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What exactly is liposuction?

Liposuction, also called lipoplasty or suction lipectomy, is a surgical procedure that vacuums out fat from beneath the skin's surface to reduce fullness in areas of localized fat deposits, such as in the abdomen, hips, thighs, knees, buttocks, upper arms, chin, cheeks and neck. It's a cosmetic, body recontouring procedure that removes pockets of fat in specific areas that don't respond to diet and exercise.

How long will the new body contours produce by liposuction last?

Liposuction, in effect, sculpts the body by removing some of the body's fixed number of fat cells. When you gain weight, the set number of fat cells you have grow larger, but don't increase in number. Similarly, when you lose weight, the fat cells shrink in size, but don't decrease in number. Your genes determine how many and where fat cells are distributed, and some people are born with more fat cells in some body areas than others. For example, some women have more fat cells in their thighs and hips, instead of a uniform fat distribution. Liposuction vacuums fat cells from such areas, permanently removing them. But, what fat cells remain in the area treated still can grow larger if weight is gained. Liposuction patients often find that newly added weight will not accumulate in the specific treated areas as it did before, and instead distributes more evenly.

How do I know whether liposuction can benefit me?

Talk to your health care professional, and ask for a referral for a consultation with a surgeon who performs liposuction. The best candidates for liposuction are healthy, fit, normal weight people with firm, elastic skin who have localized pockets of fat that do not respond to diet and exercise. If you are up to 30 pounds overweight and have good skin elasticity, liposuction may help put your body contours in better proportion. Although there are no absolute age limits for liposuction, older women who have lost skin elasticity may not achieve as good results from the procedure as younger women with elastic skin. Although liposuction removes fat cells from the body, it is not a way to lose weight. There is no way to have a layer of fat surgically removed from your entire body. The only way to achieve that is through diet and exercise.

What tests are there to see if I am a candidate for liposuction?

In evaluating whether you may be a candidate for liposuction, your surgeon may conduct a "pinch test" to assess how much fat is under the skin in the area to be treated, and to check the elasticity of your skin. During this test, the health care professional simply pinches the skin between the thumb and forefinger to see how much fat is in the area, and see how the skin springs back after releasing the pinch. If an inch or more of fat can be pinched, the area may be reduced through liposuction. A half-inch of fat needs to remain after the procedure to ensure a smooth end-result. Otherwise, skin would remain on top of bone or muscle, creating an emaciated look. If the skin springs back after the pinch, it has appropriate elasticity.

I've heard people can die from liposuction. Is that true?

As with any type of surgery, liposuction does carry risks, including death. A controversial study published in January 2000 found a death rate of about 20 in every 100,000 patients who underwent liposuction from 1994 to 1998. A task force of plastic surgeons in 1998 determined that the factors that increase the risk of death from liposuction include:

• poor patient health

• excessive fat removal

• too much fluid and local anesthesia used during the procedure

• performing multiple procedures along with liposuction in a single surgical session, especially under general anesthesia

• failing to adequately monitor patients postoperatively after removal of large amounts of fat

However, in experienced, skilled surgical hands, life-threatening complications, such as problems with anesthetics, blood clots, and perforation of the organs and tissues near the area being treated, are extremely rare.

How is liposuction performed?

There are several variations on the basic liposuction technique. Those most commonly used today involve first infusing the area to be treated with a solution of saline, a numbing drug and a drug that constricts blood vessels. Then, a hollow tube attached to a vacuum is inserted into the fat lawyer beneath the skin. The tube, called a cannula, is moved through the fat layer in a push-and-pull motion to break up the fat and suction it out. In the tumescent technique, the solution used is two to three times the amount of fat to be removed. In the super-wet technique, the amount of fluid infused is same as the amount of fat slated for removal. In ultrasound liposuction, ultrasonic energy that liquefies the fat is applied through the cannula, which also suctions out the fat. A new technique, called power liposuction, uses a motorized cannula that pushes and pulls itself while suctioning out the fat. The choice of technique depends on the individual patient, and the surgeon's skill and preference. According to the American Academy of Dermatology, the tumescent liposuction procedure is currently the standard of care for surgical fat removal.

Will I be put to sleep for a liposuction procedure?

The anesthesia used in liposuction varies, depending on the individual patient, the amount of fat to be removed, and the surgeon's preferences. A fluid containing the anesthetic lidocaine, the drug epinephrine, which constricts blood vessels, and saline is infused into the area to be treated before the fat is suctioned off. Liposuction of small areas removing 1.5 liters of fat or less can performed in an outpatient office surgical setting under the local anesthetic that is included in the solution. It is often combined with a sedative in pill form to keep the patient more relaxed during the procedure. If large amounts of fat are to be removed, such as more than 1.5 liters, and/or multiple areas of the body are to be treated, the procedure is usually performed on an outpatient basis in hospital under regional or under general anesthesia. A regional anesthesia, such as an epidural block commonly used in childbirth, may be combined with intravenous sedation. With a general anesthesia, the patient is put to sleep. In cases involving general anesthesia and large areas of fat removal, patients may be hospitalized overnight.

How long does it take to see results from a liposuction procedure?

Although recovery time from surgery varies with every person, differences in body contours are most apparent about three to six months after surgery, when swelling has disappeared. Depending on the body area treated, you should find that you are able to wear a wider variety of clothing, and your body appears more in proportion than before the surgery.