Liposuction is a surgical procedure designed to remove excess fat deposits from specific areas of the body. It is also known as lipoplasty or body contouring, as it reshapes and improves the contours of the treated areas. Common areas for liposuction include the abdomen, hips, thighs, buttocks, arms, and neck.
It’s crucial to understand that liposuction is not a weight-loss solution. It is most effective for individuals who are at a stable weight but have localized areas of excess fat that are resistant to diet and exercise. For overall weight reduction, lifestyle changes like diet and exercise or bariatric surgery are more appropriate.
Liposuction can be a suitable option for those seeking to refine their body shape in specific areas where stubborn fat accumulates.
Why Liposuction is Performed
Liposuction targets areas of the body where fat tends to accumulate and may not respond effectively to traditional weight loss methods like diet and exercise. These areas commonly include:
- Abdomen
- Upper arms
- Buttocks
- Calves and ankles
- Chest and back
- Hips and thighs
- Chin and neck
In men, liposuction can also be used to address gynecomastia, a condition characterized by excess breast tissue.
Area under the chin highlighted in blue, indicating a common liposuction treatment zone for contouring and fat reduction.
When we gain weight, fat cells enlarge in size and volume. Liposuction works by physically removing fat cells from targeted areas, reducing the number of fat cells in those specific locations. The amount of fat removed is determined by the area’s appearance and the volume of fat present. As long as a stable weight is maintained post-procedure, the resulting shape changes are generally long-lasting.
After liposuction, the skin adapts to the new contours of the treated areas. Optimal results are typically seen in individuals with good skin tone and elasticity, as their skin will retract smoothly. However, if skin elasticity is poor, the treated areas might exhibit some looseness.
It’s important to note that liposuction is not a treatment for cellulite dimpling or skin irregularities, nor does it eliminate stretch marks.
To be a good candidate for liposuction, individuals should be in good overall health and free from medical conditions that could complicate surgery. These conditions can include cardiovascular problems, blood flow issues, diabetes, or a compromised immune system.
Understanding the Risks of Liposuction
Like all surgical procedures, liposuction carries potential risks. Common risks associated with surgery in general, such as bleeding and adverse reactions to anesthesia, are also relevant to liposuction. Specific risks associated with liposuction include:
- Contour Irregularities: Uneven fat removal, poor skin elasticity, and scarring can lead to bumpy, wavy, or withered-looking skin. These contour issues can sometimes be permanent.
- Fluid Accumulation (Seroma): Temporary pockets of fluid, known as seromas, can develop beneath the skin and may require drainage with a needle.
- Numbness: Temporary or permanent numbness in the treated areas is possible, and nerve irritation in the area may also occur.
- Infection: While rare, skin infections can happen and, in severe cases, can be life-threatening.
- Internal Puncture: In rare instances, the cannula (thin tube) used during liposuction might penetrate too deeply, potentially damaging an internal organ and requiring emergency surgery.
- Fat Embolism: Fat particles can detach, enter the bloodstream, and become lodged in blood vessels, potentially traveling to the lungs or brain. This is a serious medical emergency.
- Kidney and Heart Complications: Large-volume liposuction can cause significant fluid shifts in the body, potentially leading to life-threatening kidney, heart, and lung problems.
- Lidocaine Toxicity: Lidocaine, a local anesthetic often used during liposuction, can, in rare cases, reach toxic levels, causing severe heart and central nervous system issues.
The likelihood of complications increases with the size of the treated area and the number of procedures performed simultaneously. It is essential to discuss these risks thoroughly with your surgeon to understand how they apply to your specific situation.
Body areas commonly targeted for liposuction are shaded in blue, illustrating the broad range of treatment possibilities for body contouring.
Preparing for Your Liposuction Procedure
Preparation for liposuction involves a detailed consultation with your surgeon to discuss expectations and the surgical plan. Your surgeon will:
- Review your medical history and inquire about any pre-existing medical conditions.
- Ask about all medications, supplements, and herbal remedies you are currently taking.
