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Liposuction

Treatment Overview

Liposuction removes fat from your body using suction. During liposuction, small, thin, blunt-tipped tubes (cannula) are inserted through tiny cuts in the skin. Fat is suctioned out through these tubes as the doctor moves the tubes around under the skin to target specific fat deposits.

In recent years, improved techniques have made liposuction safer, easier, and less painful. These newer techniques include:

  • Tumescent liposuction. A local anesthetic is used to numb the area of your body where the tube will be inserted. Next, a large amount of an anesthetic solution containing lidocaine and epinephrine is injected into the fatty tissue before traditional liposuction is done. Tumescent liposuction may not require general anesthesia (which makes you sleep through the procedure).
  • Ultrasound-assisted liposuction. This technique uses ultrasound to liquefy the fat, which makes it easier to remove. This technique may be particularly helpful in removing fat from the upper abdomen, sides, and back.
  • Laser-assisted liposuction. This technique uses low-energy waves to liquefy the fat, which is removed through a small cannula.

Liposuction is usually done as an outpatient procedure in a properly equipped doctor’s office, ambulatory surgery center, or hospital. In general, it does not require an overnight hospital stay unless a large volume of fat is being removed. Local anesthesia is used in some cases. And you may or may not be given a sedative to help you relax. If a large area or volume of fat is being treated, general anesthesia or deep sedation with a local anesthetic may be used.

What To Expect After Treatment

After the procedure, the area of the body that was treated is firmly wrapped to help reduce swelling, bruising, and pain. Elastic bandages and tape, support hose (such as those used to treat varicose veins), a special girdle, or another type of firm-fitting garment may be used, depending on which part of the body was treated. You may have to wear the compression garment or wrap for 3 to 4 weeks. Expect a lot of bruising and swelling for at least the first 7 to 10 days.

Fluid may drain from the incision sites for several days. You may be given antibiotics to reduce the risk of infection.

Most people are able to get up and move around as soon as the treatment is finished and after the effects of the anesthesia and any sedation have worn off. You can return to your normal activities as soon as you feel comfortable, although this may take several days to a few weeks. Most people can return to work within a few days. Recovery may take longer if large areas were treated.

Why It Is Done

The main purpose of liposuction is to reshape one or more areas of your body, not to reduce body weight. Liposuction is typically used on “problem” areas that have not responded well to diet and exercise. These areas are often on the outer thighs and hips on women and the waist and back on men. The face, neck, abdomen, back, buttocks, legs, and upper arms are all commonly treated areas.

Liposuction is sometimes used in combination with other cosmetic surgery procedures, such as a “tummy tuck” (abdominoplasty), breast reduction, or face-lift.

Liposuction may also be used to treat certain medical conditions, including:

  • Benign fatty tumors (lipomas).
  • Abnormal enlargement of the male breasts (gynecomastia or pseudogynecomastia).
  • Problems with metabolism of fat in the body (lipodystrophy).
  • Excessive sweating in the armpit area (axillary hyperhidrosis).

Liposuction is not used to treat obesity. It will not get rid of cellulite or stretch marks.

Liposuction WA: How Well It Works

Liposuction is usually very effective at removing fat deposits in small areas. But if you regain weight after having liposuction, the fatty bulges that were removed are likely to return or may appear in a different place.

Some improvement in body contour is usually noticeable right after surgery. And improvement may continue for several weeks or even months as the swelling goes away. The full effects of having liposuction may not be visible for several months to a year.

Liposuction (except for laser liposuction) generally does not tighten the skin over the treated area. After fat has been removed, the skin around the area may be somewhat loose. It may take up to 6 months for the skin to tighten around the treated area. Some people’s skin is very elastic and retracts more quickly than other people’s skin. Younger skin tends to have greater elasticity than older skin.

People who expect liposuction to help them lose weight are usually disappointed.

Risks

Liposuction done by an experienced doctor in a properly equipped facility is usually safe.1 Having more than one area treated, or having a very large area treated, may increase the risk of complications during or after the procedure.

Common side effects of liposuction include:

  • Temporary swelling, bruising, soreness, and numbness in and around the treated areas.
  • Irritation and minor scarring around the incision sites where the cannulas were inserted.
  • Baggy or rippling skin. The skin will usually tighten and retract after a few months. But in some people the skin may remain somewhat loose.

