Liposuction

Liposuction is an operation which is designed to diminish localized pockets of extra fatty tissue.  Many people who are otherwise well-proportioned have extra fatty tissue either on their abdomen, inner or outer thighs, outer hips, back (upper or lower) or above their knees.  These areas are disproportionately full compared to the rest of their bodies.  These localized areas are unfortunately extremely resistant to either exercise or diet and can persist even in the face of generalized slenderness.  Liposuction can make these areas smaller.  It is not an operation which is effective or designed for people with generalized obesity.  Being overweight should be targeted by diet and exercise, but localized fat can be addressed by liposuction.  Liposuction will help your clothes to fit better.  You may or may not go down a size.

The technique of liposuction usually involves IV sedation in my accredited office surgery suite and the use of very small incisions combined with a cannula which suctions out excess fatty tissue.  I generally perform a tumescent or “super-wet” technique.  Depending on the skin tone and the size of the fatty deposit, liposuction can accomplish either complete removal of the bulge or an improvement.  The ideal patient has good skin tone which will shrink and accommodate to the new size and shape.  A patient with poor tone may develop some skin irregularities, and I will be more conservative in removing fat.

Smokers heal poorly in terms of infection and wound breakdown, and you are advised not to smoke for at least 1 month before and after surgery. Nicotine screening may be necessary the day of your surgery.  

The operation lasts from a half hour to 2 ½ hours depending on the amount removed and number of areas which will be approached.  There is a limit to how much fat can be aspirated at once.  My maximum limit is about 2 liters (2 quarts).  This is in accordance with the recommendations of the American Society of Plastic Surgeons.

After surgery, patients are asked to wear elastic garments for 1-3 weeks.  You will bring a girdle or spandex exercise shorts with you to the office the day of your procedure.  You may need to take an over-the-counter iron supplement (SlowFe) for 1 month after your surgery.  Patients are advised to avoid strenuous exercise for approximately 2 weeks.  Most patients are able to return to work within 1 week after surgery.  The procedure is somewhat uncomfortable but usually not particularly painful.  Patients should expect that for the first few weeks or so they may be bruised and swollen.  This is routine.  Patients see an improvement in the contour soon after surgery, but this improvement continues to get better as time goes by and the swelling diminishes.  It will take up to 6 months to see the final result.

The worst complication that can happen from liposuction is the development of a clot in one of the veins of the legs.  It is for this reason as well that I am reluctant to perform liposuction on extremely obese patients.  Fortunately, this complication is extraordinarily rare.  In order to prevent this, you will need to get out of bed the very first night after surgery.  Other complications which could occur are a hematoma or a localized collection of blood or fluid which might need to be drained (less than 1 in 200).  Numbness of the skin is common and usually temporary.  The risk of infection is about 1%.  “Cellulite,” which is superficial ridges or dimpling of the skin, is NOT improved by liposuction.  There is a small possibility that this can be worsened by liposuction if skin tone is poor.  Liposuction can very rarely create some ridges or dimpling, and this can be corrected by fat grafting.  I cannot guarantee perfect symmetry after this procedure, and there is the occasional need for a touch-up with local anesthesia in 6 months for minor asymmetry.  In the rare event that you have a medical complication following a cosmetic procedure, I have purchased health insurance for all my cosmetic surgery patients through the CosmetAssure program.  This is important because your own health insurance does not cover medical problems from cosmetic procedures.

Remember that your diet, exercise and metabolism have led you to be a specific weight.  That dynamic still exists after the surgery, so your new weight needs to stabilize a few pounds less than your current weight to maintain your new shape.

By the way, if you wish, some of the fat which has been suctioned can be “recycled” into your face as fat grafts.  This fat can be used to fill your cheeks, chin, nasolabial folds or lips.  Unfortunately, some of this fat will reabsorb, but some of it will remain permanently.  The main risk of this procedure is that you may bruise, but is a very reasonable thing to do if we are already going to do liposuction.

It will be a pleasure to discuss liposuction with you.  Please call my office with any questions (804-320-8545).