|Fat removal -
Liposuction is the removal of excess body fat by
suction using special surgical equipment. A plastic surgeon
typically does the surgery.
Body Contouring / Hips - Waist - Thighs and
This 28 year old had 8
liters or 16 pounds of fat removed from her tummy,
hips, inner and outer thighs. She changed from a
size 12 to a size 6 in three hours of liposuction.
This large volume liposuction requires overnight
care in our suite.
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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
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
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
- 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
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
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.
Why the Procedure is
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The following are some of the uses
- Cosmetic reasons, including "love handles," fat bulges,
or an abnormal chin line.
- To improve sexual function by reducing abnormal fat
deposits on the inner thighs, thus allowing easier access
to the vagina.
- Body shaping for people who are bothered by fatty
bulges or irregularities that cannot be removed by diet
Liposuction is generally NOT appropriate for these uses:
- As a substitute for exercise and diet, or as a cure for
general obesity. However, it may be used to remove fat from
isolated areas at different points in time.
- As a treatment for cellulite (the uneven, dimpled
appearance of skin over hips, thighs, and buttocks).
- In certain areas of the body, such as the fat on the
sides of the breasts, because the breast is a common site
Many alternatives to liposuction exist, including a tummy
tuck (abdominoplasty), removal of fatty tumors (lipomas),
breast reduction (reduction mammaplasty), or a combination of
plastic surgery approaches.
Certain pre-existing conditions
should be checked and brought under control before liposuction,
- History of heart problems (heart attack)
- High blood pressure
- Allergic reactions to medications
- Pulmonary problems (shortness of breath, air pockets in
- Allergies (antibiotics, asthma, surgical prep)
- Smoking, alcohol, or drug use
There are also risks associated with liposuction,
- Shock (usually when not enough fluid is replaced during
- Fluid overload (usually from the procedure)
- Infections (strep, staph)
- Bleeding, blood clot
- Tiny globules of fat in the bloodstream that block
blood flow to tissue (fat embolism)
- Nerve, skin, tissue, or organ damage or burns from the
heat or instruments used in liposuction
- Uneven fat removal (asymmetry)
- Drug reactions or overdose from the lidocaine used in
- Scarring (skin surface may be irregular, asymmetric, or
even "baggy," especially in older people)
Finally, make sure to review and sign any informed consent
(legal) and permission forms for photographs.