Liposuction, also known as lipoplasty or liposculpture, is a procedure designed to remove unwanted fat that does not respond to diet and exercise.

Facial liposuction can be used to remove fat pockets in the face such as chin neck and cheeks. Fat in the body is contained within fat cells and the number and location of these fat cells is determined by ones heredity. After puberty the number and location of the fat cells are permanently fixed and dieting can only affect the amount of fat contained in each cell. Furthermore, dieting is not selective and may not reduce fat in the areas desired. Liposuction removes the actual fat cells from desired areas, resulting in a permanent reduction of fat. Therefore, liposuction is an effective method for sculpting ones body to the desired look. However, liposuction is not a cure for obesity nor should it be used as a weight loss method. Although there is always less fat cells in the treated areas weight still can be gained in those areas in proportion to the rest of the body. The best candidates for this surgery are men and women in good physical condition with good skin elasticity who are dissatisfied with unsightly fat bulges.

PRIOR TO THE SURGERY

A complete medical history and a careful examination with blood tests will be done in the initial preoperative visit to determine the general health of the patient. The surgeon will also evaluate the location of fat deposits, and determine the extent of surgery required and whether any other procedures such as an abdominoplasty (tummy tuck) would be needed to achieve the desired look. After the examination the doctor will then recommend one of the several procedures available based on your needs of effectiveness, safety, and cost. Photographs may also be taken before and after surgery to evaluate the extent of improvement. Moreover, the surgeon will discuss the procedure, realistic expected results, type of anesthesia to be used, and possible risks of surgery. Preoperative instructions generally include taking certain vitamins and elimination of certain drugs to minimize the possibility of excess bleeding. Furthermore, antibiotics or bathing with an antiseptic soap may be prescribed for the days prior to surgery in order to prevent infection.

THE OPERATION

Liposuction surgery can be done in the surgeon’s office, an outpatient surgical facility, or a hospital depending on the surgeon’s and the patient’s preference. General anesthesia, in which the patient is asleep, or a local anesthetic can be used, in which the area of interest is numbed and the patient remains awake. The length of operation can vary from 30 minutes to 4 hours depending on the amount of fat removed, the type of anesthesia, and the technique used. The procedure begins with a small incision followed by the insertion of a cannula (a tube attached to a vacuum suction or syringe system). The cannula is moved back and forth to loosen the fat, which is then sucked out of the body with the vacuum device. New breakthroughs in this procedure, however, have produced variations such as the tumescent and the ultrasound assisted lipoplasty (UAL) techniques. In the tumescent procedure, large volumes of fluid, containing salts, a local anesthetic, and a drug causing blood vessel contraction, is injected before fat removal. This method results in less blood and fluid lost and provides an adequate amount of anesthesia. The UAL technique uses a special cannula that transmits high-pressure sound waves to liquefy the fat that it contacts. The liquefied fat is then removed from the body by suction. This technique is useful for more fibrous parts of the body from which fat must be removed, and it typically takes longer and costs more than other methods. After the right amount of fat is removed the incisions are closed and a compression bandage is applied to reduce swelling and bleeding.

AFTER SURGERY

Generally one can return home right after surgery with careful supervision for about 24 hours. However, in some cases an overnight stay may be required if large amounts of fat are removed. Pain is minimal due to the small incisions and can easily be controlled with medication. Normal activity can be resumed within a week although vigorous activity is not recommended for several weeks. Scars from liposuction are small and will fade with time after about a month of swelling and discoloration.

RISKS

Risks from liposuction are rare, although bleeding and infection are possible as with any other surgeries. An uneven skin surface and numbness are other complications, but generally correct themselves over time. Patients can minimize these risks by carefully following the physician’s directions.