Liposuction method is used by the cosmetic practitioners so as to eradicate the pockets of excess fat targeting a particular region or part of the Body. So for those people who have a nice body and just one portion doesn’t go well or hinders, the complete structure of body Liposuction proves to be singular and transcendent option.

Liposuction is also known as Body Contouring and it can treat many body parts like- buttock, legs, arms, knees, breasts. It cannot be misunderstood as a substitute for diet or obesity.

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.

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.

To determine if you are a candidate for liposuction (a surgical procedure that vacuums out fat from beneath the skin’s surface to reduce fullness in certain areas), you first should consult with the health care professional who would perform the procedure. That health care professional may be a plastic surgeon, cosmetic surgeon or dermatologist.

The physician will conduct a physical examination and ask you questions about your medical history, what medications you are taking, your diet and exercise history and what you hope to achieve by having this elective surgical procedure.

It’s important that you provide an accurate medical history, including any past or present medical conditions, and what medications, including prescriptions, over-the-counter drugs and dietary and herbal supplements, you are taking. Some types of drugs, such as steroidal medications, aspirin, ibuprofen and vitamin E, thin the blood and can interfere with clotting, and your health care professional most likely will want you to stop taking such drugs about two weeks before surgery.

You may be an ideal candidate for liposuction if you are within 30 percent of your ideal weight, physically fit and healthy and have good skin elasticity, but have pockets of fat in a specific area, such as the hips, thighs, buttocks, arms, neck or chin, that don’t respond to diet and exercise programs. If you have localized fat deposits in specific areas, such as saddlebags on the thighs or extremely wide hips, and good skin elasticity, you may be a candidate for liposuction of those areas to help improve your body proportions.

If you are significantly overweight (more than 30 percent over ideal body weight for your height), appear heavy everywhere with no specific area fatter than others and have loose skin from weight fluctuations, liposuction is unlikely to benefit you. Liposuction is a body contouring procedure; it cannot remove a layer of fat from the entire body.

Additionally, patients with serious medical problems, such as uncontrolled diabetes, heart disease, circulatory problems or lung disease, generally are not candidates for any type of elective surgery, including liposuction. If you have a medical condition, your surgeon will seek medical clearance from your primary health care professional before considering you as a candidate for liposuction surgery. In addition, liposuction is not recommended for patients who are or may be pregnant.

In evaluating whether liposuction is for you, your surgeon may conduct a “pinch test” to assess how much fat is under the skin in the area considered for treatment 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.

At least a half-inch of fat needs to remain after the procedure to ensure a smooth 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. Cellulite is a dimpling of the skin surface. While liposuction of the area may be effective in removing fat bulges and helping clothes fit better, it will not remove cellulite.

During the consultation, discuss with your health care professional:

• Why liposuction can or cannot benefit you
• How the procedure would be done on you
• Where the surgery will be performed
• What kind of anesthesia would be used and your own preferences
• Risks and potential complications
• Confirm that the surgeon has a plan for medical emergencies, if the need arises
• Expected recovery time
• What kind of results you can expect
• What the procedure will cost, since it is elective and not covered by most insurance

Additionally, to make sure you select a surgeon who is right for you, ask questions about what kind of liposuction training he or she has had; whether he or she is certified by the American Board of Plastic Surgery, the American Board of Cosmetic Surgery or the American Board of Dermatology; and how much experience he or she has had performing liposuction.

Ask to see some before and after photographs of his or her patients. You may also want to ask if you can speak with former patients about their liposuction experiences. Additionally, you may want to get a second opinion from another health care professional.

If you decide to have the procedure, you likely will have a preoperative visit with your surgeon in which before photographs of the area to be treated will be taken, consent forms signed and blood drawn for lab testing. If you have a medical condition, your primary health care professional may order additional tests to ensure you are healthy enough to undergo surgery before giving medical clearance for the procedure.

Treatment

Many liposuction procedures can be done in the physician’s office-based operating room or an outpatient hospital operating room. Patients having large amounts of fat removed through liposuction or cosmetic procedures in addition to liposuction may spend the night in the hospital after surgery.

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.

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.

The technique used for your liposuction surgery depends on you and your particular problem area, your surgeon’s preference, the location and number of areas to be treated and the amount of fat to be removed.

The most commonly used techniques today include:

Tumescent and super-wet.

