Liposuction surgery treats areas of excess fat in the stomach, buttocks, hips, love handles, saddlebags, thighs, calves, ankles, breasts, back, arms and neck. Most liposuction procedures involve making a small skin puncture and then utilizing various modalities to loosen the fat prior to suctioning the fat through a small hollow tube or cannula. Some describe the procedure as “liposculpture” because the process of fat reduction with liposuction creates slimmer and more ideal shapes and contours.
Liposuction surgery can be performed alone or in conjunction with an open procedure to contour the overlying skin. The results are best when you are near your ideal weight, but have some specific areas or “pockets” of fat that are exercise and diet resistant. While liposuction can improve the look of cellulite in some cases, there is no guarantee that it will smooth out or remove the dimpled appearance in the skin.
Am I a good candidate for liposuction?
While every patient who goes in for a consultation will be individually assessed to determine if they are healthy enough to undergo surgery, there are some conditions that could indicate that liposuction is right for you:
- You have areas of fat deposits that are out of proportion with the rest of your body and do not go away with diet and exercise
- Your skin elasticity is good – there is not a lot of excess skin and the area is firm (liposuction removes fat, not skin)
- You wish there was more definition in certain areas of your body or a sleeker contour
Oftentimes, if there is too much loose skin around the stomach area due to weight loss or pregnancy, your plastic surgeon might opt for a tummy tuck vs. liposuction. A tummy tuck or abdominoplasty can tighten loose skin and muscle, while removing excess fat that is sagging or protruding from your mid-section.
You should come to the consultation prepared to discuss your medical history including previous surgeries, past and present medical conditions, allergies and current medications. It is important for you to provide complete information. High blood pressure, thyroid problems, diabetes, etc. should be reviewed as these medical conditions may increase some risks associated with surgery.
How will my ASAPS plastic surgeon evaluate me?
During the initial consultation, you may be asked to look in a mirror and point out exactly what you would like to see improved. Pictures may be taken of you, especially if the areas that will be treated are on your posterior aspect (back, buttock, etc.). This will help your plastic surgeon to understand your expectations and determine whether they can realistically be achieved.
A determination of the elasticity of the skin will also occur. The surgeon may perform specific measurements to determine the laxity of skin as well as the amount of excess fatty tissue. The ideal candidate for liposuction surgery is a patient who has excellent skin tone or tissue elasticity with isolated areas of excess fat.
There will be a discussion concerning your ideal weight and realistic weight. Plans such as future pregnancies, weight-loss programs, etc. may be discussed.
Your liposuction options
There are a multitude of technologies used for liposuction procedures and some are well established and others are relatively new. Liposuction techniques for body contouring and removal of fat were performed by French surgeons in the 1920s. Modern liposuction using blunt, hollow cannulas to suction fat began in the early 1980s and surgeons since then have added new techniques to make the fat removal process less invasive, more predictable and safer.
The introduction of tumescent fluid for anesthesia as well as minimizing blood loss was a tremendous improvement early on in the evolution of liposuction. The use of ultrasonic energy to “loosen up or melt” the fat prior to suctioning it out was yet another important development.
Other modalities of “loosening up” the fat prior to suctioning it out and in some cases not even suctioning the fat out have all been introduced in the past decade. Various lasers and other energy sources have been used with mixed results. Some newer technologies involve using energy sources (external ultrasound or other) to “melt the fat” and allow the fat to be reabsorbed by the body without suctioning (no incisions or scars). These are relatively new procedures and are now being investigated as to how effective they are and how they compare to liposuction using cannulas to remove the fat.
Here are some common forms and terms that your plastic surgeon might use or recommend:
- Tumescent liposuction is a type of anesthetic used during liposuction. A “wetting solution” that usually contains a local anesthetic such as lidocaine and another medication is injected prior to surgery, which causes blood vessels to shrink down or constrict in a balanced salt solution. Most surgeons will use this in combination with their liposuction techniques to reduce post-surgical pain and bleeding.
- Suction-assisted liposuction (SAL) is the traditional form of liposuction and involves the removal of fat with a higher vacuum.
- Power assisted liposuction (PAL) is traditional SAL with the addition of a tool to increase the motion of the cannula, which can speed the removal of your fat. This allows your surgeon to better control the movement and shaping.
- Ultrasound assisted liposuction (UAL) transmits energy through a special hand piece that helps to loosen and melt fat, enabling a greater volume of fat to be removed (best for larger areas, dense fat, or male patients). A variation of this is the VASER which is an ultrasonic cannula with several grooves which more evenly disperse the energy improving fat disruption and removal. When used correctly, it can minimize the risk of injury to the skin or other structures and tends to target fat cells preferentially.
- Laser assisted liposuction (LAL) is a relatively new technology and includes Smartlipo, Slimlipo and other brand names used for marketing. The theory is that the laser will work like ultrasound to disrupt the fat cells and make fat removal more efficient and less traumatic. So far there are few studies which show any increased effectiveness using laser technology for fat removal.
Your plastic surgeon will use their professional judgment to recommend which technique(s) may be best for you.
Your liposuction experience
How should I prepare for my liposuction procedure?
