ARLINGTON HEIGHTS, IL, Oct. 1997 — Liposuction is the most popular aesthetic (cosmetic) surgical procedure in the United States, with more than 100,000 liposuction surgeries performed annually by board-certified plastic surgeons. Like other aesthetic surgical operations, the overall risk of serious complications from liposuction is small. Tumescent liposuction is a specific technique for performing liposuction that is preferred by a majority of plastic surgeons.

What is Liposuction?

Many individuals have localized fatty deposits in specific areas of the body -- such as the face and neck, upper arms, breast or chest, trunk and lower extremities -- that are resistant to diet or exercise. Liposuction is a surgical procedure designed to reduce these areas of excess fat. It can be performed on several areas of the body at the same time, and it can also be done in conjunction with other aesthetic plastic surgical procedures.

The best candidates for liposuction are individuals of relatively normal weight, with good skin tone and realistic expectations. Liposuction is not an effective treatment for weight loss; however, large-volume liposuction can be safely performed by a qualified and competent surgeon on properly selected patients who exceed their ideal body weight.

In liposuction, fat is removed by inserting a small, hollow tube, called a cannula, through one or more tiny incisions near the area where fatty deposits are located. The cannula is connected by tubing to a vacuum pressure unit. Guided by the surgeon, the suction device removes the unwanted fat to create an improved body contour. Skin tightening occurs due to the elastic nature of the skin. Individuals with deficient skin tone may require additional surgical procedures to tighten loose skin following liposuction.

What is Tumescent Liposuction?

Prior to performing any liposuction technique, fluid is instilled into the areas of localized fatty deposits. Plastic surgeons may use varying amounts of fluid, depending on their individual preference. Over 65% of plastic surgeons responding to a recent survey by the American Society for Aesthetic Plastic Surgery (ASAPS) say that they prefer the tumescent technique over other approaches to liposuction using lesser amounts of pre-injected fluid.

The sterile fluid used for tumescent liposuction contains a salt solution, low concentrations of lidocaine (a local anesthetic) and adrenaline (a naturally occurring hormone). The adrenaline has the temporary effect of shrinking the blood vessels which subsequently decreases the patient's blood loss. Injection of this fluid is done a few minutes prior to performing liposuction. Enough fluid is injected into the fatty areas to make the tissues firm and distended.

Tumescent liposuction may sometimes be performed without additional anesthesia, since the fluid that is instilled contains a dilute local anesthetic. Some patients, however, may prefer additional sedation or general anesthesia, particularly if multiple areas of the body are being suctioned or additional surgical procedures are performed at the same time.

How Much Fat Can Safely Be Removed With Tumescent Liposuction?

Many surgeons feel that the tumescent technique has advantages over other liposuction methods. Advantages may include the capability to remove larger amounts of fatty tissue with less blood loss, diminished postoperative bruising and greater patient comfort. The maximum amount of fat that can be safely removed varies with the weight, body type and medical condition of the patient, the skill and judgment of the surgeon, and the other surgical procedures, if any, being performed at the same time. Removal of large volumes of fat by any liposuction technique may increase the risk of complications.

Points to Remember When Considering Liposuction

• Liposuction is a surgical procedure for body contouring and removal of localized fat deposits. It is not an effective or safe method for weight loss.
• There is no such thing as "lunch hour" liposuction. Liposuction is surgery and has the same types of risks as other surgical procedures.
• Overweight patients are more likely to have complications from any type of surgery.
• Longer operations involving multiple procedures can be done safely by a qualified and competent surgeon but may involve greater risk of complications.

What to Look for When Selecting a Surgeon

• Choose a surgeon who is certified by the American Board of Plastic Surgery (ABPS). Any physician legally can perform liposuction and other cosmetic surgical operations, even without surgical training. Be sure your liposuction is performed by a trained and board-certified plastic surgeon. ABPS-certified surgeons have received at least five years of surgical and plastic surgical training after medical school and have been tested by their peers prior to receiving certification.
• Check the reputation of your surgeon. Talk to your family physician or other doctors to find out about the reputation of your surgeon in the local medical community.
• Research the hospital credentials of your surgeon. Liposuction can be safely performed in a hospital, outpatient surgical facility or properly equipped office surgical facility. However, even if your surgeon plans to perform the surgery outside of the hospital, it is important to find out whether he or she has privileges to perform liposuction in an accredited hospital. Privileges to perform liposuction and other types of aesthetic surgery are granted to plastic surgeons by hospital credential committees based on documented training and ABPS certification.