Liposuction, or simply lipo, is a type of cosmetic surgery

Overview

If no quantity of diet or exercise removes those stubborn saddlebags on your hips or that potbellied spot on your abdomen, you’ll be ready to get obviate that localized area of fat through surgery. Liposuction, conjointly referred to as lipoplasty, suction reconstructive surgery or liposculpture, may be a cosmetic surgery that vacuums out fat from at a lower place the skin’s surface to scale back fullness in areas like the abdomen, hips, thighs, knees, buttocks, upper arms, chin, cheeks and neck.

Liposuction is that the most well liked style of rhytidectomy among each men and ladies within the u. s., with 283,735 procedures performed in 2009, according to the American Society for Aesthetic Plastic Surgery. Introduced within the u. s. in 1982, liposuction’s popularity increased as refinements to the technique improved results and reduced recovery times. Thirty-eight % additional ladies had liposuction in 2009 than in 1997.

Although liposuction will turn out permanent changes in body contour, it is not a substitute for a healthy low-fat diet and exercise. It will not tighten loose skin or eliminate the shallow surface fat irregularities referred to as fat. It is a sculpting technique which will improve body proportions and facilitate article of clothing work higher.

Liposuction recontours the body by removing some of the body’s finite number of fat cells. It’s a story that once you gain weight, you’re adding new fat cells to your body. In fact, all and sundry encompasses a fastened range of fat cells. When you gain weight, those fat cells grow larger however do not increase in range. When you lose weight, the fat cells shrink. Your genes confirm what number and wherever fat cells area unit distributed, and a few folks tend to possess additional fat cells in some body areas than others. For example, some women have more fat cells in their thighs and hips, instead of a uniform fat distribution.

Liposuction will for good take away some fat cells from such areas. But, the fat cells that stay within the space treated still will grow larger if you gain weight. Many liposuction patients realize, however, that newly added weight will not accumulate in the specific areas as it did before and instead distributes more evenly or in different areas. This is why weight gain is inadvisable when liposuction. People WHO do best area unit those who come back as shut as doable to their ideal weight before the procedure.

There area unit many variations on the liposuction technique, but those most commonly used involve first infusing the area to be treated with a solution of saline, a localanesthesia and a drug that constricts blood vessels. Then, a hollow tube hooked up to a vacuum is inserted into the fat layer at a lower place the skin. The tube, referred to as a tube, is moved through the fat layer in a push-and-pull motion to break up the fat. Then, the dislodged fat is sucked out of the body either via a syringe hooked up to the tube or a surgical vacuum. In the bloated technique,
the answer used is 2 to 3 times the quantity of fat to be removed. In the super-wet technique, {the quantity|the quantity|the number} of fluid infused is that the same because the amount of fat slated for removal. In ultrasound-assisted liposuction, ultrasonic energy that liquefies the fat is applied through the cannula, which also suctions out the fat. Similarly, a replacement technique as of 2007—laser-assisted liposuction—uses a shaft of light to liquefy the fat. And another fairly new methodology calledpower or assisted liposuction uses a motorized tube that pushes and pulls itself whereas suctioning out the fat.

The choice of technique depends on the patient and therefore the surgeon’s ability and preference. According to the yank Academy of medical specialty, not only does thetumescent technique offer improved safety, it offers the fastest recovery time and few significant side effects.

Liposuction of little areas are often performed in associate degree patient workplace surgical setting underneath the anesthetic that’s enclosed within the infusion answer. It is usually combined with sedation to stay the patient additional relaxed throughout the procedure. If massive amounts of fat area unit to be removed, the procedure is probably going to be performed on associate degree patient basis {in a|during a|in associate degree exceedingly|in a very} hospital or an authorised, mobile patient surgical center, employing a general or regional anaesthesia, like associate degree epidural block unremarkably utilized in childbearing, which may be combined with intravenous sedation. General anesthesia is used when the patient must be put to sleep. In cases involving anesthesia and huge areas of fat removal, patients may be hospitalized overnight.

Most liposuction patients area unit ready to come to figure in a very few days. Normal activities can usually be resumed within 10 days or less after liposuction, depending on the extent of the procedure. Patients should wear compression clothes for one to 6 weeks when surgery to assist the skin swimmingly adhere to the underlying tissue and remaining fat and to assist management swelling in the treated area. Compression clothes seem to be best within the initial seven days following surgery. Follow your surgeon’s directions, and attend all scheduled follow-up visits. Temporary bruising, numbness of the skin and swelling are common postoperative side effects.

