What is liposuction?

Liposuction is a surgical procedure designed to remove fat from certain parts of the body. The areas of fat excess that can become prominent in women are over the lower abdomen, hips, outer and inner thighs and inner knees. In men, these areas include the mower abdomen and hips. The best way to think about the goal of liposuction is that it “smoothes out the bumps”. Fat excesses on a part of the body interrupt the beautiful flowing lines of the torso and legs that reinforce a sense of youth and vibrancy. The fat deposits interrupt these lines and there becomes a loss of harmony and evenness.

The liposuction procedure itself involves filling the area to be suctioned with a fluid called “tumescent fluid”. This is mostly saline but also contains a local anesthetic and also adrenaline, a human hormone that constricts the blood vessels and so there is very minimal to no blood loss. After the tumescent fluid is instilled, a small devise called a cannula is placed via a tiny incision in the skin and the fat is removed. Care is taken to smoothly reduce the fat and to sculpt the area to achieve the smooth lines previously mentioned.

Can liposuction be done with patients awake?

Liposuction itself is a form of local anesthesia and so for small areas, the procedure can be performed with patients awake. But for most patients, multiple areas may require suction and so some form of anesthesia is necessary for patient comfort. Liposuction is generally performed under intravenous sedation or “conscious sedation” but can even be performed under general anesthesia depending on the treating physician and the goals of the treatment. When liposuction is combined with a tummy tuck, general anesthesia is almost always used.

Is Liposuction safe?

Liposuction is probably the safest surgery performed by a board certified plastic surgeon. It is very reassuring for patients to understand not only that it is safe but have a deeper understanding as to why it is safe. Most plastic surgery procedures involve diminishing the blood supply to tissues to get to a goal. For example, during a tummy tuck a space is made under the skin in order to tighten the muscle layer and remove skin excess. This decreases the overall flow of blood to the skin. During liposuction, there is no decrease in blood flow because there are no spaces made under the skin and fat is suctioned from between the blood vessels that remain intact throughout the procedure. More blood flow means quicker healing. So it is exceedingly rare for patients to have bleeding or healing problems after suction and patients also return to work and sports more quickly than any other procedure.

Are there different types of Liposuction?

Most surgeons perform what is termed “tumescent liposuction”. This is the basic technique where fluid is placed under the skin and the fat is suctioned with a small cannula that is placed under the skin through a tiny incision. Since tumescent liposuction is very basic and there is no additional energy applied to the tissues as with other procedures (see below), this alternative can provide optimal improvement with less inflammation and quicker healing and with less bruising than other procedures.

Ultrasonic liposuction and laser liposuction were more in vogue in the past and are less often used today. These techniques use sound and laser energy to break up the fat particles to facilitate their removal. Because of the excess energy they put into the tissues, swelling and bruising are more pronounced than with standard tumescent liposuction. Some patients have areas that require suction which have thick tissue between the fat particles and so mechanical suction was developed to make it easier to remove fat in these areas. These special areas include the chest in men and the back.

Overall, tumescent liposuction that was the first technique developed as liposuction has stood the test of time is safe and remains the most common liposuction procedure performed today.

Can liposuction tighten skin?

Liposuction is good at removing fat from beneath the skin but it doesn’t tighten skin. Besides understanding that liposuction is very safe, knowing that it doesn’t tighten skin is the next most important idea to understand. That doesn’t mean that suction isn’t a good alternative. In fact, in the ideal patient, liposuction can give fantastic results that are long lasting. But liposuction should not be performed where fat deposits are minimal or there is already skin looseness. Procedures that can remove and reshape loose skin have been developed that are superior to liposuction in these cases. There are no techniques that tighten skin.