It may take several months before the final results are reached, but as healing progresses you will begin to see the new contours of your body. If you continue to control your weight and maintain a healthy lifestyle, the results of liposuction will be long-lasting.