Liposuction

Liposuction remains one of our most commonly performed cosmetic procedures. It is particularly popular with people who have “problem areas,” despite regular exercise and dieting. For these people, the areas that do not respond to sit-ups, weight lifting and running can be directly and permanently treated with liposuction, leading to huge improvements in their body contour. Liposuction is appropriate for disproportioned amounts of fat in the hips, saddle bags, medial thighs, abdomen, arms, back, knees and under the chin. Usually all of these areas are treated in a single session. Advances in liposuction have been made since its introduction in the 1980s. This has lead to many catchy names such as liposculpturing, body contouring, etc. The focus in the advancements has been towards a more efficient removal of fat and tightening of the overlying skin. We use ultrasound liposuction to accomplish these goals. The ultrasonic energy fractures the fat cells creating a liquid that is removed by traditional liposuction. The heat generated from this process causes the overlying skin to contract in many patients leading to a more desirable outcome.

The type of anesthesia used is determined by the amount of fat to be removed and the number of areas to be treated. Small amounts of fat from a few areas can be easily and comfortably treated with tumescent anesthesia. This is a special local anesthetic that injects diluted concentration of local anesthetic and epinephrine in the areas to be treated. The local anesthetic allows the painless removal of the fat, and the epinephrine shrinks the blood vessels, minimizing the amount of blood lost. In cases involving large amounts of fat removal from multiple sites, general anesthesia is typically used.

On the day of surgery, the patient and surgeon agree on the areas to be treated. These are marked out on the skin. They also agree on the incisions used to remove the fat. These are typically ¼” to ½” incisions made in natural skin creases or areas hidden by a bathing suit. The fat is removed with a cannula connected to suction with a back and forth motion under the skin. There are multiple sized and shaped cannulas to access the various areas through inconspicuous incisions. Most of the liposuction cases are outpatient procedures. In some cases where an intermediate amount of fat is removed, the patients are discharged with an IV running, and a visiting home nurse checks on them in the evening. In cases involving large amounts of liposuction the patients are admitted to the hospital for overnight observation for their safety.

After surgery, a tight fitting compression garment must be worn for at least three weeks to maximize your chance that the skin will shrink uniformly and conform smoothly to your new shape. It is important that you get up and walk even the day of surgery to minimize the chances of blood clots forming in the legs. Heavy exercise is discouraged for two to four weeks because this can lead to prolonged swelling. Although liposuction is not particularly painful, you will definitely be sore in the areas treated. Bruising will occur in the areas treated. Obviously, people treated in multiple body areas will have greater discomfort. Once you are off the narcotic pain medication, you can return to work. This is typically two to five days. You can resume all of your usual activities at one month.

The contour results with liposuction are apparent within a couple of weeks. Because of swelling, the clothes worn preoperatively will still be snug for six to eight weeks. By three months the final contour can be appreciated. This new and improved “look” will be long lasting if you maintain your weight and a healthy lifestyle.