Liposuction

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What is Liposuction

Liposuction is a cosmetic surgery operation that removes fat from many different sites on the human body.

It is a method of body sculpting, body contouring or "spot-reduction" involving removal of excess, unsightly fat from specific areas of the body. Liposuction can be done in abdomen, hips, buttocks, back, thighs, knees, calves, ankles, upper arms, jowls, cheeks and neck.

Liposuction can be done alone or with other plastic surgery procedures such as breast reduction or tummy tuck (abdominoplasty). In addition, liposuction can be performed on several areas of the body at once.

Other names for liposuction are lipoplasty, suction-assisted lipectomy, ultrasound-assisted liposuction or lipoplasty, laser-assisted liposuction or lipoplasty and power-assisted liposuction or lipoplasty.

How is Liposuction performed
Liposuction is typically performed under general anesthesia, but in some cases local anesthesia can be used. Other options include intravenous sedation or epidural block.

Wetting solutions are infused into the area before fat is removed. The fluid contains saline (salt water) and epinephrine (which constricts blood vessels to minimize any blood loss in the aspirate) and a local anesthetic. The reason that surgeons use a wetting solution is simple: they want to minimize blood loss, to increase the safety of liposuction. Various types of wetting solutions are used in liposuction. The main difference among them is the amount of fluid used.

Fat removal
There are many different ways to vacuum out the fat during liposuction.

• Traditional suction-assisted liposuction. This involves inserting a cannula (a long, thin tube) through a tiny incision to vacuum the fat cells. The surgeon moves the cannula back and forth through the fat layer to break it up, and then suction out, the excess fat.
• Ultrasound-assisted liposuction. Here the surgeon inserts a special cannula through small "access" incisions. The cannula emits sound waves to help break up the fat, presumably making it easier to vacuum. Vaser-assisted liposuction is the cutting-edge, third-generation version of ultrasound liposuction technology. In a nutshell, the cannula used for Vaser-assisted liposuction emits gentler sound waves to break up and then remove fat. These do not disturb blood vessels, nerves and connective tissue, resulting in less bruising, swelling and pain than traditional suction-assisted liposuction.
• Power-assisted liposuction. This uses a motorized cannula to break up fatty tissue that will then be vacuumed out. It is inserted through the same tiny incisions.
• Laser-assisted liposuction. This involves a small incision and the insertion of a laser fiber probe that produces a burst of energy to liquefy the fat before it is removed. (Two of the brand names you may see are SmartLipo and CoolLipo.) Proponents say that laser liposuction is the latest and greatest and may also tighten skin. But detractors say it adds nothing to the results of liposuction except for expense and for making the procedure more cumbersome for both the patient and surgeon. And, they say, it can add many hundreds of dollars to the cost of liposuction without proven extra benefit.
• Body-jet liposuction. Using a thin, fan-shaped jet that pulsates water, your surgeon loosens fat cells from connective tissue, while simultaneously vacuuming them out. It is sometimes called water-jet assisted liposuction or water-assisted liposuction. While other liposuction techniques destroy or break apart the fat cells before suctioning them out of the body, the new water-assisted technique may loosen the fat cells first. As a result, water-assisted liposuction may be less traumatic than traditional liposuction methods. There may also be a shorter recovery time if the technique is proven to be gentler. Body-Jet liposuction does not use as much fluid as tumescent liposuction. What's more, the fluid is infused while the procedure is being performed, not beforehand as it is with other types of liposuction. The water is then immediately sucked back out with the fat; which may make it easier for your surgeon to determine if any areas need additional suctioning. Water-assisted liposuction flushes the fat instead of destroying it, so there may be an opportunity to harvest fat for fat transfer to other parts of the body where it is needed to restore plumpness. Water-assisted liposuction may be performed under local anesthesia, but general anesthesia will likely be needed for larger areas of fat removal. The bottom line is that more research is needed to determine the exact benefits and risks of water-assisted liposuction.

Risks of Liposuction
Liposuction is generally safe. As with any surgery, however, the procedure does have the potential for complications.

Occasional risks of liposuction include:

• Heavy bleeding (less of a problem with ultrasound-assisted liposuction)
• A bad reaction to the anesthetic
• Emergency hospital admission
• Noticeable irregularities in body contour
• Prolonged swelling
• Brown spots on the skin (hyperpigmentation)
  

The following factors increase the risks of liposuction:

• Removal of too much fat
• Inadequate monitoring after removal of a large volume of fat (greater than 10 pounds)
• Injection of overly large amounts of fluid and anesthetic
• Performance of multiple surgical procedures in the same surgical session
• Poor health, such as having diabetes, poor circulation, or severe lung or heart disease
  

Rare complications of liposuction are:

• Infection
• Lasting nerve damage
• A hole (perforation) in the bowel during abdominal procedures
• Blood clots, particularly in women taking birth control pills
• Skin tissue death (necrosis), especially in smokers and people with diabetes
• Skin burn (during ultrasound-assisted liposuction from the heat of the ultrasound device)
• Fluid in the lungs (during tumescent liposuction)
• Shock

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