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Liposuction Surgery

Learn about the factors that affect the cost of surgery

Liposuction or lipoplasty is a cosmetic procedure that uses gentle suction to remove fat deposits from different areas on the body. Some of the most common areas treated include the thighs, hips, buttocks, or abdomen. Patients who undergo liposuction find that they are able to achieve a more proportionate body contour by directly treating their problem areas, which cannot be accomplished with diet or exercise alone.

Are You a Good Candidate?

You may be a good candidate if you are near your goal weight (less than 30 pounds overweight) but have specific areas you wish to target for fat removal. Liposuction can be performed on patients who are overweight but whose weight has been stable over the past several years. Most patients are between the ages of 30 and 60, although this procedure has also been successfully performed on both younger and older patients. Ideally some skin elasticity remains, which helps the body to adapt to its changing contours quickly.

You should not undergo this procedure if you are planning to become pregnant or lose a significant amount of weight in the near future. Like most surgical procedures, you should not undergo liposuction if you have serious medical conditions or concerns.

If you are considering liposuction, its important to have realistic expectations. This procedure cannot make you look like a supermodel, and will not remove every ounce of fat from your body. Patients should not think of liposuction as a fast-track to weight loss, but as a way to create more aesthetically pleasing silhouette through removing five pounds or less of targeted fat.

Different Techniques & Wetting Solutions

There are many variations of liposuction, most of them designed to allow for easier or more precise fat removal. The following provides a brief overview of the different techniques used to remove fat deposits during liposuction surgery.

Before the fat is removed, wetting solutions containing saline and epinephrine are infused into the target areas to minimize blood loss and increase the safety of the procedure. The following are the various types of solutions used:

  • The “wet” Technique: Infusion of 100 to 300 ml of fluid into each treatment site. With this approach, 20 to 25 % of whats is suction out is blood.
  • The “Super-Wet” Technique: Infusion of fluid greater than the “wet” technique which results in less than 1% of what is suctioned out is blood.
  • Tumescent Technique: Infusion of 3 to 6 times (greater than “super-wet”) as much fluid as volume of fat, fluid and blood to be removed. As a result, it swells the tissues making it easier to remove fat.

After the solutions are infused, the fat is vacuumed out using one of the following methods:

  • Traditional suction-assisted liposuction. A small tube (known as a cannula) is inserted under the skin into the fat layer. The surgeon moves the cannula back and forth to break up the fat layers, then suctions out the excess fat tissue.
  • Ultrasound-assisted Liposuction (UAL). Involves inserting a special cannula that emits sound waves to break down the fatty tissue that is being targeted for removal. Ultrasonic sound waves are beyond the range of normal human hearing. Breaking down the fat in this manner facilitates the surgeon’s ability to extract the fat from the body through a cannula. The precision use of this ultrasonic energy enables the surgeon to exercise greater precision, sculpting the body with the goal of giving your new curves a more natural look. Ultrasound assisted technologies also help to minimize the risk of accidental damage to the surrounding tissues.
  • Power-assisted liposuction (PAL). This method uses a high-speed vibrating cannula to break up the fatty tissue which is then vacuumed out of the body.
  • Laser-assisted liposuction (LAL). Also known as laser assisted lipolysis, this technique uses laser energy to liquify the fat for easier removal. There are a number of different types including SmartLipo, ProLipo, CoolLip, LipoLite, LipoTherme, and ThinLipo. The difference between these procedures are the wavelength and the intensity of the laser beam used. Fat cells respond differently to various wavelengths of light in terms of their ability to absorb the energy.
  • Water-assisted liposuction: It is one of the most popular forms of liposuction that promises to wash away fat with less bruising and trauma. During the procedure, the surgeon injects a large volume of water-based solution into the target area which loosens the fat cells for easier removal. If desired, these fat cells can then be saved and used to plump up other areas of the body. This differs than other techniques which destroy or break apart the fat cells before being suctioned out.

The Procedure

As mentioned above, there are various approaches to liposuction and your plastic surgeon will recommend an approach depending on your preferences, body shape and prior and future treatments. The following provides a basic overview of how the procedure is performed.

  1. Your surgeon will use a magic marker to circle the areas of your body where the fat will be removed.
  2. You will then be given anesthesia.
  3. After you are anesthetized, the surgeon injects the marked areas with a large amount of sterile wetting solution. The solution acts as a local anesthetic and constricts the blood vessels, which reduces discomfort and lessens the bruising that follows liposuction. There are various types of wetting solutions used in liposuction surgery such as the dry, wet, super-wet and tumescent technique.
  4. Next the fat is removed using a narrow tube called a cannula. There are several different ways to vacuum out the fat. They include traditional suction-assisted liposuction, ultrasound-assisted liposuction, power-assisted liposuction, laser-assisted liposuction and water-assisted liposuction.
  5. Once the fat is removed, the incision is stitched up and a compression bandage is applied to the treated area.

Potential Risks & Complications

Liposuction is relatively safe however there are risks that you should be fully aware of before proceeding with surgery. Some possible risks include:

  • Adverse reactions to anesthesia or medications
  • Scarring:  This can occur from the incisions that are made from which the fat tissue is removed. These incisions are typically only 4 to 10 millimeters in length and oftentimes hidden within the natural creases within the skin. In most cases, the scars should fade away within a year’s time, leaving only a thin white line as a remnant. However its something that should be considered before undergoing surgery.
  • Bumpy or uneven results: These complications may detract from the desired appearance you were expecting to achieve as an outcome of the procedure. These imperfect results could be caused by a number of factors such as an inexperienced plastic surgeon, the uneven removal of fat, abnormal healing of the skin, or inadequate elasticity of the skin. These complications could be either temporary or permanent.
  • Infection from bacteria entering the incision.
  • Loose skin. Older patients or people who have a relatively large amount of fat to remove are the ones who are most susceptible to this complication. This depends upon the elasticity of your particular skin. If this occurs, you may need to undergo a secondary surgery to remove the excess skin, known as a “body lift” operation.
  • Nerve damage:  Resulting from the insertion of the cannula, which is the metal tube used to suction the fat cells out of your body. This can cause numbness in the impacted area of the body, which could either be temporary, or in rare cases, permanent. On rare occasions, a cannula may be inserted too deep into the skin, to the point where it punctures a bodily organ, requiring emergency surgery to seal the puncture.
  • Fat embolism:  Resulting from the way the fat is suctioned out of the body. Minute particles of fat may end up being redirected into a blood vessel rather than exiting the body through the cannula. If this occurs, deposits of this fat could move through the blood into the lungs or the brain, a situation that constitutes a potentially life-threatening medical emergency.

Depending on the type of liposuction procedure, there may be other risks involved. To reduce the possibility of complications, it’s recommended that you choose your plastic surgeon carefully.

Choosing Your Surgeon

When choosing a liposuction surgeon, ensure that they are certified by the American Board of Plastic Surgery (ABPS) or other established association such as the American Society of Plastic Surgeons (ASPS) or the American Society for Aesthetic Plastic Surgery (ASAPS). While being a member in any society or board-certification doesn’t guarantee a successful outcome most certifying boards like these require extensive medical training, experience, and rigorous surgical education which can ensure that the most appropriate techniques are used for your surgery, while reducing the risks of liposuction surgery.