Liposuction

Liposuction, or liposculpture, is a cosmetic surgery procedure that removes excess fat from various parts of a person's anatomy, using small, hollow instruments connected to a medical-grade vacuum. Liposuction has been proven to be such a safe, effective procedure that it ranked as the most frequently performed surgical cosmetic procedure in 2005. However, while liposuction is sometimes prescribed as treatment for fat tumors like lipomas, it's generally considered a cosmetic choice rather than a medical necessity, so few if any health insurance plans cover the procedure. Even so, liposuction has become an increasingly affordable choice for millions of Americans.

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The ideal liposuction patient is someone of average weight, in good physical condition, who has firm, elastic skin but carries sections of fat that can't be removed through dieting and regular exercise. Liposuction is not recommended as a treatment for obesity, although, in rare instances, it may be used as a supplement to other, more targeted obesity procedures.

There are several different ways to perform liposuction. The most common, traditional technique starts with an injection of fluid (made up of salt solution, an anesthetic, and epinephrine) into the targeted area. This injection numbs the area, firms up the skin around it, and reduces blood loss and bruising. Once the area is desensitized, the surgeon makes a small incision in the skin and inserts a hollow, stainless steel tube known as a cannula. The surgeon moves the cannula back and forth across the fat deposit to break it up, then uses a vacuum pump or a large syringe to remove the fat from the patient's body.

The length of this procedure will vary, depending on how many fatty deposits are being removed, the size and mass of each deposit, and the type of anesthesia involved. While some patients only require local anesthesia and an IV sedation drip, other patients may need to be put under general anesthesia.

Other, more recently developed liposuction techniques include:

• Tumescent liposuction, which uses larger amounts of fluid (up to three times the amount of fat to be removed) and anesthesia. This technique can last up to five hours, which is longer than traditional liposuction usually takes.
• Super-wet liposuction, in which the amount of fluid injected into the fatty area is approximately equal to the amount of fat that will be removed. Patients undergoing super-wet liposuction will be put under general or intravenous anesthesia.
• Ultrasound-assisted lipoplasty, or UAL, in which the walls of the fat cells are liquefied with ultrasound waves before being removed via the traditional liposuction method.

During and immediately after the procedure, the patient needs to be watched closely for signs of fluid loss and leaking from the site of the incision(s). The surgical team will apply dressings to the liposuction site, and the patient will be fitted with a specialized garment that will be worn for a month or so, depending on the location of the removed fat area.

After a few hours of observation at the hospital, surgical center or surgeon's office, most patients can go home the same day with a spouse or close friend who can monitor the patient for 12 to 24 hours. However, if the patient has had large areas of fat removed, the surgeon may choose to keep the patient in the hospital overnight. Although soreness, swelling and bruises can last up to several weeks, most liposuction patients are cleared to go back to work within a few days of the procedure and can resume normal activities in a couple of weeks.

The results of the liposuction are permanent but limited. The targeted fat cells have been removed for good, but liposuction is not a suitable substitute for dieting and exercise. Patients will need to stick to an effective diet and exercise program to keep their weight off and maintain their new shape.