Less common side effects include:

  • Permanent color changes in the skin.
  • Uneven skin surface over the treated area.
  • Damage to the nerves and skin. The heat generated during ultrasound-assisted liposuction may burn the skin or damage the tissue under the skin.

If you gain weight after having liposuction, your body may store the new fat in a different place than where you had fat cells removed. New fat can grow deep inside your body, around your organs, such as your heart or liver. This type of fat can be more harmful to your body than fat that is stored near the surface of your body, such as on your hips or thighs. So people who have liposuction need to be careful not to gain extra weight.

Dangerous complications

Although death is very rare with liposuction, it can happen. If you are having a large amount of fat removed, are obese, or have health problems, your risks go up. Possible complications include:

  • Excessive blood and fluid loss, leading to shock. But this is extremely unlikely.
  • Fat clots or blood clots, which may travel to the lungs (pulmonary embolism) and become life-threatening.
  • Buildup of fluid in the lungs (pulmonary edema). This is most likely to occur when a large volume of fluid is injected into the body.
  • Infection. In some cases, antibiotics may be given before or after liposuction to help prevent infection.
  • Toxic reaction to the injected solution (lidocaine toxicity), especially if large areas or many areas are treated at one time.
  • A puncture into the cavity containing the abdominal organs or damage to an organ such as the spleen.

Liposuction should not be done in people who have severe heart problems, who have blood-clotting disorders (such as thrombophilia, a disorder in which the blood clots easily or excessively), or during pregnancy.

What To Think About

Liposuction should be done only by a doctor who has special training in liposuction and surgery of the skin and in how to respond to complications during surgery. You will also be at less risk for complications if liposuction is not done at the same time as other cosmetic procedures.

If you are trying to lose weight, liposuction is not a substitute for exercise and a balanced diet. In fact, most cosmetic surgeons agree that the best candidates for liposuction are healthy people who are at or close to a healthy weight but who have stubborn fat deposits that do not respond to exercise.

Before…

Before you undergo liposuction, you should undergo a complete physical exam so that your doctor can determine if you are an acceptable candidate for liposuction. It is important for you to discuss any medical conditions that you have and to tell your doctor about any medications that you are taking including any herbal or other non-prescription ones. If your doctor decides that you can have liposuction, discuss the procedure thoroughly with him or her before deciding if you want to go through with the procedure. Just because a physician says that you may have liposuction does not mean that you must decide to have liposuction. You may still change your mind even after discussing the procedure with a physician.

Your physician should be able to answer any questions that you have about liposuction including questions about what to expect during and after liposuction and the complications or problems that sometimes occur with liposuction. Some physicians will provide written information about liposuction. You may also take information from this website to your appointment to discuss with your physician.

You may want to have someone drive you to your appointment for liposuction. You may be tired or uncomfortable after liposuction and unable to drive yourself home. Discuss this with your physician before the day of your procedure.

Your physician may prescribe an antibiotic drug for you to take before and after the surgery. This is to prevent infections.

During…

On the day of the liposuction surgery, the physician will mark your body with a pen to indicate where the fat is to be removed. Then you will receive anesthesia, that is medicine that prevents you from feeling pain. Some physicians use only local anesthesia, that is, anesthesia that they inject with a syringe or pump into the area where they will do the liposuction. The anesthesia medicine is injected along with a lot of fluid, usually buffered salt water and epinephrine, a drug to reduce bleeding. Large volumes of liquid may be injected, until the skin is very firm. If your physician uses only this kind of local anesthesia, also sometimes called tumescent anesthesia, then you will be awake during the procedure. Other physicians use local anesthesia and a sedative that can be taken by mouth or injected from a syringe. Still others prefer to use general anesthesia, that is to use anesthesia that will put you to sleep during the procedure. This is usually done in a hospital.

Once the anesthesia is working, the physician will make an incision (cut) in the area where the liposuction will be performed. A canula, a hollow tube that is about the size and shape of a skinny pen, will be inserted into the incision. The physician moves this canula back and forth to suction out the fat. The fat, and liquid that has been injected, are collected in a flask. The physician will monitor the amount of fluid and fat that are removed. Because you will be losing liquid and fat from your body, it may be necessary to replace some of that fluid. This is done with an intravenous (i.v.) line for the replacement of fluid.

