Liposuction: Procedure & Alternatives

Liposuction (also known as lipoplasty and suction lipectomy) is a medical procedure that breaks up and “vacuums” unwanted fat from the body. The procedure is a type of plastic surgery that aids in fat removal and ultimately leads to improved body contouring.

Liposuction often targets areas of stubborn fat that have been unresponsive to an individual's efforts to diet and exercise. Liposuction can successfully reshape many areas of the body, such as the:

• abdomen
• buttocks
• cheeks
• chin
• hips
• knees
• neck
• thighs
• upper arms.

Different Liposuction Techniques

Over the past decade, surgeons have refined the liposuction procedure, improving results. Here is a list of the various types of liposuction procedures you an surgeon can choose from:

• dry technique: This procedure doesn’t require fluid injections into the fatty tissue before it’s suctioned out. However, because about 30 percent of the substance removed in the dry technique is blood, surgeons typically don’t use this method any more when performing liposuctions.
• super-wet technique: This type of liposuction requires that surgeons inject the patient’s fat with about half of the anesthetic fluid as used in the tumescent procedure. The super-wet technique uses less anesthesia than the tumescent method. Although more blood is removed in this newer technique than is with the tumescent method (about 8 percent of the substance removed in super-wet liposuctions is blood), this liposuction method is generally safer than the tumescent technique.
• tumescent technique: As another newer method of liposuction, the tumescent procedure calls for surgeons to inject large amounts of fluid into the patient’s fatty areas. Typically, the amount of fluid injected is equal to the amount of fat being removed. The tumescent method minimizes blood loss during the surgery, as well as post-operative swelling, pain and bruising. Only about 1 percent of blood is lost during this liposuction technique.
• UAL (ultrasound assisted liposuction): This newer liposuction technique starts with the surgeon injecting the patient’s fat with a local anesthesia that includes both lidocaine and epinephrine. Then, using a specialized cannula, ultrasonic energy directly penetrates fatty tissues. The energy explodes fat cells, and then sucks out the remaining liquid. Procedure is lengthier than traditional liposuction procedure.

   

  Because of its associated complications, including severe skin burns, UAL liposuctions have yet to be approved by the Food and Drug Administration (FDA).
• wet technique: This older liposuction method calls for surgeons to inject patients with about 100 milliliters of anesthetic fluid. Although the wet technique is safer than the dry method of liposuction, it still causes significant blood loss. Between 15 to 20 percent of the removed substances is blood.

Liposuction Candidates

Liposuction is not for everyone. The best candidates for this cosmetic procedure are healthy patients of a normal weight that have firm, elastic skin. Patients should also be emotionally stable with realistic expectations of the outcome of liposuction.

Those who have pockets of excess fat that they cannot lose through normal diet and exercise are also good candidates for liposuction. Older patients with less elastic skin may have less satisfactory results. As a result, they may actually need additional skin tightening procedures performed after their liposuction has been done.

Liposuction Complications

The following medical conditions are considered to put people at a higher risk of developing complications:

• diabetes
• heart disease
• lung disease
• recent surgery near area selected for contouring
• reduced blood circulation.

People who have any of these conditions should talk to their liposuction doctor about the severity of possible complications.

What to Expect

During an initial consultation, the surgeon will evaluate the patient's health, taking note of his or her skin condition and where fat deposits are stored. Based on this evaluation, the surgeon will lay out the safest body contouring method for your situation, as well as the associated cost of and recovery from the procedure.

This is a great time to explain exactly what you expect from the procedure and to confirm that those expectations are realistic. Ask a lot of questions, and take notes so that you won’t forget anything the doctor tells you.

Liposuction Procedure

During a liposuction, the surgeon makes one or multiple tiny incisions in the fatty area of the body. A cannula (narrow tube) is then inserted in the incision, and the fat is broken up and vacuumed from deep below the skin. Using a vacuum or large syringe to suction out the fat, doctors will individually suction fat from the selected areas of the body, doing one area at a time.

The patient can receive one of three types of anesthesia:

• general anesthesia, which makes the patient completely unconscious
• local anesthesia, which numbs sensation at the surgical site
• regional anesthesia, which numbs an entire region of the body much like an epidural does for women in labor.

As the procedure progress, the patient will also receive intravenous fluids to replace the fluids that are lost with the fat. Without this fluid replacement, patients can go into shock.

Liposuction Alternatives

Non-surgical alternatives to liposuction include:

• Lipo-dissolve: Medications and enzymes are injected into fatty areas with this procedure. The chemicals work on dissolving the fat, which is then flushed out of the body via urine. This may be a good method for toning the face and reducing cellulite.
• Mesotherapy: This procedure works via an injection of amino acids, medications and holistic compounds that break down fat.
• Smart Lipo: This liposuction alternative is considered an effective treatment for the more difficult areas. During Smart Lipo surgery, fat is removed with a laser that also tightens the surrounding skin.
• Thermage: Thermage works through a heated laser that melts the patient’s fat.

Liposuction Recovery

After liposuction, patients should expect some fluid drainage from the surgery site and, therefore, may need a temporary drainage tube. Additionally, surgeons may recommend that patients wear an elastic garment to aid in healing and to control swelling. Some patients experience temporary pain or discomfort, such as numbness, bleeding, burning sensations or swelling. Doctors also typically prescribe recovering liposuction patients antibiotics to reduce the risk of developing an infection.

Liposuction Pros and Cons

Liposuction can take a problem area and turn it into a newly contoured, attractive part of the body. Many people are thrilled with the results, and it is considered a safe procedure.

As with any surgical procedure, however, risks and complications can occur. Although liposuction is considered safe, discuss specific risks with your surgeon before getting this procedure. Generally speaking, risks increase with larger operative sites and multiple surgical areas.

The following list provides some of the risk factors associated with liposuction:

• adverse reaction to anesthesia
• blood clots
• damage to skin or nerves
• delays in healing
• excessive fluid loss (can lead to shock)
• fat clots
• fluid accumulations (which will need to be drained)
• friction burns
• imperfections in final appearance
• infection
• need for additional surgery (such as skin tightening operations)
• perforation injury to vital organs
• pigmentation changes
• unfavorable drug reactions.

Cost of Liposuction

Liposuction costs vary based on:

• the amount of time and effort the procedure requires
• the area of the body needing work
• the degree of difficulty the technique entails
• the health of the patient
• the size of the patient
• the surgeon's individual rates.

Typically, liposuctions cost between $1,500 and $7,500.

Resources

American Society of Plastic Surgeons (2007). Lipoplasty. Retrieved August 18, 2007, from the American Society of Plastic Surgeons Web site: http://www.plasticsurgery.org/patients_consumers/procedures/.Lipoplasty.cfm

Derma Network (2007). Skin Rejuvenation and Facial Rejuvenation. Retrieved August 18, 2007, from the Derma Network Web site: www.dermanetwork.org.

Liposuction (2007). Liposuction. Retrieved August 18, 2007, from the Liposuction Web site: http://www.liposuction.com/.

Your Plastic Surgery Guide (2007). Liposuction. Retrieved August 18, 2007, from the Your Plastic Surgery Guide Web site: http://www.yourplasticsurgeryguide.com/liposuction/.