Liposuction, also called lipoplasty, liposculpture suction, lipectomy, or lipo, is a type of cosmetic surgery that breaks up and "sucks" fat from the body.
Most commonly, liposuction is used on the abdomen, thighs, buttocks, neck, chin, upper and backs of the arms, calves, and back.
During liposuction, the fat is removed through a hollow instrument - a cannula - which is inserted under the skin. A powerful, high-pressure vacuum is applied to the cannula.
Liposuction is the most common cosmetic operation in America and the United Kingdom. More than 300,000 procedures are carried out in the United States each year with costs ranging from roughly $2,000-3,500.
Fast facts on liposuction
Here are some key points about liposuction. More detail and supporting information is in the main article.
- The operation is normally carried out under general anesthetic
- Liposuction is not a weight-loss tool, it is purely cosmetic, and its effects are subtle
- Over 400,000 liposuction procedures are carried out yearly
- There are a number of associated risks including infection and scarring
- Liposuction is not a treatment for obesity
What is liposuction?
Liposuction is not an overall weight-loss method.
Patients who undergo liposuction generally have a stable body weight, but would like to remove undesirable deposits of body fat in specific parts of the body.
Liposuction is not an overall weight-loss method - it is not a treatment for obesity.
Liposuction does not remove cellulite, dimples, or stretch marks. The aim is aesthetic - the patient wishes to change and enhance the contour of their body.
Liposuction permanently removes fat cells, altering the shape of the body. However, if the patient does not lead a healthy lifestyle after the operation, there is a risk that the remaining fat cells will grow bigger.
The amount of fat that can be safely removed is limited.
Liposuction has a number of possible risks, including infection, numbness, and scarring. If too much fat is removed, there may be lumpiness or dents in the skin. Experts say that the surgical risks are linked to the amount of fat removed.
What are the uses of liposuction?
Liposuction is mainly used to improve how a person looks, rather than providing any physical health benefits. In many cases, the patient would probably achieve the same, sometimes even better, results if they adopted a healthy lifestyle - balanced diet, regular exercise, and a healthy sleep schedule.
Experts say that liposuction should ideally only be used if the individual did not achieve the desired results with a lifestyle change. For example, if some obstinate areas of fat are resistant to exercise and diet.
When an individual gains weight, each fat cell increases in size and volume. Liposuction reduces the number of fat cells in isolated areas.
Patients should discuss the pros and cons of liposuction with their doctor before deciding on whether to proceed. Liposuction should only be carried out after a lot of thought. Results are never dramatic; they are subtle. The following body areas are commonly targeted for liposuction treatment:
Liposuction is cosmetic rather than health-focused.
- Inner knees
- Flanks (love handles)
- Neckline and the area under the chin (submental)
- Thighs - saddlebags (outer thighs), and inner thighs
- Upper arms
Experts say that the best liposuction candidates are those who have good skin tone and elasticity, where the skin molds itself into new contours. People whose skin lacks elasticity may end up with loose-looking skin in areas where the procedure was done.
The patient needs to be in good health - people with circulation (blood flow) problems, such as coronary artery disease, diabetes, as well as those with weakened immune systems should not undergo liposuction. Candidates should be over the age of 18 years.
Liposuction is sometimes used to treat certain conditions, including:
- Lymphedema - a chronic (long-term) condition in which excess lymph (fluid) collects in tissues, causing edema (swelling). The edema commonly occurs in the arms or legs. Liposuction is sometimes used to reduce swelling, discomfort, and pain.
- Gynecomastia - sometimes fat accumulates under a man's breasts.
- Lipodystrophy syndrome - fat accumulates in one part of the body and is lost in another. Liposuction can improve the patient's appearance by providing a more natural looking body fat distribution.
- Extreme weight loss after obesity - if a morbidly obese person has lost at least 40 percent of their BMI, excess skin and other abnormalities may need treatment.
- Lipomas - benign fatty tumors.
Before, during, and after the liposuction operation
Before the operation - patients will need to undergo some health tests to ensure that they are fit for surgery. The medical team will ask the patient to:
- Stop taking aspirin and anti-inflammatory drugs for at least 2 weeks before surgery
- Women may be asked to stop taking the contraceptive pill
- Patients with anemia may be asked to take iron supplements
- Consent form - the patient will be asked to sign a consent form, which confirms that they are fully aware of the risks, benefits, and possible alternatives to the procedure
During the operation
The procedure takes around 1-4 hours.
Anesthesia - the patient will most likely be under a general anesthetic; they are put to sleep before the procedure and remain asleep throughout.