As with any surgery, liposuction carries risks, including death. A polemic study revealed within the journal Plastic operation in Jan twenty00 found a death rate of concerning 20 in each a hundred,000 patients who underwent liposuction from 1994 to 1998. According to the yank Society for Aesthetic cosmetic surgery (ASAPS), a task force of plastic surgeons in 1998 determined that the factors that increase the chance of death from liposuction include:

  • poor patient health
  • excessive fat removal
  • too much fluid and local anesthesia used during the procedure
  • performing multiple procedures along with liposuction in a single surgical session, especially under general anesthesia

However, in skilled surgical hands, life-threatening complications from anesthetics, blood clots and even perforation of the organs near the area being treated are extremely rare. Bleeding, excessive bruising and infection area unit potential however uncommon. Seromas, or pockets of fluid that have collected below the skin, can also occur once giant amounts of fat area unit removed, but can be treated in an office setting by draining with a needle and syringe.

More common complications that typically need further liposuction surgery embody irregularities in contour, like lumps or divots wherever the operating surgeon has removed deficient or an excessive amount of fat, and asymmetry, wherever the contour differs on both sides of the body. These forms of complications will be the results of poor surgical technique, lack of expertise within the procedure or acting a liposuction technique on a patient United Nations agency isn’t appropriate for the procedure. That’s why it is vital to rigorously choose your operating surgeon and raise questions about the surgeon’s expertise with liposuction. Various studies within the medical literature have according revision rates starting from 5 to twenty %, looking on the sort of patient, the number of areas treated at one time and how much fat was removed. A small quantity of fat is taken into account but one.5 liters, whereas an oversized quantity is four to 5 liters. Removing over 5 liters of fat AN exceedingly|in a very} single liposuction treatment is taken into account too risky by most surgeons unless performed in an exceedingly hospital with an nightlong keep.

In addition to rigorously selecting your operating surgeon, it is vital that you just have realistic expectations of your liposuction surgery. Liposuction will improve your body contour, however it’ll not cause you to match or skinny. The only way to get in shape is to eat a healthy diet and exercise. The best candidates for liposuction area unit healthy, normal-weight individuals with firm, elastic skin who have localized pockets of fat that do not respond to diet and exercise. Although there are not any absolute age limits for liposuction, older ladies United Nations agency have lost skin physical property might not reach pretty much as good results from the procedure as young women with elastic skin. Skin imperfections can occur after any liposuction. The skin surface may be irregular, asymmetric or baggy, and these problems tend to occur more often in women whose skin is no longer elastic enough to smooth out and tighten after the underlying fat is removed.

Diagnosis

To determine if you’re a candidate for liposuction (a operation that vacuums out fat from to a lower place the skin’s surface to scale back fullness in sure areas), you initially ought to consult with the health care professional who would perform the procedure. That health care skilled could also be a sawbones, sawbones or specialist.

The doc can conduct a physical examination and raise you questions about your anamnesis, what medications you’re taking, your diet and exercise history and what you hope to achieve by having this elective surgical procedure. It’s important that you provide an accurate medical history, including any past or present medical conditions, and what medications, including prescriptions, over-the-counter drugs and dietary and herbal supplements, you are taking. Some sorts of medication, such as steroidal medications, aspirin, ibuprofen and vitamin E, thin the blood and can interfere with clotting, and your health care professional most likely will want you to prevent taking such medication concerning period before surgery.

You may be a perfect candidate for liposuction if you’re inside thirty % of your ideal weight, physically fit and healthy and have good skin elasticity, but have pockets of fat in an exceedingly specific space, like the hips, thighs, buttocks, arms, neck or chin, that do not answer diet and exercise programs. If you’ve got localized fat deposits in specific areas, like saddlebags on the thighs or very wide hips, and good skin elasticity, you may be a candidate for liposuction of these areas to assist improve your body proportions. If you are significantly overweight (more than 30 percent over ideal body weight for your height), appear heavy everywhere with no specific area fatter than others and have loose skin from weight fluctuations, liposuction is unlikely to benefit you. Liposuction could be a body contouring procedure; it cannot take away a layer of fat from the whole body.

