Removal of body fat by suction (liposuction) has been done in the United States since 1982. Today, it is proven to be a safe and effective surgical alternative that can result in a better body contour with minimal scarring. The procedure offers the best result when it is used to remove localized areas of unwanted fat after a person has reached a desirable weight through diet and exercise.
Liposuction normally is performed under general anesthesia, but also can be performed using local anesthetics and sedation in selected circumstances. In either case, however, liposuction is often performed as an outpatient procedure. When a patient wants to have large amounts of fat removed, it is safer to keep the patient in the hospital. In these cases, the physician may recommend that the patient donate several units of his or her own blood that can be used during the surgery. The length of the procedure varies depending on how much fat is removed.
The areas of the body that respond well to liposuction include the abdomen, flanks, hips, buttocks, thighs, knees and legs. Some of the areas, such as the abdomen, hips, buttocks and thighs, yield particularly rewarding results in selected patients.
During liposuction, a small incision is made near the area where the fat will be removed. A thin, blunt-tipped, hollow rod is inserted under the skin and carefully manipulated through the fat tissue. The hollow rod is attached to a vacuum source which suctions out unwanted fat cells. When the fat is removed, the surgeon closes the incisions and applies a dressing. Following surgery, patients wear special conforming garments under their clothes and over the area of fat removal. This minimizes swelling and discoloration, and helps the healing process. However, there will be some swelling and discoloration. The discoloration subsides in several weeks, but the swelling may take several months to subside.
Following surgery, moderate discomfort is well controlled with oral pain medicine. Patients must drink extra fluids postoperatively. Gatorade is a good fluid to drink because it contains electrolytes. After about one week, patients can return to near normal activity, but they should wait several weeks before resuming strenuous exercise.
Complications following liposuction can occur, but are relatively uncommon. Although liposuction has become one of the most commonly performed cosmetic operations in this country, there have been a few deaths that have resulted from infection or blood clots in the lungs. Minor complications include serum- or blood-filled pockets underneath the skin. In most cases, these minor problems will resolve with time. Occasionally, antibiotics are required for minor infections.
The most common problem following liposuction is waviness of sagging skin which results from irregular fat removal or inadequate skin shrinkage over the newly contoured areas. In some cases, there may be depressions from too much fat removal. Sometimes a minor secondary procedure is necessary to achieve optimal results. Cellulite (dimpling) and other surface irregularities that were present before surgery will still be present following the procedure.
Overall, liposuction is a safe and effective procedure for removal of unwanted body fat. The best results can be achieved on younger people who have good skin tone and very focal deposits of extra fatty tissue. However, many older people are quite pleased with their results if they have realistic expectations and recognize the limitations of the surgery.
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