A liposuction operation may last for 1-4 hours. The doctor may use an epidural for treatments on the lower body - the anesthetic is injected into the epidural space surrounding the dura (fluid-filled sac) around the spine, partially numbing the abdomen and legs.
A local anesthetic might be used when liposuction is done on very small areas.
If the patient requires only local anesthesia, they might be asked to stand up during the procedure to ensure proper fat removal.
There are a number of liposuction techniques:
Several liters of a saline solution with a local anesthetic (lidocaine) and a vessel-constrictor (epinephrine) are pumped below the skin in the area that is to be suctioned.
The fat is suctioned (sucked out) through small suction tubes (microcannulas). This is the most popular form of liposuction.
No fluid is injected before the fat is removed. This method is seldom used today. There is a higher risk of bruising and bleeding.
Ultrasound-assisted liposuction (UAL)
Also known as ultrasonic liposuction, the cannula is energized with ultrasound. This makes the fat melt away on contact - the ultrasound vibrations burst the walls of the fat cells, emulsifying the fat (liquefying it) and making it easier to suction out. This method is a good choice for working on more fibrous areas, such as the male breast, back, and in areas where liposuction has been done before.
After ultrasonic liposuction, it is necessary to perform suction-assisted liposuction to remove the liquefied fat.
Power-assisted liposuction (PAS)
Also known as powered liposuction, PAS uses a specialized cannula with a mechanized system that rapidly moves back-and-forth, allowing the surgeon to pull out fat more easily.
Laser Assisted Lipolysis (LAL)
Also known as laser-guided lipo, this procedure requires the use of tumescent fluid. It is a far less invasive and bloody procedure than the traditional liposuction method for removing fat.
A microcannula is inserted through a small incision to deliver laser energy and heat into subcutaneous fat (fat under the skin).
After the operation, the surgeon may leave the incisions open so that excess fluid and blood can drain from the body.
After the liposuction operation
After the operation, the patient might experience numbness in some areas.
- Anesthetic - patients who have a general anesthetic usually spend the night in hospital. Those who had a local anesthetic may be able to leave hospital on the same day.
- Support bandages - the patient will be fitted with either an elasticated support corset or bandages for the targeted area after the operation.
- Antibiotics - patients may be given antibiotics immediately after the operation.
- Painkillers - the doctor will most likely prescribe or recommend analgesics (painkillers) to relieve pain and inflammation.
- Stitches - the patient will be given a follow-up appointment to have the stitches removed.
- Bruising - there will be significant bruising in the targeted area.
- Numbness - patients may experience numbness in the area where fat was removed. This should improve within 6-8 weeks.
Results - patients and their doctors will not be able to fully appreciate the results of liposuction until the inflammation has gone down, which in some cases may take several months. Typically, most of the swelling will have settled after about 4 weeks, and the area where fat was removed should appear less bulky.
Patients who maintain their weight can usually expect permanent results. Those who gain weight after the procedure may find that their fat distribution alters. Those who previously had fat accumulating in their hips might find that their buttocks become the new problem area.
If a patient has thought everything through carefully beforehand, talked to their doctor and surgeon about their aims, motives, and expectations, the surgeon is skilled and well qualified, and there are no complications, most patients are pleased with their results.
Risks of liposuction
Any major surgery carries a risk of bleeding, infection, and an adverse reaction to anesthesia. The risk of complications is usually associated with how large the procedure is, as well as the surgeon's skills and specific training. The following risks, unpleasant side effects, or complications are possible:
- Bad bruising.
- Inflammation - the swelling in some cases may take up to 6 months to settle. Sometimes fluid may continue to ooze from the incisions.
- Thrombophlebitis - a blood clot forms in a vein, causing inflammation of that vein.
- Contour irregularities - if the patient has poor skin elasticity, has healed in an unusual way, or fat removal has been uneven, the skin may appear withered, wavy, or bumpy.
- Numbness - the area that was worked on may feel numb for a while; this is usually only temporary.
- Infections - although rare, skin infections may occur after liposuction surgery. Sometimes this needs to be treated surgically, with the risk of scarring.
- Internal organ punctures - this is very rare.
- Death - anesthesia carries with it a small risk of death.
- Kidney or heart problems - as fluids are being injected and or suctioned, the change in the body's fluid levels may cause kidney or heart problems.
- Pulmonary embolism - fat gets into the blood vessels and travels to the lungs, blocking the circulation in the lungs; this can be life-threatening.
- Pulmonary edema - this may be a result of fluid being injected into the body. Fluid accumulates in the lungs.
- Allergic reaction - there may be an allergic reaction to medications or material used during surgery.
- Skin burns - the cannula movement may cause friction burns to the skin or nerves.