What is liposuction?
Liposuction is the surgical removal of body fat. Also called lipoplasty, body shaping, and body contouring, liposuction can remove excess fat tissue on many body areas. These include the abdomen, buttocks, back, face, neck, arms, breasts, hips and legs. Most often people seek liposuction for aesthetic reasons. However, in some cases, doctors use liposuction to treat medical conditions involving excess fat deposits, such as gynecomastia and lipoma.
Liposuction is one of the most common cosmetic surgical procedures in the world. It is also major surgery with significant risks and potential complications. You may have less invasive treatment options. Consider getting a second opinion about all of your treatment choices before having a liposuction.
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Why is liposuction performed?
Your doctor may recommend liposuction as a medical treatment for certain conditions that cause a buildup of excess body fat. However, liposuction is most commonly a cosmetic surgical procedure to change the size and shape of the body, such as in the thighs, abdomen and breasts. Your doctor may only consider liposuction if other treatment options that involve less risk of complications have not worked. Ask your doctor about all of your treatment options and consider getting a second opinion.
Liposuction is a surgery your doctor may use to remove excess body fat caused by:
Gynecomastia, which is excess breast tissue growth in men
Heredity, which causes body fat deposits that healthy diet and regular exercise cannot eliminate
Lipoma, which is a benign (noncancerous) type of slow-growing tumor made up of fat cells (adipocytes). Lipomas are usually small but can grow quite large. Liposuction is not the standard treatment for removal of these benign tumors but can be performed in selected cases.
Who performs liposuction?
Plastic surgeons often perform liposuction. A plastic surgeon is a specialist in aesthetic and reconstructive surgery. Dermatologists, doctors who specialize in treating conditions of the skin, hair and nails, may also perform liposuction.
How is liposuction performed?
Liposuction is performed in a hospital, a surgeon's office, or an outpatient surgery clinic.
Surgical approaches to liposuction
Your surgeon will perform liposuction using one of the following approaches:
Traditional liposuction, also called tumescent or fluid injection liposuction, is the most common type of liposuction. Your surgeon makes a few small incisions in the fat removal area and injects a fluid mixture containing a salt solution, a local anesthetic, and epinephrine through the incisions. This fluid prevents excessive blood loss, swelling, and bruising. Your surgeon then inserts a thin, hollow tube called a cannula into the incisions and pumps it back and forth to loosen and dislodge the fat cells. A small surgical vacuum or syringe is used to remove the fat through the cannula.
Ultrasound-assisted liposuction (UAL) is a type of liposuction that the Food and Drug Administration (FDA) approved for use in the United States in 1996. Your surgeon makes a few small incisions in the fat removal area and uses ultrasonic vibrations to heat and break up the fat. Your surgeon will apply these ultrasound vibrations above your skin with an emitter device, or below the skin with an ultrasonic cannula (a thin tube). A small surgical vacuum or syringe is used to remove the fat through the cannula.
Laser-assisted liposuction is also called by its brand name: SmartLipo. The FDA approved laser-assisted liposuction in 2007. Your surgeon makes a few small incisions in the fat removal area and injects a fluid mixture containing a salt solution, a local anesthetic, and epinephrine through the incisions. This fluid prevents excessive blood loss, swelling, and bruising. Your surgeon inserts a thin laser fiber into the incisions to heat and loosen the fat. A small surgical vacuum or syringe is used to remove the fat through a cannula.
Your surgeon will determine which type of surgery is best for you. Learn about the different liposuction procedures and ask why your surgeon will use a particular type for you.
Types of anesthesia that may be used
Your surgeon will perform liposuction using either regional anesthesia or general anesthesia:
General anesthesia is a combination of intravenous (IV) medications and gases that put you in a deep sleep. You are unaware of the procedure and will not feel any pain.
Regional anesthesia is also known as a nerve block. It involves injecting an anesthetic around certain nerves to numb a large area of the body. To numb a smaller area, your doctor injects the anesthetic in the skin and tissues around the procedure area (local anesthesia). You will likely have sedation with regional anesthesia to keep you relaxed and comfortable.
What to expect the day of your liposuction
The day of your surgery, you can expect to:
Talk with a preoperative nurse. The nurse will perform an exam and ensure that all needed tests are in order. The nurse can also answer questions and will make sure you understand and sign the surgical consent.
