Liposuction

What is liposuction?

Liposuction is a surgical procedure for removing fat from part of the body using suction. It is a type of cosmetic surgery and may be done nearly anywhere on the body. Common areas for liposuction are:

• hips
• thighs
• abdomen
• knees
• ankles
• face
• neck

When is it done?

Liposuction may be done to take out excess fat that is not easily lost with exercise and diet. It can shape areas of your body, but it is not a substitute for weight loss. People who have the best results from this procedure are at or near a healthy weight.

Before having the surgery, find out as much as you can about the procedure:

• the results you can expect from the procedure
• the risks involved
• the costs
• the credentials of your surgeon

Always select a board-certified plastic surgeon with training and experience in the procedure. Health insurance does not usually cover cosmetic surgery. Call your health plan to find out what is covered.

How do I prepare for this procedure?

The first step is a visit with the plastic surgeon:

• The surgeon looks at your body and the areas to be suctioned.
• The surgeon may take photos.
• The surgeon should show you photos of the results of examples of liposuction procedures he or she has done.

One to 2 weeks before your surgery you will need to have some basic medical tests:

• a detailed medical history and physical exam
• blood tests
• an EKG (a recording of the electrical activity of your heart)

If you are a smoker, quit at least 2 weeks before the surgery. Smoking may delay healing and decrease your chances of having a good outcome.

You may need to stop taking some types of medicines before you have the surgery, including:

• aspirin and other nonsteroidal anti-inflammatory drugs, such as ibuprofen
• thyroid medicines
• antidepressants

Check with your healthcare provider before stopping any medicines. And be sure you know when to start taking them again.

What happens during the procedure?

Liposuction can be done at the surgeon's office or at an outpatient clinic. In some cases you may need a general anesthetic. A general anesthetic relaxes your muscles and causes a deep sleep. It will prevent you from feeling pain during the procedure. The surgeon will make small cuts in the area being treated and stick small tubes into the cuts. A machine will suction out the fat. The entire surgery may last an hour or so, depending on how many areas are being treated. The cuts will be closed with stitches.

If you have a procedure called tumescent liposuction, you will not need a general anesthetic. Fluid that contains a numbing medicine (local anesthetic) and other medicines is injected into many places around the surgical site before the fat is removed. Tumescent liposuction causes less bleeding, less bruising, quicker recovery, and the need for less pain medicine after surgery than traditional liposuction.

A method called ultrasonic-assisted liposuction uses the energy from sound waves to turn fat into liquid before it is suctioned. A small heated probe is inserted into the layer of fat. It causes the fat cells to rupture, releasing their oily contents. The oil is then suctioned out. An advantage of this method is that it makes it easier to remove fat from difficult places, such as the upper abdomen, the back, and the male chest. Disadvantages include the possibility of more pain, swelling, skin burns, and other complications.

What happens after the procedure?

By 24 hours after surgery you will be able to walk around. You will have swelling and bruising around the surgery site and some pain from the surgery.

You should be able to go back to desk work in 3 to 5 days. It may be 2 to 4 weeks before you can return to full physical activity. Depending on where the liposuction was done, you may or may not be comfortable returning to work with the after-surgery bruising, so you will need to plan ahead.

Stitches are usually removed in 7 to 10 days. Some swelling at the surgery site may last for several months. Some results from the surgery can be seen in the first couple of weeks, but you may not see the full effects until 6 months after the surgery.

If you had skin dimpling before the procedure, you will likely have it afterwards as well. There is a chance your skin will look rippled after the procedure. Your skin may sag permanently if it is unable to shrink to the new shape.

What are the benefits of liposuction?

The main benefit for liposuction is removal of unwanted fat from specific areas of the body. You may feel that you look better. Also, the loss of body fat can improve your health, decreasing your risk of heart disease, diabetes, high blood pressure, and high cholesterol.

What are the risks and possible complications of liposuction?

The possible complications of liposuction are:

• sagging of the skin (especially if the treated area is the arms)
• uneven skin if the surgical site was the inner thigh area
• damaged nerves if the surgical site was the chin

Serious complications of liposuction include:

• infection
• a blood clot (which might move to the lungs)
• a puncture of the lungs or abdominal area
• an overdose of numbing medicine
• collection of fluid or blood around the site after the surgery (called a seroma or hematoma)

When should I call my healthcare provider?

Call your provider right away if:

• The surgery site seems infected (redness, tenderness, pus drainage).
• The pain is getting worse instead of better.
• You develop chest pain.
• You have trouble breathing.

Call during office hours if:

• You are feeling faint or dizzy.
• You have any questions after the surgery.