Liposuction- Plastic and Cosmetic Surgery

Liposuction is a medical procedure in which a plastic surgeon or a dermatologist removes excess fat from different parts of your body using a suction device. The procedure can be performed to improve the appearance and contour your arms, buttocks, thighs, hips, or neck.

You should know that liposuction is not an alternative to weight loss by diet, exercise, or bariatric surgery. It is usually reserved for people with stable weight, who have specific areas of their body that need contouring.

Indications

Liposuction is usually reserved for people who have tried diet and exercise, however, still have persistent fat in certain locations of their body that just won’t go away. Our fat cells increase in size when we gain weight, so removing them by liposuction can result in a permanent change in contour in the treated area, as long as your weight remains stable.

The areas that could be possibly treated by liposuction include:

• Neck and chin
• Arms
• Hips
• Buttocks
• Thighs and legs
• Chest and back

Risks

Liposuction is generally considered a safe procedure, however, it can carry some surgical risks and some undesirable outcomes. The list includes, but is not limited to:

• Infection: As with any surgery, infection is always a risk. Your doctor will give you IV antibiotics before surgery to prevent this and will instruct you on how to perform proper cleaning and dressing of your wounds to minimize the risk.
• Seroma formation: A seroma is the medical term used to describe fluid accumulation in the wounds. Seromas are usually harmless and drain without causing any problems.
• Traumatic injury: Since the procedure entails inserting a sharp cannula under your skin, there’s the rare possibility of injury to underlying organs.
• Fat embolism: This is one of the uncommon, yet dangerous complications of liposuction. A piece of fat might break off and enter your circulation, blocking certain vessels and causing various problems that will need urgent care.
• Losing sensation: After surgery, you might experience numbness in some of the treated parts of your body. This can be a temporary or permanent condition.
• Irregular contour: The treated parts of your body might appear irregular and bumpy after liposuction. This depends largely on your individual anatomy and skin type, however, the experience of the surgeon can also play a role.

Make sure to discuss complications of liposuction with your surgeon during your initial visit. They can tell you based on your specific body and skin type how likely they are to happen.

Preparing for liposuction

After obtaining your medical history and learning about your home medications, your doctor will tell you which medications you should stop taking and how many days before the procedure. An example of these medications is blood thinners like aspirin. Your doctor might order a routine blood test to make sure you don’t have any bleeding disorders or conditions that should be addressed before surgery. You will be asked to stop eating and drinking the night before the procedure.

Procedure

There are several liposuction techniques that can be used, and your surgeon will choose one depending on your specific body type and needs:

• Tumescent liposuction: This is the most frequently used technique. The surgeon injects a mixture of saltwater, epinephrine, and lidocaine in the areas that are to be treated, and then inserts a thin rod-like instrument (called a cannula) connected to a vacuum, to suction out all the fat.
• Ultrasound-assisted liposuction (UAL): This technique can be used with tumescent liposuction. The cannula used in UAL emits ultrasound waves that help break down the fat and makes it easier to be removed.
• Laser-assisted liposuction (LAL): In this type of liposuction, your doctor will insert a laser fiber through a small skin incision at the area being treated. The laser will break down fat cells and they will then be suctioned by a cannula
• Power-assisted liposuction (PAL): This technique utilizes rapid vibrations of the cannula to break down fat and suction it. PAL may cause less swelling and pain and can provide more precise liposuction.

Depending on the technique used, the amount of fat to be removed, and the locations, your doctor might choose either general anesthesia where you will be completely asleep, or local anesthesia where you will be given a minor sedative while the doctor injects an anesthetic in the area being treated. Either way, you should not feel any pain. The procedure can take up to several hours, depending on how much fat needs to be removed.

After surgery

You will probably be discharged on the same day, after a few hours of monitoring at the hospital. Your doctor might leave a drain under your skin to drain out fluids for a few days. He/she will teach you how to empty it and when you should come back in to remove it. You might be asked to wear tight stockings or compression garments for a couple of weeks to prevent swelling.

You should expect some bruising, swelling, and pain at the sites that were treated. These will get better day after day, and you will be prescribed pain killers to reduce the pain. Your doctor might also prescribe antibiotics to reduce the risk of infection.

Results

You will feel the difference in size and contour immediately after surgery, however, the final results won’t be apparent until a few months have passed. During the first few weeks, the treated areas will typically be swollen. Day after day, the swelling will lessen, and the treated areas will look leaner.

Depending on your skin type, the skin around the treated areas may regain firmness, or become a little loose. Liposuction results are usually permanent, as long as you maintain a stable weight. If you gain weight after liposuction, your fat distribution might change.

Sources:

• https://www.uptodate.com/contents/obesity-in-adults-overview-of-management
• https://www.asds.net/Skin-Experts/Skin-Treatments/Liposuction
• https://journals.lww.com/plasreconsurg/Fulltext/2017/01000/Evidence_Based_Medicine___Liposuction.51.aspx
• https://www.plasticsurgery.org/cosmetic-procedures/liposuction
• https://www.plasticsurgery.org/cosmetic-procedures/liposuction/procedure

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