Many patients look at liposuction as a means of weight reduction, but in fact the amount of total body weight that is removed with liposuction is relatively small. The limits recommended for safe liposuction are 5000 cc of total fluid removal for each surgery, which means that only 5 or 6 pounds of fat are removed with liposuction. That amount of liposuction can produce a dramatic improvement in body contour, but a minimal reduction in weight. Before considering liposuction, it is wise to optimize body weight with diet, exercise, and other weight reduction programs, and then have liposuction to remove the fatty tissue that is resistant to diet and exercise programs. The best candidates for liposuction are those people whose weight is within the normal or mildly overweight limits based on their height.

There are many methods that can be used to make liposuction safer and easier. "Tumescent" liposuction uses fluid containing local anesthetics and epinephrine (adrenalin) to reduce blood loss with liposuction, and in some cases allows the procedure to be done with minimal sedation instead of general anesthesia. The amount of fluid injected prior to performing liposuction determines whether the procedure is done with general anesthesia or not. Fluid injection is certainly safe and effective, and is used in some form in almost all liposuction procedures done today.

Ultrasound waves may be used to "lyse" or break up the fat before liposuction is done, thus facilitating the removal of the fat. The technique is especially valuable in areas where the fatty tissue is more fibrous and tough, such as the male breast, the back, and in cases where liposuction is repeated and scar tissue is present. Ultrasound-assisted lipoplasty (UAL) is safe if performed by a surgeon who is properly trained to perform liposuction -- such as a surgeon who is certified by the American Board of Plastic Surgery -- and who is trained and experienced in the use of ultrasound technology. Recently, newer methods of UAL, using the "Vaser" technology, have made the process even safer and more effective. There are risks with UAL, including skin burns and nerve injuries, but these are rare in the hands of an experienced, properly trained surgeon. You should always discuss possible risks and complications with your surgeon before having any procedure. Making certain that your surgeon is properly trained and board-certified, and that the surgery will be done in an accredited surgical facility, are the most important steps you can take to help ensure a safe and successful surgery.

Liposuction

The usual recommendation is to wait until all drainage has ceased, and the breast fullness has subsided. This is a variable period in women, but it is best to wait until the true breast volume is evident, and the tissues are back to normal in terms of swelling and firmness.

Breast Augmentation

There is no absolute "life span" of breast implants, whether silicone gel or saline filled devices. The implant manufacturers currently recommend follow-up examinations regularly by the surgeon as well as routine monthly self examination by the patient. They emphasize that the implants are not lifetime devices, but do not state any specific expectation of the longevity of the implants. Magnetic resonance imaging (MRI) evaluation of silicone gel devices is recommended by both manufacturers starting at 3 years after implantation, and then every two years as the best means of detecting a "silent" rupture. Mammograms are recommended for women with breast implants on the same schedule as for women without implants.

Replacement of the breast implants, or their removal is recommended only to treat problems associated with the implants, such as rupture, leakage, clinically significant capsular contracture (hardening), malposition, asymmetry, desire for style/size change, etc. If no problems occur, there is no need to replace breast implants.

Breast Augmentation