Remove all clothing and jewelry and dress in a hospital gown. It is a good idea to leave all jewelry and valuables at home or with a family member. The surgical team will give you blankets for modesty and warmth.
Meet with your surgeon. Your surgeon will use a special pen to mark the area(s) of your body where fat will be removed.
Talk with the anesthesiologist or nurse anesthetist about your medical history and the type of anesthesia you will receive.
A surgical team member will start an IV.
The anesthesiologist or nurse anesthetist will start your anesthesia.
A tube will be placed in your windpipe to protect and control breathing during general anesthesia. You will not feel or remember this or the surgery as they happen.
The surgical team will monitor your vital signs and other critical body functions. This occurs throughout the procedure and your recovery until you are alert, breathing effectively, and your vital signs are stable.
What are the risks and potential complications of liposuction?
As with all surgeries, liposuction involves risks and potential complications. Complications may become serious and life threatening in some cases. Complications can develop during the procedure or throughout your recovery.
General risks of surgery
The general risks of surgical procedures include:
Anesthesia reaction, such as an allergic reaction, toxicity, and problems with breathing
Bleeding, which can lead to shock
Blood clot, in particular a deep vein thrombosis that develops in the leg or pelvis. A blood clot can travel to your lungs, heart or brain and cause a pulmonary embolism, heart attack, or stroke.
Infection and septicemia, which is the spread of a local infection to the blood
Potential complications of liposuction
Potential complications of liposuction include:
Body asymmetry caused by removing different amounts of fat tissue from different body areas
Damage to skin, muscle, nerves, and internal organs
Fat embolism, which are loosened fat cells that enter the bloodstream and block blood flow
Irregularities in skin texture or contour, such as dimpling or bagginess
Pooling of liquid where fat is removed
Skin burns from ultrasound-assisted liposuction
Swelling, which can take months to go away
Skin necrosis, which is death of skin cells above the fat removal area. This can lead to a serious infection.
Reducing your risk of complications
You can reduce the risk of certain complications by following your treatment plan and:
Following activity, dietary and lifestyle restrictions and recommendations before surgery and during recovery. This includes physical therapy, occupational therapy and other rehabilitation treatments.
Informing your doctor if you are nursing or there is any possibility that you may be pregnant
Notifying your doctor immediately of any concerns, such as bleeding, fever, increase in pain, or wound redness, swelling or drainage
Taking your medications exactly as directed. Your doctor may prescribe an antibiotic before surgery to prevent infection. Take this as directed.
Not smoking. Many plastic surgeons will not perform elective surgery on smokers because of the increased risk of complications.
Telling all members of your care team if you have any allergies
How do I prepare for my liposuction?
You are an important member of your own healthcare team. The steps you take before surgery can improve your comfort and outcome. You can prepare for liposuction by:
Answering all questions about your medical history and medications you take. This includes prescriptions, over-the-counter drugs, herbal treatments, and vitamins. It is a good idea to carry a current list of your medical conditions, medications, and allergies at all times.
Getting preoperative testing as directed. Testing will vary depending on your age, health, and specific procedure. Preoperative testing may include a chest X-ray, EKG (electrocardiogram), blood tests, and other tests as needed.
Losing weight before surgery through a healthy diet and exercise plan.
Not eating or drinking just prior to surgery as directed. Your doctor may cancel your surgery if you eat or drink too close to the start of the procedure because you can choke on stomach contents during general anesthesia.
Stopping smoking as soon as possible. Even quitting for just a few days can be beneficial and help the healing process.
Taking or stopping medications exactly as directed. This may include not taking aspirin, ibuprofen (Advil, Motrin), and blood thinners.
Questions to ask your doctor
Facing surgery can be stressful. It is common for patients to forget some of their questions during a doctor’s office visit. You may also think of other questions after your appointment. Contact your doctor with any concerns or questions before surgery and between appointments.
It is also a good idea to bring a list of questions to your appointments. Questions can include:
What kind of training and experience do you have in performing liposuction?
Am I good candidate for liposuction? Are there any other options for treating my condition?
What type of liposuction procedure will I need?
How long will the procedure take? When can I go home?