Basic liposuction involves infusing the area to be treated with a solution of saline; lidocaine, an anesthetic; and epinephrine, a drug that constricts blood vessels to curb bleeding. The difference between techniques is the total amount of fluid used. 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 the same as the amount of fat slated for removal. Which version of these two techniques is used depends on your surgeon’s preference and judgment regarding which is best for you.What kind of anesthesia is used for these techniques also depends on the amount of fat to be removed and your surgeon’s preferences and medical judgment pertaining to what is best for you. Because the large volume of fluid used in the tumescent technique includes an anesthetic, your surgeon may not administer additional anesthesia before the procedure, especially when a small amount of fat is to be removed, such as 1.5 liters or less from one or two areas on the body.

In such cases, a sedative in pill form may be given to relax you before surgery begins. Because the super-wet technique uses less anesthesia-containing fluid, additional anesthesia, such as an intravenous sedation, an epidural block or general anesthesia is used. General anesthesia is more common when large amounts of fat, such as more than 1.5 liters, are to be removed, or multiple areas on the body, such as thighs and hips, are to be treated.

In these fluid infiltration techniques, a thin metal tube is inserted into the fat layer beneath the skin in the area to be treated. This tube is attached to an infusion pump, which pumps the solution into the area. This tube is removed and, after waiting for the anesthesia in the solution to take effect, an incision is made into the skin to accommodate a small hollow tube. This tube, called a cannula, is attached to a vacuum.

The cannula is inserted through the incision into the fat layer beneath the skin. It is moved through the fat layer in a push-and-pull motion to break up the fat and suck it out of the body.The surgeon may make two to more incisions in each area for insertion of the cannula in various locations in the treatment area to suction out fat from different directions. Using a crisscross technique helps avoid creating tunnels in the fat that would result in wavy-looking skin irregularities after surgery.

Ultrasound-assisted.

This technique uses the same basic preparation as tumescent and super-wet liposuction, but employs a different type of cannula that emits ultrasound waves at its tip to liquefy the fat and then suctions it out of the body.When the ultrasonic energy hits the fat, the high-frequency vibrations explode the fat cells. The fat mixes with body fluids and the infused solution and is sucked out of the body.

The real potential advantage of ultrasonic-assisted liposuction is the possibility for increased skin tightening. Also, in areas of the body that have a lot of fibrous tissue, such as the male chest, the addition of ultrasonic energy may provide a significant advantage.Disadvantages to the ultrasound-assisted liposuction procedure may include a more obvious scar due to a larger opening required for insertion, increased discomfort and a higher incidence of complications, such as skin burns and seromas (a collection of body fluid causing swelling).

The latest generation of ultrasonic liposuction systems are much safer, and these complications occur much less frequently.Like other liposuction techniques, anesthesia for ultrasound-assisted liposuction varies from local to general, depending on the individual patient, how much fat is to be removed and the surgeon’s preference.

Laser-assisted.

Similarly to ultrasound-assisted liposuction, laser-assisted liposuction, introduced in 2007, uses thermal (heat) energy to liquefy the fat. As with other liposuction techniques, laser-assisted liposuction involves the use of tumescent solution and standard liposuction to remove the liquefied fat. During the procedure, the surgeon inserts a thin laser fiber through small incisions in the skin.

In addition to breaking up fat cells, the laser heats surrounding tissues. Side effects may include bruising, swelling, numbness, burns and minimal bleeding. Some studies have found no differences between the laser-assisted liposuction and standard liposuction techniques in terms of results, but many surgeons and some recent studies suggest enhanced skin tightening with laser-assisted liposuction

Power.

Using the same basic techniques as tumescent and super-wet liposuction, power liposuction, also called power-assisted liposuction, involves use of a motorized cannula. In addition to the surgeon physically moving the cannula back and forth through the fat to help break it up while suctioning, the cannula moves or vibrates itself under electrical or nitrogen power, moving short stroke distances.

Meanwhile, the surgeon manipulates the direction of the cannula. Surgeons favoring power liposuction say it permits them to perform the procedure faster and with more precision, resulting in less trauma to surrounding tissues, and therefore, less bruising and discomfort and quicker recovery times. Power liposuction can be performed under local anesthesia or with IV sedation or general anesthesia.

Because liposuction vacuums out body fluids along with fat, patients should have intravenous fluid replacement while undergoing liposuction to prevent dehydration and shock.

