Liposuction

The most common problem areas include the thighs, hips, abdomen, buttocks, knees, ankles, calves and arms, but are also found in the facial areas such as the chin, cheeks, jowls and neck.

During the past decade, liposuction has benifited from several new refinements, including new techniques such as ultrasound-assisted lipoplasty (UAL), tumescent technique and the super-wet technique. These new techniques are providing more precise results and quicker recovery time.

Liposuction can also be performed in combination with a tummy tuck, facelift or chin augmentation to achieve the desired result.


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The patient should be healthy and psychologically stable. Older patient may have a less elastic skin and may not achieve the same results as a younger patient.

Liposuction can be a more risky procedure for people with diabetes, heart or lung diseases, poor blood circulation or people who recently had surgery near the area to be contoured. A good candidate must have realistic expectations about what the procedure can do.


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The surgeon will give instructions on how to prepare for the surgery. These instructions include guidelines on smoking, eating and drinking, taking or avoiding certain vitamins, iron tablets and medications. Although rarely necessary, the doctor may recommend that the patient draws blood in case it is needed during surgery.

Liposuction can be performed in a surgeon's office-based facility, an outpatient surgery center or in a hospital. If a large amount of fat will be removed a stay in a hospital or overnight nursing facility may be necessary.

The type of anesthesia that will be used depends on the amount of fat that will be removed. Local anesthesia only numbs the affected areas and can be used in combination with intravenous sedation to keep the patient more relaxed. Regional anesthesia, such as the epidural block, can be used in more extensive procedures. Some patients prefer general anesthesia, particularly when a large amount of fat is being removed.

The duration of the surgery may vary depending on the size of the area, the amount of fat being removes and the type of anesthesia.

There are several liposuction techniques that can be used. Through a small incision a tube is inserted. This vacuums the fat layer, breaking up the fat cells and suctions them out. The suction action is provided by a vacuum pump or a large syringe. If many areas are being treated the surgeon will move on to the next, keeping the incisions as inconspicuous as possible.

Fluid is lost during the procedure and it's crucial that this fluid is replaces to prevent shock. For this reason patients need to be carefully monitored and receive intravenous fluids during and immediately after surgery.

Fluid injection, a technique in which a medicated solution is injected into fatty areas before the fat is removed, is commonly used by plastic surgeons today. The fluid (containing intravenous salt solutions, lidocaine and epinephrine) helps the fat be removed more easily, reduces blood loss and provides anesthesia during and after surgery. Furthermore it reduces the bruising after surgery.

Tumescent liposuction is another technique, in which large volumes of fluid, sometimes three times the amount of fat that will be removed, are injected. This technique if mostly used on patients who only need local anesthetic and will take significantly longer that traditional liposuction (sometimes 4 or 5 hours). The fluid contains an adequate amount of anesthetic and therefore additional anesthesia may not be necessary.

The super-wet technique is similar to the tumescent technique, except that lesser amounts of fluid are used. Usually the amount of fluid equals the amount of fat to be removed. The super-wet technique requires IV sedation or general anesthesia and typically takes one to two hours of surgery.

Another technique is Ultrasound-Assisted Lipoplasty (UAL). This technique required the use of a special cannula that produces ultrasonic energy. As it passes through the areas of fat, the energy explodes the walls of the fat cells, liquefying the fat. The fat is then removed with the traditional liposuction technique. UAL improves the ease and effectiveness of liposuction in fibrous areas, such as the upper back or the enlarged male breast. Also it's often used in procedures that require enhanced precision. UAL takes longer to perform than traditional liposuction.

After surgery, the patient will experience some fluid drainage from the incisions. Sometimes a small drainage tube may be inserted beneath the skin for a couple of days to prevent fluid build-up. The patient may have to wear a snug elastic garment to control the swelling and to help the skin better fit its new contours. The doctor may also prescribe antibiotics to prevent the patient from infection.

The newer techniques may reduce some discomforts after the surgery, but the patient shouldn't expect to look or feel great right after surgery. The patient may experience pain, burning, swelling, bleeding or temporary numbness. The pain can be controlled with prescribed medications, but the patient may still feel stiff and sore for a few days. It is normal to feel anxious or depressed in the days or weeks after surgery. This feeling will go away as the patient begins to look and feel better.

The surgeon will probably want the patient to start walking around as soon as possible, as this reduces swelling and prevents the forming of blood cloths in the legs. The patient will feel better after about a week or two and should be back to work within a few days. The stitches will be removed or dissolve on their own within seven to ten days.

As the body is still healing, strenous activity should be avoided for about a morth. Most of the bruising and swelling usually disappears within three weeks, some swelling may remain for six months or longer. The surgeon will schedule follow-up visits to monitor the healing progress.


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Though they are rare, complications can and do occur. Risks increase if a greater number of areas will be treated at the same time or if the sites are larger in size. Removal of a large amount of fat and fluid may require longer operating times. The combination of these factors can create greater hazards for infection; healing delay; formation of fat clots or blood clots, which may migrate to the lungs and cause death; excessive fluid loss, which can lead to shock or fluid accumulation that must be drained; friction burns or other damage to the skin or nerves or perforation injury to the vital organs; and unfavorable drug reactions.

In UAL, the heat from the ultrasoung device used to liquefy the fat cells may cause injury to the skin or deeper tissues. Also, be aware that the long-term effects of ultrasound energy on the body are not yet known.

In the tumescent and super-wet techniques, the anesthetic fluid that is injected may cause lidocaine toxicity, if the solution's lidocaine content is too high, or may cause collection of fluid in the lungs, if too much fluid is administered.

The scars are small and placed to be hidden from the view. However, imperfections in the final appearance are not uncommon. The skin may be irregular or asymmetric, especially in older patients. Numbness and pigmentation changes may occur.

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