After…

Depending upon the amount of fat removed and the location of the surgery (doctor’s office, surgical center, hospital), you may leave the doctor’s office soon after the surgery or you may spend the night in the surgical center or hospital. Ask your doctor how long it will be before you should be able to return to your normal level of activity or if you will need to miss work after liposuction.

The cuts where the doctor inserted the canula may be leaky or drain fluids for several days. In some cases, the doctor may insert a drainage tube to drain fluid away from the wound.

You will wear special tight garments to keep your skin compressed after the liposuction procedure. Your doctor will tell you how long to wear these, usually for weeks. Some doctors provide these garments but others will tell you where to purchase them before your surgery.

Your doctor will also probably give you some after-surgery instructions. This will include information about wearing compression garments, taking an antibiotic if that has been prescribed, and the level of activity that is safe for you after your liposuction procedure. You should also have information about signs of problems that you should be aware of, for instance the signs of infections or other problems that you need to know about.

When the anesthesia wears off, you may have some pain. If the pain is extreme or of a long duration, you should contact your physician. You will also have some swelling after the surgery. In some cases, this swelling will remain for weeks or even months. If you have pain and swelling, this may be the sign of infection and you should contact your physician.

You will have scars, usually small, where the physician cuts your skin and inserts the canula to remove fat tissue.

Will I look the way I want after liposuction?

While medical complications are important, the reason that people have liposuction surgery is for cosmetic reasons. The cosmetic effect after liposuction may be very good and many patients report being satisfied. However, it is possible that the cosmetic effect will not be what you expected. In other words, your appearance after liposuction may not be what you expected or wanted. Some physicians counsel their patients that reasonable expectations are important. It may be difficult to have reasonable expectations after reading advertisements and looking at pictures of women and men who have had liposuction. Remember that advertising is made to make you want to purchase a product or service. Advertisements do not usually tell you about problems or shortcomings of the product or service. If you want to know more about advertising ethics, or want to report on false advertising, explore the following website:

Some cosmetic shortcomings after liposuction include:

  • There may be scars at the site where the doctor made the cut to insert the liposuction canula. These scars are usually small and fade with time but in some people, scars may be larger or more prominent.
  • The liposuction site may have a wavy or bumpy appearance after liposuction.
  • Liposuction results may not be permanent. If you gain weight after liposuction surgery, the fat may return to sites where you had liposuction or to other sites.
  • Results may be less dramatic than what you were expecting and this can be disappointing.

Liposuction WA Surgery Checklist

Know what makes you a poor candidate for liposuction

Medical conditions – Do you have any medical conditions that could interfere with healing after liposuction?

Medications – Are you taking any medications, including herbal remedies or non-prescription medications, that can increase your risk for complications or that may interfere with healing?

Cost – Can you really afford this procedure?

Weight loss – Are you considering liposuction as a way to lose weight? Consider changing your diet and exercise regimen if you are trying to lose weight. Liposuction is not a good way to lose weight.

Know all the risks and procedure limitations

Risks – Do you understand that complications could happen to you and that some of the complications from liposuction can be serious and even occasionally fatal?

Liposuction outcomes – Do you understand that although many people will be satisfied with the outcome after liposuction, that some people will not have the outcome that they wished for?

Understand all the answers to your questions about liposuction

Questions answered – Have you read about and do you understand what liposuction is? Has your doctor answered all of your questions to your satisfaction?

Read and understand the informed consent – Has your doctor given you an informed consent form to take home and read?

Know what to before during and after the liposuction operation

Have a thorough medical exam -Have you had a thorough medical examination and are fit for liposuction?

Arrange for transportation to and from appointment – Can someone drive you home after surgery?

Plan to take a few days to recover – Can you take time off if necessary to recover?

Expect some pain/discomfort – Do you know how much pain to expect?

Know when to seek help – Do you know what the signs are for different complications after liposuction? Do you know when to seek medical help? Did you receive after care instructions from your doctor telling you what to do if you experience problems after liposuction?

Liposuction WA