Liposuction

Liposuction, or lipoplasty, is a procedure for contouring the body by removing localized deposits of fat from different areas of the body. Women complain most about fatty deposits under the chin, in the “hips”, the abdomen, the thighs, both inner and outer, and the knees. Men are bothered by fat under the chin, in the “flanks”, and the abdomen.

As stated, liposuction is designed to remove localized deposits of fat to provide a uniformly smooth, contoured area, and is not designed for generalized weight loss or fat removal. There are limits as to how much fat can safely be removed during one procedure, and many of the sensational liposuction disasters so popular on TV and in the printed press usually occur when the surgeon exceeds the safety boundaries regarding fatty volume removed, sterile procedure, and patient hours under anesthesia. When performed correctly, liposuction is one of the safest procedures done today.

Also, a candidate for liposuction should be in essentially good overall health, and not have heart or lung disease. The best candidate is one who is at or near her/his ideal body weight with localized fatty deposits that will not go away with diet and exercise. Many female athletes, as an example, are all too familiar with “saddlebags” on the thighs that persists despite a six-mile-a-day running program.

The actual procedure is usually performed under general anesthesia and may take 2 ½ to 3 hours, depending on the number of areas treated. Small “stab-wound” incisions easily closed with one suture each are made in the areas to be treated. The incisions are usually hidden in the hairline or in the body folds. At this point a very dilute solution of local anesthetic and a vaso-constrictor is injected into the area until the skin is firm to the touch. This is called the “tumescent technique.” The solution dramatically cuts down on post-op pain and blood loss during the surgery. In fact, nearly all of the material removed with the tumescent technique is pure fat. After a few minutes, a metal small-diameter cannula is inserted deep in the skin into the fatty layer. The cannula is attached by a tube to a machine that creates a high vacuum. As the surgeon manipulates the cannula, fat cells are broken up and suctioned away. This is done until the thickness of the treated area is essentially the same as the surrounding area. Great care is used to avoid over-resection leading to a depression. Conservative technique is the rule, as any residual fat can be removed at a future date, but the fat is nearly impossible to put back.

After the surgery the incisions are closed, and the patient is placed into a snug elastic body support garment. This must be worn to control swelling and bleeding, and to help the skin shrink to its new contour. This garment will be worn approximately six weeks, creating a smoother, smaller appearance.

Liposuction is real surgery and real complications can occur. These include infection, contour irregularities, skin damage, and others. Of course, only a thorough consultation with a board-certified plastic surgeon can cover everything you need to know when considering the surgery.

Periodically new versions of liposuction machines are introduced. Some of there may perform better in certain very specific cases, but as in the case with many other things, it is most often the carpenter and not the tools that are responsible for the desired good result.