Additionally, patients with serious medical problems, such as uncontrolled diabetes, heart disease, circulatory problems or lung disease, generally are not candidates for any type of elective surgery, including liposuction. If you’ve got a medical condition, your surgeon will seek medical clearance from your primary health care professional before considering you as a candidate for liposuction surgery. In addition, liposuction isn’t counseled for patients United Nations agency area unit or could also be pregnant.

In evaluating whether or not liposuction is for you, your Dr. might conduct a “pinch test” to assess what quantity fat is below the skin within the space thought of for treatment and to check the elasticity of your skin. During this check, the health care skilled merely pinches the skin between the thumb and index to visualize what quantity fat is within the space and see however the skin springs back after releasing the pinch. If an in. or additional of fat may be pinched, the area may be reduced through liposuction. At least a half-inch of fat has to stay once the procedure to make sure a swish result. Otherwise, skin would stay on high of bone or muscle, creating an emaciated look. If the skin springs back once the pinch, it has appropriate elasticity. Cellulite is a dimpling of the skin surface. While liposuction of the world could also be effective in removing fat bulges and serving to garments work higher, it will not remove cellulite.

During the consultation, discuss with your health care professional:

  • Why liposuction can or cannot benefit you
  • How the procedure would be done on you
  • Where the surgery will be performed
  • What kind of anesthesia would be used and your own preferences
  • Risks and potential complications
  • Confirm that the surgeon has a plan for medical emergencies, if the need arises
  • Expected recovery time
  • What kind of results you can expect
  • What the procedure will cost, since it is elective and not covered by most insurance

Additionally, to make sure you select a surgeon who is right for you, ask questions about what kind of liposuction training he or she has had; whether he or she is certified by the yank Board of cosmetic surgery, the American Board of Cosmetic Surgery or the American Board of Dermatology; and how much experience he or she has had performing liposuction. Ask to visualize some before and once images of his or her patients. You may additionally wish to raise if you’ll speak with former patients concerning their liposuction experiences. Additionally, you may want to get a second opinion from another health care professional.

If you choose to own the procedure, you possible can have a operative visit together with your Dr. within which before images of the world to be treated are taken, consent forms signed and blood drawn for workplace testing. If you’ve got a medical condition, your primary health care professional may order additional tests to ensure you are healthy enough to undergo surgery before giving medical clearance for the procedure.

Treatment

Many liposuction procedures may be tired the physician’s office-based operating theatre or associate patient hospital operating theatre. Patients having giant amounts of fat removed through liposuction or cosmetic procedures additionally to liposuction might pay the night within the hospital once surgery.

The technique used for your liposuction surgery depends on you and your particular problem area, your surgeon’s preference, the location and number of areas to be treated and the amount of fat to be removed. The most commonly used techniques today include:

  • Tumescent and super-wet. Basic liposuction involves infusing the world to be treated with an answer of saline; local anesthetic, associate anesthetic; and vasoconstrictive, a drug that constricts blood vessels to curb harm. The distinction between techniques is that the total quantity of fluid used. In the tumid technique, the answer used is 2 to 3 times the number of fat to be removed. In the super-wet technique, {the quantity|the quantity|the number} of fluid infused is that the same because the amount of fat slated for removal. Which version of those 2 techniques is employed depends on your surgeon’s preference and judgment concerning that is best for you.What reasonably physiological state is employed for these techniques also depends on the number of fat to be removed and your surgeon’s preferences and medical judgment touching on what’s best for you. Because the massive volume of fluid utilized in the tumid technique includes associate anesthetic, your physician might not administer further physiological state before the procedure, particularly once alittle quantity of fat is to be removed, such as 1.5 liters or less from one or 2 areas on the body. In such cases, a sedative in pill type is also given to relax you before surgery begins. Because the super-wet technique uses less anesthesia-containing fluid, further physiological state, like associate blood vessel sedation, associate epidural block or anesthesia is employed. General anesthesia is additional common once massive amounts of fat, like quite one.5 liters, area unit to be removed, or multiple areas on the body, like thighs and hips, are to be treated.In these fluid infiltration techniques, a thin metal tube is inserted into the fat layer beneath the skin in the area to be treated. This tube is hooked up to associate infusion pump, that pumps the answer into the world. This tube is removed and, when anticipating the physiological state within the resolution to require result, an incision is made into the skin to accommodate a small hollow tube. This tube, referred to as a tube, is attached to a vacuum. The tube is inserted through the incision into the fat layer below the skin. It is stirred through the fat layer during a push-and-pull motion to interrupt up the fat and suck it out of the body.The surgeon may make two to more incisions in every space for insertion of the tube in numerous locations within the treatment space to suction out fat from totally different directions. Using a crisscross technique helps avoid making tunnels within the fat that will lead to wavy-looking skin irregularities when surgery.
  • Ultrasound-assisted.Ultrasound-assisted. this system uses identical basic preparation as tumid and super-wet liposuction, however employs a special kind of tube that emits ultrasound waves at its tip to liquefy the fat so suctions it out of the body.When the ultrasonic energy hits the fat, the high-frequency vibrations explode the fat cells. The fat mixes with body fluids and also the infused resolution and is sucked out of the body. The real potential advantage of ultrasonic-assisted liposuction is that the risk for enlarged skin adjustment. Also, in areas of the body that have loads of plant tissue, like the chest, the addition of supersonic energy might offer a major advantage.Disadvantages to the ultrasound-assisted liposuction procedure might embody a additional obvious scar because of a bigger gap needed for insertion, increased discomfort and a higher incidence of complications, such as skin burns and seromas (a assortment of humor inflicting swelling). The latest generation of supersonic liposuction systems area unit abundant safer, and these complications occur abundant less oft.Like other liposuction techniques, anesthesia for ultrasound-assisted liposuction varies from local to general, depending on the individual patient, what quantity fat is to be removed and also the surgeon’s preference.
  • Laser-assisted. Similarly to ultrasound-assisted liposuction, laser-assisted liposuction, introduced in 2007, uses thermal (heat) energy to liquefy the fat. As with other liposuction techniques, laser-assisted liposuction involves the use of tumescent solution and standard liposuction to remove the liquefied fat. During the procedure, the surgeon inserts a thin laser fiber through small incisions in the skin. In addition to breaking up fat cells, the laser heats surrounding tissues. Side effects may include bruising, swelling, numbness, burns and minimal bleeding. Some studies have found no differences between the laser-assisted liposuction and standard liposuction techniques in terms of results, but many surgeons and some recent studies suggest enhanced skin tightening with laser-assisted liposuction
  • Power. Power. Using the same basic techniques as tumescent and super-wet liposuction, power liposuction, also called power-assisted liposuction, involves use of a motorized cannula. In addition to the surgeon physically moving the cannula back and forth through the fat to help break it up while suctioning, the cannula moves or vibrates itself under electrical or nitrogen power, moving short stroke distances. Meanwhile, the surgeon manipulates the direction of the cannula. Surgeons favoring power liposuction say it permits them to perform the procedure faster and with more precision, resulting in less trauma to surrounding tissues, and therefore, less bruising and discomfort and quicker recovery times. Power liposuction can be performed under local anesthesia or with IV sedation or general anesthesia.

Because liposuction vacuums out body fluids along with fat, patients should have intravenous fluid replacement while undergoing liposuction to prevent dehydration and shock.

After the procedure is complete, the incisions may be closed with stitches; in some cases, incisions are so small they do not require stitches. A compression garment is then placed over the body area treated. For a hip and thigh treatment, for example, a girdle-type garment is used. The garment smooths the treated area to help healing so the skin appears flat, and it helps control swelling. Most patients wear compression garments for one to six weeks, but they appear to be most effective in the first seven days after surgery. Your health care professional also may give you a prescription for postoperative pain, such as acetaminophen with codeine. An antibiotic also may be prescribed.

Patients usually are told to rest for at least two days after surgery. Many patients have their surgery on a Friday morning, return home that afternoon, rest over the weekend and resume work on Monday. Normal exercise and activities can be resumed in about a week or two. A follow-up visit to check on progress and remove any stitches is usually required five days to a week after surgery.

Common temporary postoperative side effects of liposuction are bruising, swelling and numbness of the skin in the area treated. They usually are temporary and subside in six weeks or less. Swelling, however, may take several months to disappear.

Although it is usually done on an outpatient basis and may be performed in your health care professional’s office surgical suite, you must recognize that liposuction is still surgery, and all surgeries carry risks, including death.

