Liposuction

What is liposuction?

Liposuction is a type of surgery that removes fat from the body. This is done using a thin, metal tube called a cannula. The cannula sucks out the fat like a vacuum. This is the most common form of liposuction surgery. It’s called suction-assisted liposuction (SAL).

Another form of this procedure is power-assisted liposuction (PAL). It uses a motor attached to the cannula to speed the rate of fat removal.

Another type of liposuction is laser-assisted liposuction (LAL). It uses laser energy to liquefy fat cells. They are then suctioned out of the area.

A minimally invasive form of liposuction is called radiofrequency-assisted liposuction (RFAL). As radiofrequency waves melt (liquefy) the fat, it is immediately suctioned from the body using a cannula. These waves also stimulate your body to make collagen beneath the skin. This makes the skin look firmer and more toned.

Other procedures use ultrasound energy (sound waves) to liquefy fat cells. They are then suctioned out of the area. This is called ultrasound assisted liposuction (UAL).

Insurance typically does not cover liposuction. It is considered cosmetic surgery.

Why might I need liposuction?

Liposuction is mainly a cosmetic procedure. It can help improve your body image and change the way you look. It's best used for:

• Fat deposits in your body that aren’t in proportion with the rest of your body. and don’t go away with exercise or diet

• Areas that have good skin elasticity and minimal amounts of excess skin

It can be used to enhance and reshape many parts of the body:

• Buttocks

• Hips

• Stomach

• Waist

• Back

• Arms

• Neck

• Thighs

• Calves

• Ankles

• Breasts

Liposuction is used in both men and women.

What are the risks of liposuction?

Risks depend on where and the amount of treatment done. The risks may include:

• Reactions to the medicines used during the procedure

• Bleeding or blood clots, heart and lung complications

• Cannula breakage

• Indentations or body irregularities at the site(s) of the liposuction

• Collections of blood or fluid under the skin that may need to be drained with a needle

• Scarring

• Damage to nearby body parts and organs, such as muscles, nerves, and blood vessels

• Infection

• Loss of feeling in the treated area(s)

• Ongoing pain in the treated area

• Thermal burn or heat injury from ultrasound with the ultrasound-assisted lipoplasty method

• Irregular skin coloring

• Poor wound healing

In some cases, you may not be satisfied with the results from liposuction. You may need to have another procedure to correct any problems. Liposuction will not take care of loose or hanging skin.

Pregnancy, weight gain, and aging can affect results.

If you have certain health conditions, such as high blood pressure, diabetes, or thyroid problems, you may not be a good candidate for liposuction. You’ll want to discuss any medical problems you have with your surgeon.

There may be other risks, depending on your health. Talk about any concerns with your surgeon before the procedure.

How do I get ready for liposuction?

• The surgeon will explain the procedure to you and give you a chance to ask questions. Be sure you know what to expect from liposuction.

• You will be asked to sign a consent form that gives your permission to do the procedure. Read the form carefully and ask questions if anything is unclear.

• Your healthcare provider will ask about your medical history. They may give a physical exam. This is to make sure you are in good health before having the procedure.

• You may be asked to fast (not eat or drink anything) for some time before the procedure. Your healthcare provider will give you specific instructions.

• If you are pregnant or think you might be, tell your provider.

• Tell your provider if you are sensitive to or are allergic to any medicine, latex, iodine, tape, or anesthesia.

• Tell your provider of all medicines (prescription and over-the-counter), vitamins, herbs, and supplements that you are taking.

• Tell your provider if you have a history of bleeding disorders. Or if you are taking any anticoagulant (blood-thinning) medicines, aspirin, or other medicines that affect blood clotting. You may need to stop these medicines before the procedure.

• If you smoke, it's important to quit smoking before the surgery. Smoking can greatly delay the rate at which you heal. Your surgeon may wish to delay surgery if you are smoking.

• Most liposuction procedures can be done on an outpatient basis. Make sure you have someone to drive you home afterwards. You will not be able to drive after the procedure.

What happens during liposuction?