Your surgeon will likely advise you to stop taking certain medications, such as blood thinners and nonsteroidal anti-inflammatory drugs (NSAIDs), at least one week prior to surgery. You may also need to undergo specific lab tests before the procedure.
Depending on the amount of fat to be removed, liposuction may be performed in a clinic, medical office, or a hospital setting. If a large volume of fat is being removed, or if other procedures are combined with liposuction, a hospital setting is more likely. Regardless of the setting, you will need to arrange for someone to drive you home and stay with you for at least the first night following the procedure.
What to Expect During Liposuction
Before the Procedure
Before the liposuction procedure begins, the surgeon may use markers to outline the treatment areas on your body. Photographs may also be taken to document the pre-operative appearance for comparison with post-operative results.
The specific liposuction technique used will depend on your treatment goals, the areas being treated, and whether you have had liposuction previously.
Liposuction Techniques
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Suction-Assisted Liposuction (SAL): This is the most common liposuction technique. It involves injecting a solution of saline, a local anesthetic (like lidocaine), and epinephrine into the treatment area. The saline solution helps with fat removal, lidocaine minimizes pain, and epinephrine constricts blood vessels to reduce bleeding.
A small incision is made, and a cannula is inserted beneath the skin. The cannula is connected to a vacuum, which suctions out fat and fluids. In some cases, multiple incisions may be needed to access and treat an area from different angles.
A surgeon performing suction-assisted liposuction, utilizing a cannula connected to a vacuum to extract fat from under the chin area.
- Ultrasound-Assisted Liposuction (UAL): UAL is sometimes used in conjunction with traditional liposuction. A specialized cannula emits ultrasound energy to liquefy fat cells before removal. VASER-assisted liposuction is a more advanced form of UAL that uses vibration to enhance skin contouring.
- Laser-Assisted Liposuction (LAL): LAL employs laser energy delivered through a fiber inserted into the treatment area to liquefy fat cells, which are then removed via a cannula.
- Power-Assisted Liposuction (PAL): PAL uses a cannula that vibrates rapidly, making it easier and faster to remove fat, especially in areas with dense fat. PAL can also result in less pain and swelling and allow for more precise fat removal. It may be preferred for large-volume liposuction or revision procedures.
During the Procedure
Anesthesia options for liposuction include local, regional, or general anesthesia. Local anesthesia numbs only the treatment area, while regional anesthesia numbs a larger portion of the body. General anesthesia induces a state of unconsciousness. If local or regional anesthesia is used, you may also receive intravenous sedation to help you relax.
Throughout the procedure, your heart rate, blood pressure, and blood oxygen levels will be monitored. If you experience pain under local anesthesia, inform your surgeon, as adjustments to medication or technique can be made.
The duration of the liposuction procedure can range from one to several hours, depending on the amount of fat being removed.
If you received general anesthesia, you will wake up in a recovery room. You will typically remain under observation in the clinic or hospital for at least a few hours post-procedure to ensure stable recovery. If a significant amount of fluid was removed, an overnight stay may be necessary to monitor for dehydration or shock.
After the Procedure
Expect to experience pain, swelling, and bruising following liposuction. Your surgeon may prescribe pain medication and antibiotics to prevent infection.
Incisions may be left open to facilitate fluid drainage, or temporary drains may be inserted. You will be instructed to wear compression garments for several weeks to minimize swelling and support healing.
You may need to take a few days off work and refrain from strenuous activities, including exercise, for a few weeks.
During the initial recovery period, you may notice some shape irregularities as residual fat settles. It can take several weeks to months for swelling to fully subside and for the final results to become apparent.
Liposuction Results
Swelling following liposuction typically resolves within a few weeks, and the treated area will begin to appear less bulky. Over several months, the treated area will continue to refine, revealing a slimmer contour.
While skin firmness naturally decreases with age, liposuction results are generally long-lasting, provided you maintain a stable weight. Significant weight gain after liposuction can alter fat distribution, and fat may accumulate in different areas of the body, even those that were not originally treated.
By Mayo Clinic Staff
Liposuction care at Mayo Clinic
Sept. 19, 2024
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