What You Need to Know About Liposuction

Reviewed by Munish K. Batra, MD, FACS

Liposuction may be termed in a variety of ways to describe the procedure designed to remove localized fat in one or more areas of the body, including abdominal liposuction (stomach liposuction), face liposuction (chin liposuction and cheek liposuction), neck liposuction, as well as liposuction of the thighs and arms.

Most people who choose liposuction are women, but male liposuction has become more and more popular in recent years.

The Liposuction Procedure

This plastic surgery procedure is typically performed under general anesthesia, but in some cases, local anesthesia. The decision for which type of anesthesia to use involves both you and your doctor and takes into account how much time the surgery takes. Time in surgery varies, depending on the size of the area being treated, but it is usually less than an hour. However, many people choose to treat multiple areas, which will increase the total time. General anesthesia is also preferred for people who wish to avoid the possibility of anxiety or discomfort that they may associate with the procedure.

With more recently developed techniques such as tumescent liposuction, local anesthetics provide both a numbing effect and a means to help remove fat. Also, a local anesthetic may be better when removing small areas of fat in one region that doesn't require much time in surgery.

Fat deposits adhere to the underside of the skin and can be removed if they can be dislodged. First, you would receive a local anesthetic in the area to be treated, as well as any additional anesthetics that you and your doctor decide upon. Your surgeon would make an incision and insert a cannula (a long, hollow needle) under the skin, scraping it along the underside skin surface to loosen the fat deposits. The fat deposits are then sucked into the vacuum through a tube connected to the cannula.

Mainstream Liposuction Techniques

Under the mainstream liposuction category are three tried-and-true options for the permanent removal of localized fat:

Tumescent Liposuction, otherwise known as Micro-Liposuction: In tumescent liposuction your surgeon would first inject a large amount of anesthetic solution into the tissue, causing it to swell and become firmer. Currently this technique is considered the safest and most effective. [Learn more about tumescent liposuction.]

Ultrasound-Assisted Liposuction, also called Ultrasonic Liposuction: In ultrasound-assisted liposuction, ultrasonic wave energy ruptures the fat cells so they are liquefied before removal. It may be a good option in places where the tissue is firm or especially fibrous, or when large amounts of fat are to be removed. This method takes significantly longer to complete than tumescent liposuction.

Superwet Technique: The superwet technique is similar to the tumescent technique, but the amount of fluid is equal to the amount of fat to be removed.

Emerging Techniques

In the emerging techniques category, one involves liposuction, and the other two do not. These techniques have not been tested over a long enough period of time to determine the long-term quality of the results. Please note that some doctors may be familiar with these techniques, and others may not.

Smartlipo, also known as Laser-Assisted Lipolysis: In laser-assisted lipolysis, which was FDA-approved in November 2006, the Smartlipo laser system uses a cannula that contains a laser fiber. The laser energy ruptures the fat cells before they are vacuumed through the cannula. The laser's energy also causes the tissue to coagulate and possibly tighten. The treatment may be more suitable for small areas than for large ones, and possible risks include burning.

Two techniques that may be liposuction alternatives are lipodissolve and mesotherapy. These techniques involve the injection of medications that produce a chemical reaction in conjunction with the body's physiology to dissolve localized areas of fat. [Read more about lipodissolve.]

Liposuction Incision Size

The location of the liposuction treatment plays an important role in determining the size of the cannula and the number of incisions. The most common liposuction cannulas are 3 mm, but they can range from 1.5 mm to 6 mm. For smaller cannulas, more incisions are needed, but the incisions are smaller and leave less scarring. Larger cannulas with larger incisions achieve results over a larger area through possibly only one incision. In either case, your surgeon works to minimize scarring as much as possible.

After Liposuction

The skin will be swollen and sore, and this can last for several days. In some cases the incisions are left open temporarily so that fluids and residual fatty deposits can empty through an inserted drain. An antibiotic may be prescribed to reduce the possibility of infection.

Often the treatment area is wrapped with elastic bandages, or support hosiery or a girdle is prescribed, to compress tissue and help control swelling and bruising. Your surgeon may want you to wear the bandage or garment for several days.

Liposuction final results may not be fully evident for up to six months. Liposuction can be repeated for a given area of the body a number of times, as long as the area has completely healed from the previous treatment. But this is not usually necessary, because with traditional liposuction the fat removal is permanent.

For Liposuction, Consult a Qualified Surgeon

Liposuction is a widely performed procedure, and the health risks from complications are low; however, it is always best to consult a board-certified plastic surgeon who has extensive experience with liposuction specifically in the area that you are having treated. The technique used, the choice of cannula, and the number of incisions can have a great impact on the results and on your satisfaction. A qualified surgeon will use the most appropriate techniques for your condition, increase your odds of success, and reduce the risk of complications.

Liposuction is sometimes performed in conjunction with other procedures, such as facelift and breast reduction. When appropriate, combining treatments can save you time and money, but it is important to choose a surgeon who is well qualified in all the procedures to be performed. For more information on this, please read our article on comprehensive treatment plans.

Related Topics

• Plastic surgeons discuss how to get bikini ready for summer
• Abdominal etching
• Top five cosmetic surgery procedures for 2007

[page updated May 2008]