Liposuction is often done in an outpatient facility or a cosmetic surgeon’s office. It can be done under general anesthesia (drugs are used to put you into a deep sleep) or local anesthesia with intravenous (IV) sedation (the area is numbed and you are sleepy). The type used will depend on many factors, including your preference, the surgeon, the extent of liposuction to be done, and your age. You can usually go home the same day as the procedure. With more extensive liposuction treatments, an overnight hospital stay might be needed.

Generally, liposuction follows this process:

1. You will be asked to remove any clothing, jewelry, or other objects that might get in the way during the procedure. A bracelet with your name and an identification number will be put on your wrist. You may get a second bracelet if you have allergies

2. You will change into a hospital gown.

3. Before the procedure starts, your healthcare provider may take some “before” photographs and use a marker to make guidelines for the liposuction.

4. An intravenous (IV) line will be started in your arm or hand to give you fluids and medicines.

5. In most cases, medicine will be used to numb the area where the procedure is to be done, and you will be given medicine in your IV to make you feel relaxed and sleepy. In some cases, you may be given general anesthesia to put you in a deep sleep.

6. Your heart rate, blood pressure, respiratory rate, and oxygen level will be monitored during the procedure.

7. The skin over the surgical site will be cleaned with an antiseptic solution.

8. The healthcare provider will make some small incisions (cuts) at the sites of the liposuction for the cannula. A sterile solution (tumescent solution) will be injected into the area to limit bleeding and reduce pain.

9. Depending on your specific needs, the healthcare provider will remove the fatty deposits from your body with suction-assisted liposuction (SAL) or power-assisted liposuction (PAL). In some cases, the plastic surgeon may use ultrasound (UAL) or laser technology to help break down the fatty deposits so they can be removed faster.

10. Once the procedure is done, the surgeon will stitch up and bandage any incisions.

What happens after liposuction?

After the surgery, you’ll be taken to the postanesthesia care unit (PACU) where nurses will closely monitor you until you have recovered from the anesthesia. You’ll likely be fitted with a compression garment that helps shrink the skin and limit swelling in the area where the liposuction was done.

Once you are alert and stable and can take fluids well by mouth, you will be allowed to go home.

It’s important to follow all your surgeon's instructions and keep all your follow-up appointments. Your stitches will be removed at one of these appointments.

Follow your surgeon’s instructions for taking your pain medicines.

These may be included in your home-care instructions:

• You should be able to go back to a normal diet as tolerated.

• You may be limited to a sponge bath for several days. Your surgeon will let you know when you may take a shower and have a tub bath.

• During the first few days after surgery, expect to feel sore.

• The incisions where the healthcare provider inserted the cannula may be leaky or drain fluid for several days. Sometimes a drainage tube is inserted to help drain fluid away from the wound.

• For the first few days after the procedure, rest as much as possible. Elevate the part of the body that was treated, if you can. Don't strain, bend, or lift.

• Your surgeon may also advise you to continue wearing the compression garment for several weeks to help keep your skin compressed. 

• At first, the treated areas may not look like you thought they would. The swelling and bruising will go away as you heal, and should be gone in about a month. The incision lines will also fade over time. Final results may not be seen for many months.

• You will gradually be able to return to normal activities over several days. You may need to wait a few weeks before returning to physical activities. Ask your surgeon when it's safe to return to work or go back to specific activities.

Tell your surgeon or get medical care right away if you develop any of the following:

• Increasing pain or pain that is not relieved by prescribed pain medicine

• Increasing fluid leaking, bleeding, redness, or swelling around the incisions

• Fever

• Leg pain or leg swelling

• Trouble breathing, chest pain, or heart palpitations (Call 911)

Next steps

Before you agree to the test or procedure make sure you know:

• The name of the test or procedure

• The reason you are having the test or procedure

• What results to expect and what they mean

• The risks and benefits of the test or procedure

• What the possible side effects or complications are

• When and where you are to have the test or procedure

• Who will do the test or procedure and what that person’s qualifications are

• What would happen if you did not have the test or procedure

• Any alternative tests or procedures to think about

• When and how you will get the results

• Who to call after the test or procedure if you have questions or problems

• How much you will have to pay for the test or procedure