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Liposuction

Fat removal - suctioning; Body contouring

Liposuction is the removal of excess body fat by suction using special surgical equipment. A plastic surgeon typically does the surgery.

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Fat layer in skin

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Liposuction - series - Indications

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Description

Liposuction is a type of cosmetic surgery. It removes unwanted excess fat to improve body appearance and to smooth irregular body shapes. The procedure is sometimes called body contouring.

Liposuction may be useful for contouring under the chin, neck, cheeks, upper arms, breasts, abdomen, buttocks, hips, thighs, knees, calves, and ankle areas.

Liposuction is a surgical procedure with risks, and it may involve a painful recovery. Liposuction can have serious or rare fatal complications. So, you should carefully think about your decision to have this surgery.

TYPES OF LIPOSUCTION PROCEDURES

Tumescent liposuction (fluid injection) is the most common type of liposuction. It involves injecting a large amount of medicated solution into the areas before the fat is removed. Sometimes, the solution may be up to three times the amount of fat to be removed). The fluid is a mixture of local anesthetic (lidocaine), a drug that contracts the blood vessels (epinephrine), and an intravenous (IV) salt solution. Lidocaine helps numb the area during and after surgery. It may be the only anesthesia needed for the procedure. Epinephrine in the solution helps reduce loss of blood, bruising, and swelling. The IV solution helps remove the fat more easily. It is suctioned out along with the fat. This type of liposuction generally takes longer than other types.

Super-wet technique is similar to tumescent liposuction. The difference is that not as much fluid is used during the surgery. The amount of fluid injected is equal to the amount of fat to be removed. This technique takes less time. But it often requires sedation (medicine that makes you drowsy) or general anesthesia (medicine that allows you to be asleep and pain-free).

Ultrasound-assisted liposuction (UAL) uses ultrasonic vibrations to turn fat cells into liquid. Afterward, the cells can be vacuumed out. UAL can be done in two ways, external (above the surface of the skin with a special emitter) or internal (below the surface of the skin with a small, heated cannula). This technique may help remove fat from dense, fiber-filled (fibrous) areas of the body such as the upper back or enlarged male breast tissue. UAL is often used together with the tumescent technique, in follow-up (secondary) procedures, or for greater precision. In general, this procedure takes longer than the super-wet technique.

Laser-assisted liposuction (LAL) uses laser energy to liquefy fat cells. After the cells are liquefied, they can be vacuumed out or allowed to drain out through small tubes. Because the tube (cannula) used during LAL is smaller than the ones used in traditional liposuction, surgeons prefer using LAL for confined areas. These areas include the chin, jowls, and face. A possible advantage of LAL over other liposuction methods is that energy from the laser stimulates collagen production. This may help prevent skin sag after liposuction. Collagen is the fiber-like protein that helps maintain skin structure.

HOW THE PROCEDURE IS DONE

Why the Procedure is Performed

The following are some of the uses for liposuction:

Liposuction is not used:

Many alternatives to liposuction exist, including a tummy tuck (abdominoplasty), removal of fatty tumors (lipomas), breast reduction (reduction mammaplasty), or a combination of plastic surgery approaches. Your doctor can discuss these with you.

Risks

Certain medical conditions should be checked and be under control before liposuction, including:

Risks associated with liposuction include:

Before the Procedure

Before your surgery, you will have a patient consultation. This will include a history, physical exam, and a psychological evaluation. You may need to bring someone (such as your spouse) with you during the visit to help you remember what your doctor discusses with you.

Feel free to ask questions. Be sure you understand the answers to your questions. You must understand fully the pre-operative preparations, the liposuction procedure, and the post-operative care. Understand that liposuction may enhance your appearance and self-confidence, but it will probably not give you your ideal body.

Before the day of surgery, you may have blood drawn and be asked to provide a urine sample. This allows the health care provider to rule out potential complications. If you are not hospitalized, you will need a ride home after the surgery.

After the Procedure

Liposuction may or may not require a hospital stay, depending on the location and extent of surgery. Liposuction can be done in an office-based facility, in a surgery center on an outpatient basis, or in a hospital.

After the surgery, bandages and a compression garment are applied to keep pressure on the area and stop any bleeding, as well as to help maintain shape. Bandages are kept in place for at least 2 weeks. You will likely need the compression garment for several weeks. Follow your surgeon's instructions on how long it needs to be worn.

You will likely have swelling, bruising, numbness, and pain, but it can be managed with medicines. The stitches will be removed in 5 to 10 days. Antibiotics may be prescribed to prevent infection.

You may feel sensations such as numbness or tingling, as well as pain, for weeks after the surgery. Walk as soon as possible after surgery to help prevent blood clots from forming in your legs. Avoid more strenuous exercise for about a month after the surgery.

You will start to feel better after about 1 or 2 weeks. You may return to work within a few days of the surgery. Bruising and swelling usually go away within 3 weeks, but you may still have some swelling several months later.

Your surgeon may call you from time to time to monitor your healing. A follow-up visit with the surgeon will be needed.

Outlook (Prognosis)

Most people are satisfied with the results of the surgery.

Your new body shape will begin to emerge in the first couple of weeks. Improvement will be more visible 4 to 6 weeks after surgery. By exercising regularly and eating healthy foods, you can help maintain your new shape.

References

McGrath MH, Pomerantz JH. Plastic surgery. In: Townsend CM, Beauchamp RD, Evers BM, Mattox KL, eds. Sabiston Textbook of Surgery: The Biological Basis of Modern Surgical Practice. 20th ed. Philadelphia, PA: Elsevier; 2017:chap 68.

Stephan PJ, Dauwe P, Kenkel J. Liposuction: a comprehensive review of techniques and safety. In: Peter RJ, Neligan PC, eds. Plastic Surgery, Volume 2: Aesthetic Surgery. 4th ed. Philadelphia, PA: Elsevier; 2018:chap 22.1.

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Review Date: 4/20/2019  

Reviewed By: David A. Lickstein, MD, FACS, specializing in cosmetic and reconstructive plastic surgery, Palm Beach Gardens, FL. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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