After the procedure is complete, the incisions may be closed with stitches; in some cases, incisions are so small they do not require stitches. A compression garment is then placed over the body area treated. For a hip and thigh treatment, for example, a girdle-type garment is used. The garment smooths the treated area to help healing so the skin appears flat, and it helps control swelling. Most patients wear compression garments for one to six weeks, but they appear to be most effective in the first seven days after surgery. Your health care professional also may give you a prescription for postoperative pain, such as acetaminophen with codeine. An antibiotic also may be prescribed.

Patients usually are told to rest for at least two days after surgery. Many patients have their surgery on a Friday morning, return home that afternoon, rest over the weekend and resume work on Monday. Normal exercise and activities can be resumed in about a week or two. A follow-up visit to check on progress and remove any stitches is usually required five days to a week after surgery.

Common temporary postoperative side effects of liposuction are bruising, swelling and numbness of the skin in the area treated. They usually are temporary and subside in six weeks or less. Swelling, however, may take several months to disappear.

Although it is usually done on an outpatient basis and may be performed in your health care professional’s office surgical suite, you must recognize that liposuction is still surgery, and all surgeries carry risks, including death.

Among the extremely rare, potentially life-threatening complications are:

• Anesthesia-related problems, such as breathing difficulties and fluid in the lungs
• Blood clots or fat clots that can migrate to the lungs
• Perforation of organs with the cannula
• Burning of tissues in ultrasound-assisted or laser-assisted liposuction

Uncommon complications include:

• Bleeding
• Excessive bruising
• Infection
• Seromas, or pockets of fluid collection under the skin, also can occur when large amounts fat are removed, but usually can be treated in an office setting by draining with a needle and syringe (seromas tend occur more often with ultrasound-assisted liposuction).

More common complications include:

• Irregularities in contour, such as lumps or divots where too little or too much fat was removed
• Asymmetry, where the contour differs on each side of the body
• Skin irregularities, such as loose, baggy or wavy skin

Many of the complications can be the result of poor surgical technique, lack of experience in the procedure or poor patient selection. Contour and symmetry problems can require additional, touch-up liposuction surgery, known as revision surgery. Various studies in the medical literature have reported revision rates ranging from five percent to 20 percent, depending on the type of patient, the number of areas treated at one time and how much fat was removed. A small amount of fat is considered less than 1.5 liters, while a large amount is four to five liters. Special considerations are needed when large amounts of fat (usually more than five liters) are removed.

Risks

Liposuction done by an experienced doctor in a properly equipped facility is usually safe. 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.

Facts to Know

1. Liposuction is the most popular form of cosmetic surgery among both men and women in the United States, with 283,735 procedures performed in 2009, according to the American Society for Aesthetic Plastic Surgery.
2. Thirty-eight percent more women had liposuction in 2009 than in 1997, according to the American Society for Aesthetic Plastic Surgery.
3. Liposuction is an elective surgical procedure that contours the body.
4. Liposuction is not a weight-loss technique.
5. Body contour improvements produced by liposuction are permanent.
6. Each person has a set number of fat cells and, when weight is gained, the size of the fat cells increases, but not the number. Liposuction works by removing some fat cells.
7. The best candidates for liposuction are healthy, fit people within 30 percent of their ideal body weight with elastic skin who have isolated areas of fat that do not respond to diet and exercise.
8. Irregularities in body contours and symmetry are possible common complications of liposuction that can require additional, touch-up surgery.
9. Like any surgery, liposuction carries risks, including death. When performed by experienced, skilled surgeons, life-threatening complications are extremely rare. Other complications, such as bleeding, excessive bruising, infection and pockets of fluid collection under the skin, are also uncommon.
10. A small amount of fat removal during liposuction is considered less than 1.5 liters, while a large amount is four to five liters. Removing more than five liters of fat in a single liposuction treatment is considered too risky by most surgeons unless performed in a hospital with an overnight stay.

Key Q&A

1. What exactly is liposuction?Liposuction, also called lipoplasty or suction lipectomy, is a surgical procedure that vacuums 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.
2. How long will the new body contours produced 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 grows larger, but the cells 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.
3. 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 within 30 percent of your ideal weight 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.
4. 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 to 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.
5. I’ve heard people can die from liposuction. Is that true?As with any 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

   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.

6. 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. Recently introduced laser-assisted liposuction uses laser energy to liquefy the fat. And a fairly 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.
7. 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 be 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 a hospital or an ambulatory surgery center under regional or 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.
8. 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.

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