Among the extremely rare, potentially life-threatening complications are:

  • Anesthesia-related problems, such as breathing difficulties and fluid in the lungs
  • Blood clots or fat clots that can migrate to the lungs
  • Perforation of organs with the cannula
  • Burning of tissues in ultrasound-assisted or laser-assisted liposuction

Uncommon complications include:

  • Bleeding
  • Excessive bruising
  • Infection
  • Seromas, or pockets of fluid collection under the skin, also can occur when large amounts fat are removed, but usually can be treated in an office setting by draining with a needle and syringe (seromas tend occur more often with ultrasound-assisted liposuction).

More common complications include:

  • Irregularities in contour, such as lumps or divots where too little or too much fat was removed
  • Asymmetry, where the contour differs on each side of the body
  • Skin irregularities, such as loose, baggy or wavy skin

Many of the complications is the results of poor surgical technique, lack of expertise within the procedure or poor patient choice. Contour and symmetry issues will need extra, touch-up liposuction surgery, called revision surgery. Various studies within the medical literature have reportable revision rates starting from 5 p.c to twenty p.c, looking on the kind of patient, the number of areas treated at one time and how much fat was removed. A small quantity of fat is taken into account but one.5 liters, whereas an outsized quantity is four to 5 liters. Special concerns ar required once giant amounts of fat (usually over 5 liters) ar removed.

Facts to Know

  1. Liposuction is that the most well liked kind of rhytidectomy among each men and girls within the u. s., with 283,735 procedures performed in 2009, according to the American Society for Aesthetic Plastic Surgery.
  2. Thirty-eight percent more women had liposuction in 2009 than in 1997, according to the American Society for Aesthetic Plastic Surgery.
  3. Liposuction is an elective surgical procedure that contours the body.
  4. Liposuction is not a weight-loss technique.
  5. Body contour improvements produced by liposuction are permanent.
  6. Each person has a set number of fat cells and, when weight is gained, the size of the fat cells increases, but not the number. Liposuction works by removing some fat cells.
  7. The best candidates for liposuction ar healthy, work individuals at intervals thirty p.c of their ideal weight with elastic skin UN agency have isolated areas of fat that don’t respond to diet and exercise.
  8. Irregularities in body contours and symmetry are possible common complications of liposuction that can require additional, touch-up surgery.
  9. Like any surgery, liposuction carries risks, including death. When performed by full-fledged, mean surgeons, severe complications ar extraordinarily rare. Other complications, like hemorrhage, excessive bruising, infection and pockets of fluid assortment beneath the skin, also are uncommon.
  10. A small quantity of fat removal throughout liposuction is taken into account but one.5 liters, whereas an outsized quantity is four to 5 liters. Removing over 5 liters of fat {in a|during a|in associate exceedingly|in a very} single liposuction treatment is taken into account too risky by most surgeons unless performed during a hospital with an nightlong keep

