The Skinny on Liposuction
What is Liposuction
Sometimes despite a healthy diet and regular exercise people have fatty deposits on their body that they can’t get rid of. Liposuction surgery is used to remove these localized fat deposits. Liposuction, lipoplasty, is the removal of unwanted fat via a suction technique. Liposuction was the most popular plastic surgery procedure preformed in the U.S in 2011.
Liposuction, lipoplasty, is a surgical procedure that removes fat, contours the body and gives the patient an overall slimmer appearance. Lipo targets fat that collects in the subcutaneous layer between the muscles and skin.
Liposuction should only be preformed by a plastic surgeon or trained physician that is experienced with the liposuction technique that is right of you. There are many different types of liposuction, during your consultation with your doctor you will want to discuss your goals and medical history to determine the best option.
During the liposuction surgery small incisions are made and a hollow metal tube called a cannula is inserted into the deep fat layer of the adipose tissue, located underneath the skin. The cannula is connected to a powerful vacuum that sucks the fat cells out. In most liposuction techniques an antiseptic fluid is injected into the fat to break up and dissolve the fat cells. The medicated fluid called tumescent fluid or wetting solution helps to lubricate the cannula allowing easier passage through the fat cells, while also reducing blood loss, pain and discomfort before and after the surgery.
The fluid, wetting solution, is mostly made up of saline or a lactated ringer solution. Lactated ringer is a sterile solution used to replace fluids and electrolytes lost by the body. The liposuction fluid generally contains three things in addition to the saline or lactated ringer solution: 1) A numbing agent like lidocaine 2) Epinephrine or adrenaline, to constrict the blood vessels and minimize blood loss 3) Sodium bi-carbonate a chemical compound that decreases the acidity of the wetting solution, this decreases the irritation on the tissues and minimizing pain.
How Does Liposuction Work?
Simply put liposuction works by removing fat cells in the adipose tissue. The fat cells removed by all lipo techniques are the subcutaneous fat cells contained in between the muscles and skin. Liposuction is one of the only ways to actually remove fat cells. As we gain and lose weight our fat cells shrink and swell, rarely does a person ever loose or gain more fat cells in adulthood. Fat cells die and new ones grow, but the overall number of fat cells remains consistent throughout adulthood.
Liposuction is best preformed on an area where fat is localized , like the love handles, inner thighs or lower abdomen.
Where on the body can Lipo be preformed?
Liposuction can be preformed almost anywhere on the body. Lipo is best on areas where the fat is concentrated in pockets. The most common areas where pockets of fat accumulate are the abdomen, inner thighs and outer thighs. Other common areas are chin, upper arms and love handles. There also has to be elasticity in the skin of the treatment are, so that the skin will form to the new shape. As we age the elasticity in our skin diminishes. Fat distribution varies from person to person, so it is best to discuss your individual goals with your surgeon and get their recommendations.
Am I a Candidate for Liposuction?
People who have fat deposits or “problem areas” that can not be eliminated through physical exercise and a healthy diet make good candidates for liposuction. Lipo is not a treatment for obesity nor an alternative to diet and exercise. People who have maintained a healthy weight for 6 months before liposuction have the best chance of longterm results.
Liposuction surgery is a surgical procedure and you must be in good enough physical condition to be put under anesthesia. Make sure you disclosure your complete medical history to the physician preforming the surgery in addition to allergies to medication.
Cost of Liposuction
The cost of liposuction is an important consideration, however should come second to getting the best care. The total cost of liposuction includes: surgeons fee, facility fee, anesthesiologist fee, medication and garments. The cost varies by procedure type, where on the body it is preformed and how much fat is removed. You will get a written estimate from your surgeons office once you finalize the details of your specific surgery.
The national average physician fee for liposuction in 2011 was $2,773 (according to The American Society for Aesthetic Plastic Surgery).
Consultation with Plastic Surgeon
During your consultation for liposuction with a plastic surgeon you can expect to discuss your goals, lifestyle and expectations. The surgeon will ask you about the area you want to target and recommend the best liposuction procedure. You will also want to discuss your lifestyle, specifically your diet and exercise habits.