What kind of restrictions will I have after the surgery? When can I return to work and other activities?
How should I care for my incisions? When can I shower?
How will I look after the surgery?
What kind of assistance will I need at home?
What medications will I need before and after the surgery? How do I take my usual medications?
How will you manage my pain?
- When should I follow up with you?
How should I contact you? Ask for numbers to call during and after regular office hours.
What can I expect after my liposuction?
Knowing what to expect can help make your road to recovery after liposuction as smooth as possible.
How long will it take to recover?
Most people stay in the surgeon’s office, surgical center, or hospital for an hour or two after a liposuction. Some people may stay in the hospital overnight. Your care team will discharge you when you are alert, breathing normally, and your vital signs, such as blood pressure and pulse, are stable. You may still be drowsy from sedation or anesthesia, so you will need a friend or family member to give you a ride home from your surgery.
When you wake up from surgery, you may have a sore throat if a tube was placed in your windpipe during surgery. This is usually temporary, but tell your care team if you are uncomfortable.
You will have bandages and possibly a compression garment covering the surgical area. The compression garment will help minimize swelling and maintain the new body shape. You may also have small drains in your incisions for a few days to drain away excess fluid and blood. Your doctor will remove them when drainage has stopped. You will most likely have swelling and bruising on the surgical area. The bruises should lessen within a few weeks.
Recovery after surgery is a gradual process. Recovery time depends on the specific type of liposuction, the amount and areas of fat removal, your general health, age, and other factors. Full recovery may take from weeks to months, and it may take up to a year for your swelling to completely subside to show your more permanent body shape.
Will I feel pain?
Pain control is important for healing and a smooth recovery. There will be discomfort after your surgery. Your doctor and care team will treat your pain so you are comfortable and can get the rest you need. Contact your doctor if your pain gets worse or changes because it may be a sign of a complication.
When should I call my doctor?
It is important to keep your follow-up appointments after liposuction. Call your doctor if you have any concerns or questions between appointments. Call your doctor right away or seek immediate medical care if you have:
Breathing problems, such as shortness of breath, difficulty breathing, labored breathing, or wheezing
Change in alertness, such as passing out, unresponsiveness, or confusion
Chest pain, chest tightness, chest pressure, or palpitations
Fever. A low-grade fever (lower than 101 degrees Fahrenheit) is common for a couple of days after surgery. It is not necessarily a sign of a surgical infection. However, you should follow your doctor's specific instructions about when to call for a fever.
Inability to urinate, pass gas, or have a bowel movement
Leg pain, redness or swelling, especially in the calf, which may indicate a blood clot
Pain that is not controlled by your pain medication
Unexpected drainage, pus, redness or swelling from your incisions or drains
How might liposuction affect my everyday life?
If you have liposuction for a medical disease or condition, such as a lipoma, the liposuction may cure your condition or significantly reduce your fat deposits. If you have liposuction for cosmetic reasons, the new appearance of your affected body area or areas may give you increased satisfaction with your appearance and increase your self-confidence.
The effects of liposuction, however, may be lost if you gain excessive weight. Many surgeons caution that it is important to be realistic about how much liposuction may improve your self-image, so be aware of what cosmetic liposuction can and cannot do for your overall appearance.
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- Continuous peripheral nerve blocks in acute pain management. British Journal of Anaesthesia. http://bja.oxfordjournals.org/content/105/suppl_1/i86.abstract.
- Laser and Ultrasound Assisted Liposuction. American Society of Plastic Surgeons. http://www.plasticsurgery.org/Cosmetic-Procedures/Laser-and-Ultrasound-Assisted-Liposuction.html.
- Laser-assisted liposuction (SmartLipo). American Society of Plastic Surgeons. http://www.plasticsurgery.org/news-and-resources/technology-briefs/laser-assisted-liposuction-%28sma....
- Lipoma. Healthgrades. http://www.healthgrades.com/conditions/lipoma.
- Liposuction Information. U.S. Food and Drug Administration. http://www.fda.gov/MedicalDevices/ProductsandMedicalProcedures/SurgeryandLifeSupport/Liposuction/def....
- Liposuction Procedure. American Society of Plastic Surgeons. http://www.plasticsurgery.org/Cosmetic-Procedures/Liposuction.html.