Key Q&A

  1. What exactly is liposuction?Liposuction, additionally referred to as lipoplasty or suction selective lipectomy, may be a surgical operation that vacuums fat from to a lower place the skin’s surface to cut back fullness in areas of localized fat deposits, such as in the abdomen, hips, thighs, knees, buttocks, upper arms, chin, cheeks and neck. It’s a cosmetic, body recontouring procedure that removes pockets of fat in specific areas that don’t respond to diet and exercise.
  2. How long will the new body contours produced by liposuction last?Liposuction, in effect, sculpts the body by removing some of the body’s fixed number of fat cells. When you gain weight, the set number of fat cells you have grows larger, but the cells don’t increase in number. Similarly, after you slenderize, the fat cells shrink in size but don’t decrease in number. Your genes confirm what number and wherever fat cells square measure distributed, and some people are born with more fat cells in some body areas than others. For example, some women have more fat cells in their thighs and hips, instead of a uniform fat distribution. Liposuction vacuums fat cells from such areas, permanently removing them. But, what fat cells stay within the space treated still will grow larger if weight is gained. Liposuction patients typically notice that freshly another weight won’t accumulate within the specific treated areas because it did before, and instead distributes a lot of equally.
  3. How do I know whether liposuction can benefit me?Talk to your health care skilled and raise a referral for a consultation with a MD WHO performs liposuction. The best candidates for liposuction square measure healthy, fit, normal-weight individuals with firm, elastic skin WHO have localized pockets of fat that don’t reply to diet and exercise. If you’re among thirty p.c of your ideal weight and have smart skin physical property, liposuction might facilitate place your body contours in higher proportion. Although there are not any absolute age limits for liposuction, older ladies WHO have lost skin physical property might not attain pretty much as good results from the procedure as young women with elastic skin. Although liposuction removes fat cells from the body, it’s not the simplest way to slenderize. There is no thanks to have a layer of fat surgically far from your entire body. The only thanks to attain that’s through diet and exercise.
  4. What tests are there to see if I am a candidate for liposuction?In evaluating whether or not you will be a candidate for liposuction, your MD might conduct a “pinch test” to assess what quantity fat is beneath the skin within the space to be treated and to check the elasticity of your skin. During this check, the health care professional simply pinches the skin between the thumb and forefinger to see how much fat is in the area and to see how the skin springs back after releasing the pinch. If an in. or a lot of of fat will be pinched, the world could also be reduced through liposuction. A half-inch of fat must stay once the procedure to make sure a swish end-result. Otherwise, skin would stay on prime of bone or muscle, making associate haggard look. If the skin springs back once the pinch, it’s applicable physical property.
  5. I’ve heard people can die from liposuction. Is that true?As with any surgery, liposuction does carry risks, including death. A moot study revealed in Jan twenty00 found a death rate of regarding 20 in each a hundred,000 patients WHO underwent liposuction from 1994 to 1998. A task force of plastic surgeons in 1998 determined that the factors that increase the risk of death from liposuction include:
    • Poor patient health
    • Excessive fat removal
    • Too much fluid and local anesthesia used during the procedure
    • Performing multiple procedures along with liposuction in a single surgical session, especially under general anesthesia

    However, in experienced, skilled surgical hands, life-threatening complications, such as problems with anesthetics, blood clots and perforation of the organs and tissues near the area being treated, are extremely rare.

  6. How is liposuction performed?There square measure many variations on the fundamental liposuction technique. Those most commonly used today involve first infusing the area to be treated with a solution of saline, a numbing drug and a drug that constricts blood vessels. Then, a hollow tube attached to a vacuum is inserted into the fat lawyer beneath the skin. The tube, known as a tube, is affected through the fat layer during a push-and-pull motion to interrupt up the fat and suction it out. In the puffy technique, the answer used is 2 to a few times the number of fat to be removed. In the super-wet technique, quantity|the quantity|the number} of fluid infused is same because the amount of fat slated for removal. In ultrasound liposuction, unhearable energy that liquefies the fat is applied through the tube, which also suctions out the fat. Recently introduced optical maser-assisted liposuction uses laser energy to liquefy the fat. And a reasonably new technique, known as power liposuction, uses a motorized cannula that pushes and pulls itself while suctioning out the fat. The choice of technique depends on the individual patient and also the surgeon’s ability and preference.
  7. Will I be put to sleep for a liposuction procedure?The anesthesia used in liposuction varies, depending on the individual patient, the amount of fat to be removed and the surgeon’s preferences. A fluid containing the anesthetic local, the drug neurotransmitter, that constricts blood vessels, and saline is infused into the realm to be treated before the fat is suctioned off. Liposuction of tiny areas removing one.5 liters of fat or less can be performed in an outpatient office surgical setting under the local anesthetic that is included in the solution. It is usually combined with a sedative in pill kind to stay the patient a lot of relaxed throughout the procedure. If massive amounts of fat square measure to be removed, like over one.5 liters, and/or multiple areas of the body are to be treated, the procedure is usually performed on associate patient basis {in a|during a|in associate exceedingly|in a very} hospital or an mobile surgery center beneath regional or anaesthesia. A regional anaesthesia, such as an epidural block commonly used in childbirth, may be combined with intravenous sedation. With a anaesthesia, the patient is place to sleep. In cases involving anaesthesia and enormous areas of fat removal, patients is also hospitalized long.
  8. How long does it take to see results from a liposuction procedure?Although recovery time from surgery varies with every one, differences in body contours are most apparent about three to six months after surgery, when swelling has disappeared. Depending on the body space treated, you ought to realize that you simply square measure able to wear a wider kind of wear, and your body seems a lot of in proportion than before the surgery.