Preparation for liposuction surgery begins after the surgeon examines you and discusses the details of the procedure. If there are weight benchmarks or lifestyle changes that are recommended, you should do your best to follow them to ensure the best results and minimize the chance of complications.
If you are a smoker, you should stop smoking well in advance of surgery since smoking can impair the healing process. Certain medications that increase the risk of bleeding such as Aspirin, non-steroidal anti-inflammatory medications (NSAIDS: Advil, Motrin, Aleve), and some vitamins/homeopathic regimens should be discontinued before undergoing liposuction surgery.
Regardless of the type of surgery to be performed, hydration is a very important aspect of any surgery. Hydration before and after surgery is critical for safe recovery and optimizing outcome. Your surgeon will provide you with additional preoperative instructions.
Day of surgery
The goal of your plastic surgeon and the entire staff is to make your surgical experience as easy and comfortable for you as possible. Your liposuction surgery may be performed in an accredited hospital, free-standing ambulatory facility or office-based surgical suite.
Be sure to arrange for someone to drive you home after surgery and to stay with you for the next 24 hours. If you are undergoing large volume of liposuction, it may be suggested that you be hospitalized overnight.
What will happen during surgery/procedure?
Medications are administered for your comfort during the surgical procedure. Frequently, local anesthesia and intravenous sedation are used for patients undergoing liposuction surgery, although general or regional anesthesia may be desirable in some instances. For your safety during the operation, various monitors are used to check your heart, blood pressure, pulse and the amount of oxygen circulating in your blood.
Your plastic surgeon will already have a surgical plan that involves the techniques discussed with you prior to surgery. Once the operation has begun, decisions to combine various techniques or change a technique all together might be made to ensure the best result. It is important that you feel comfortable and trust your doctor to make these decisions.
The amount of time your liposuction procedure will take depends on the amount of fat being removed and if you there are multiple procedures being performed.
Other treatments: Fat Injection or Fat Transfer
For some patients, some of the removed fat may be transferred to other areas where volume is helpful. Depending on your needs, your fat may be transferred to your face, buttocks, or breast area.
When surgery is completed, you will be taken into a recovery area where you will continue to be closely monitored. You will most likely be wearing a compression garment, usually used to help support and “shrink” the skin. Concerning postoperative pain, many patients state that the area feels sore, as if they underwent a vigorous work out.
You probably will be permitted to go home after a short period of observation, although some patients may stay overnight in the hospital or surgical facility.
When can I resume my normal daily activities?
It is important to realize that the amount of time it takes for recovery varies greatly among individuals.
The first few days after surgery, you should rest quietly. Patients are often encouraged to try and get up and walk around slowly. Remember, you must not take aspirin or certain anti-inflammatory medications. You most likely will wear a compression garment. If it is too tight you should promptly notify your surgeon.
During the first 48 hours following surgery, patients experience varying degrees of swelling and bruising. The swelling persists longer. Bruising typically disappears within seven to ten days. Stitches are usually removed within a week of surgery.
Straining, bending over and lifting should be avoided during the early postoperative period. In many instances, you will be able to resume most of your normal activities within ten days or less.
Understanding the risks of liposuction
Fortunately, significant complications from liposuction surgery are infrequent. Liposuction surgery is one of the two most common procedures performed by plastic surgeons. This surgery is usually performed without experiencing any major problems.
The subject of risks and potential complications of surgery is best discussed on a personal basis between you and your plastic surgeon. The risks in most surgeries are similar. Some of the potential complications that may be discussed with you include hematoma (an accumulation of blood under the skin that may require removal), infection, sensation changes, scarring, allergic reactions, damage to underlying structures, need for revisions, possible need for additional procedures, or other medical risks. Other risks more specific to liposuction may include indentations and irregularities.
You can help minimize certain risks by following the advice and instructions of your board-certified plastic surgeon, both before and after your liposuction surgery.
Results of liposuction
What to expect
Liposuction surgery usually improves contours. In some instances it may be used in a circumferential fashion, thinning an area. Since the healing process is gradual, you should expect to wait at least several months to get an accurate picture of the results of your surgery. The small incisions used for access of the instrument known as a cannula, will fade over a number of months usually becoming barely visible.
How long will the results last?
The results of liposuction surgery are technically permanent because the fat cells have been removed. However, your body shape and contours might be affected by weight gain, aging, pregnancy, family genetics, and lifestyle factors. It is crucial to maintain healthy habits and a stable weight to prolong the results from liposuction.
Follow up with your ASAPS surgeon
You will return to your plastic surgeon’s office for follow-up care at prescribed intervals, at which time your progress will be evaluated.
Please remember that the relationship with your plastic surgeon does not end when you leave the operating room. If you have questions or concerns during your recovery from liposuction surgery, or need additional information at a later time, you should contact your plastic surgeon.
Cost of Liposuction
Cost is always a consideration in elective surgery. Prices for liposuction vary widely, and are dependent on the area to be treated, the volume of fat to be removed, your surgeon’s experience and the geographical location.
The fees are often broken down into several components:
- Surgeon’s professional fee
- Facility fee
- Anesthesia fee
- Surgical garments
- Medical tests
In 2012, the average cost of liposuction (surgeon’s fees only) was $2830.
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