There are various types of liposuction. The basic steps are the same for most liposuction procedures. Lipolysis procedures start with small incisions in the skin, a thin tube called a cannula is inserted into the incisions and sucks the fat out. The two major differences in lipo techniques are the method used to break up the fat cells and the amount of solution used to dilute the fat.
The most common form of lipo is called tumescent liposuction. Tumescent lipo uses the most wetting solution to dilute the fat. The wetting solution is infused into the the fatty layer of your skin before the cannula is inserted to vacuum the fat out.
Types of Lipo
Laser Liposuction (Laser Assisted Liposuction): A laser melts fat cells to make them easier to suction out through the cannula. Several different names are used when speaking about laser liposuction, including SmartLipo, CoolLipo, iLipo and ProLipo.
PAL (Power Assisted Liposuction): Fat cells are manipulated by using a thin cannula to suction fat while the power is supplied by an electric motor or air which is compressed. This produces a rapid in-and-out movement or a spinning rotation of the cannula.
SAL (Suction Assisted Liposuction): Traditional liposuction which suctions fat cells through a cannula as a doctor manually inserts the tube through the incision.
TCL (Twin Cannula Assisted Liposuction or TCAL): This method uses a tube within a tube, as a cannula. As the inner tube vibrates, it covers more area (up to 2 inches, rather than just 1/4 of an inch) than other power-assisted devices to remove fat cells. The surgeon's labor is minimized, and the patient's "friction burns" are lessened since the outer tube protects the person from the heat created by the inner tube's vibration.
Tumescent Liposuction: A fluid is injected to help loosen fat cells prior to suctioning. This solution also helps to control bleeding and pain. A “wet” technique, it can be used in combination with other techniques like UAL.
UAL (Ultrasound Assisted Liposuction): Ultrasound ruptures fat cells to make them easier to suction out through the cannula. The thermal energy may also help to tighten your skin.
Finding a Plastic Surgeon
One of the most important decisions, if not the most important, during your liposuction journey will be selecting a doctor. Most complications can be avoided by going to a board certified, experienced plastic surgeon.
Do your homework before going under. Look for patient reviews, certification and always look at before and after photos specific to your procedure. If you are going to a group practice, make sure you look at photos from actual patients of the surgeon preforming your surgery. There is a certain amount of artistry required for liposuction and body contouring procedures, some doctors have the skill others don’t.
Day of the Surgery
The day of the surgery it is vital to have someone to drive you to and from the doctor’s office. The surgeon will mark your body prior to surgery to act as a guide during the procedure. A nurse will monitor you as your wake up.
Recovery after Liposuction
The recovery after liposuction depends on the amount of fat extracted on where on the body the liposuction was preformed. You can expect swelling, bruising and some pain after your lipolysis. It is important to take it easy for the first 7-10 days to allow yourself time to heal. You will also be required to wear compression garments after all liposuction procedures to help drain or absorb the fluid.
It is always best to discuss your individual recovery plan with your plastic surgeon before your surgery and make sure that you have a loved one available to help you out after your surgery. View our recovery from liposuction page for a detailed description of what to expect during recovery from lipo.
You will see the results of your liposuction surgery after the swelling goes down, with full results seen in the first 4 months. The results of lipo are permanent in that the fat cells don’t grow back in the treated area. However, as you gain weight your physic will change. People who gain weight after liposuction will often see the fat re-distribute. Patients that have the best results after liposuction maintain a healthy weight before and after surgery. View lipo before and after photos to get a first hand look at the results you can expect.
Risks of Liposuction
Liposuction is a routine surgery with few risks if preformed by a board certified plastic surgeon. Most liposuction complications occur when a non certified doctor preforms the procedure without proper training. The most common complications infections however the following have also been reported infrequently: burns, embolisms, cardiac arrhythmia, edema, seroma, nerve compression and anesthesia-related problems. Get more details about liposuction complications from our risks page.
The Next Step
If you think liposuction
is for you, find a board certified plastic surgeon
for a consultation. If you’d like to learn more about the procedure, be sure to read more of LipoSite’s Liposuction Guide
LipoSite's Guide To Liposuction