Are you considering liposuction for body contouring and the removal of unwanted fat? This popular cosmetic procedure has been used successfully since the 1980s. Today, you have more options than ever including micro-lipoplasty for facial contouring and laser lipo techniques that claim to firm up skin and remove fat at the same time.

Liposuction for removing unwanted pockets of fat and smoothing body contours is one of the most popular cosmetic surgery treatments in the United States. For more than a decade, lipoplasty has enjoyed a spot among the top five most commonly requested plastic surgery procedures. According to the American Society of Plastic Surgeons, more than 200,000 patients underwent liposuction in 2010.

History of Liposuction

Lipoplasty has only been a part of the cosmetic surgery scene since the late 1970s. Initially, the treatment simply involved inserting a metal tube into the fatty tissue and using it to break up and suck out fat cells. In 1985, a more effective and less risky technique called tumescent liposuction was introduced. This version of the procedure begins with the injection of a large volume of liquid. This solution generally includes:

  • Saline — to plump up the fatty tissue and make it easier extract with less disruption or damage to muscles and connective tissue
  • Lidocaine — to anesthetize the treatment area
  • Epinephrine — to further numb the area and to minimize bleeding by constricting the blood vessels

This technique has proven so successful at providing results with few complications that it is still used by most cosmetic surgeons today.

Modern Advances in Liposuction

Over the last 20 years, additional liposculpting equipment and methods have been introduced. These include various forms of:

  • Ultrasound assisted liposuction (UAL)
  • Laser lipo (including SmartLipo, CoolLipo and other “name-brand” techniques)
  • Power assisted lipo
  • Water jet assisted lipo

Each of these newly developed technologies is typically used in conjunction with traditional tumescent liposuction. Their purpose is to break up or dissolve fat more efficiently by using heat, vibration or mechanical agitation. Some techniques are also designed to provide a slight firming effect for the overlying skin. The claims made for the various brands of liposculpting equipment are still being explored. At this time, it’s not possible to say if one is substantially better than the other — or if any of them provide superior results compared to traditional tumescent lipo.

Who is a Candidate for Liposuction?

Both women and men are candidates for lipoplasty surgery. Being in good overall health with a stable body weight and excellent skin elasticity are the most important criteria. The closer you are to your ideal weight prior to this surgery, the better. Patients who are committed to staying fit with appropriate diet and exercise are most likely to maintain their results over the long term. Individuals who smoke and those with health conditions that make them higher-risk candidates for any surgery are poor candidates for liposuction.

This surgery works best for reducing discrete areas of fat accumulation. It is ideal for patients who have one or more “bulges” of fat that don’t respond to healthy weight loss techniques. Some of the most popular areas for treatment in male and female patients include:

  • Upper and lower abdomen
  • Love handles/waist
  • Thighs
  • Buttocks
  • Upper arms
  • Face and neck (micro-liposculpting)

Liposuction Procedure Overview

The process begins with a consultation to determine what areas you want reshaped or reduced with liposuction. Your plastic surgeon will take a full medical history as part of the consultation process prior to treatment to evaluate your risks. You will find out where the small scars will be located (usually in areas that are hidden by clothing). This is also the time when you will learn about any potential complications — including rare complications like excessive bleeding and infection. Other potential unwanted side effects may involve:

  • Sagging or uneven skin due to poor elasticity
  • Changes in skin sensation due to nerve damage
  • Changes in skin color (dark patches)
  • Lumps of scar tissue under the skin
  • Fluid buildup requiring surgical drainage

This is the time to discuss sedation options to minimize discomfort. Occasionally, patients are placed under general anesthesia for removal of large volumes of fat. Some patients prefer a light sedative while others do not need any anesthesia besides the local anesthetic in the tumescing solution. Finally, you will be given detailed instructions on how to prepare for surgery and what to do afterward to ensure a speedy recovery.
During the procedure itself, the surgeon:

  • Injects the tumescing solution into the treatment area
  • Creates small incisions for the insertion of the cannula (a hollow metal tube used to break up and extract fat)
  • Inserts the cannula and moves it back and forth under the skin to disrupt fatty tissue and suck it out of the treatment area
    Generally, these small incisions are left open to allow the remaining saline solution to drain out over the next couple of days. This can help reduce post-operative swelling and discomfort.

Liposuction Recovery

Lipoplasty is usually an outpatient procedure and you will be released the same day (you will need someone to drive you home). Following post-op instructions for limiting movement and wearing your compression garment is critical for minimizing discomfort following surgery. Swelling, tenderness, bruising, and numbness are normal following liposuction. These side effects fade over time. Most patients are able to resume non-strenuous activity within a couple of days and feel back to normal within a couple of weeks (although some bruising may still be visible). Swelling is usually the last symptom to disappear. It may take six months or more to see the final results of treatment. This is because it takes some time for skin to adjust into a new position and for the underlying tissues to fully heal. At this time, you should see smoother contours in the reshaped areas.