Through a tiny incision, a narrow tube (cannula) is inserted and used to vacuum the fat layer that lies deep beneath the skin. The cannula is pushed then pulled through the fat layer, breaking up the fat cells and suctioning them out. The suction action is provided by a vacuum pump or a large syringe, depending on the surgeon's preference. If many sites are being treated, each is done one at a time, working to keep incisions as inconspicuous as possible.
Technique variations: the basic technique of liposuction, as described above, is used in all patients undergoing this procedure. However, as the procedure has been developed and refined, several variations have been introduced.
Tumescent technique, a procedure in which a medicated solution is injected into fatty areas before the fat is removed, is commonly used by plastic surgeons today. The fluid - a mixture of intravenous salt solution, lidocaine (a local anesthetic) and epinephrine (a drug that contracts blood vessels) - helps the fat be more easily removed, reduces blood loss and provides anesthesia during and after surgery. It also helps reduce the amount of bruising after surgery.
Super-wet technique is similar to the tumescent technique, except that lesser amounts of fluid are used. Usually the amount of fluid injected is equal to the amount of fat to be removed. This technique often requires IV sedation or general anesthesia and typically takes one to two hours of surgery time.
Ultrasound-Assisted Lipoplasty (UAL) requires the use of a special cannula that produces ultrasonic energy. As it passes through areas of fat, the energy explodes the walls of fat cells, liquefying the fat. The fat is then removed with the traditional liposuction technique.
Length: The time required to perform liposuction may vary considerably, depending on the size of the area, the amount of fat being removed, the type of anesthesia and the technique being used. On average, 1 to 2 hours or more. UAL: 20-40 percent longer than traditional liposuction.
Anesthesia: Various types of anesthesia can be used for liposuction procedures including local, epidural or general.
In/Outpatient: Liposuction is usually performed on an outpatient basis. Extensive procedures may require short inpatient stays.
Side Effects & Risks
Liposuction carries greater risk for individuals with medical problems such as diabetes, significant heart or lung disease, poor blood circulation, or those who have recently had surgery near the area to be contoured.
In the tumescent and super-wet techniques, the anesthetic fluid that is injected may cause lidocaine toxicity (if the solution's lidocaine content is too high) or the collection of fluid in the lungs (if too much fluid is administered).
The combination of these factors can create greater hazards for infection; delays in healing; the formation of fat clots or blood clots, which may migrate to the lungs and cause death; excessive fluid loss, which can lead to shock or fluid accumulation that must be drained; friction burns or other damage to the skin or nerves or perforation injury to the vital organs; and unfavorable drug reactions.
In the UAL technique, the heat from the ultrasound device may cause injury to the skin or deeper tissues. Also, you should be aware that even though UAL has been performed successfully on several thousand people worldwide, the long-term effects of ultrasound energy on the body are not yet known.
The scars from liposuction are small and strategically placed to be hidden from view. However, imperfections in the final appearance are not uncommon. The skin surface may be irregular, asymmetric or even "baggy," especially in the older patient. Numbness and pigmentation changes may occur. Sometimes, additional surgery may be recommended.
You will see a noticeable difference in the shape of your body quite soon after surgery. However, improvement will become even more apparent after about four to six weeks*, when most of the swelling has subsided. After about three months*, any persistent mild swelling usually disappears and the final contour will be visible.
You may find that you are more comfortable in a wide variety of clothes and more at ease with your body. And, by eating a healthy diet and getting regular exercise, you can help to maintain your new shape.
Q. Who are the best candidates for Liposuction?
A. The best candidates for liposuction are normal-weight people with firm, elastic skin who have pockets of excess fat in certain areas.
Q. Will the fat return after liposuction?
A. Significant weight gain after liposuction can result in the formation of new fat cells where the removed ones were. Barring significant weight gain, fat will be less likely to collect in treated areas. Liposuction removes the fat cells entirely, which means that they are no longer available for storage. It is likely that if you gain a small amount of weight after surgery, it will collect in untreated areas.
Q. With all of the variations in liposuction, how will I know which is best for me?
A. Individuals considering liposuction often feel a bit overwhelmed by the number of options and techniques available today. In helping you decide which is the right approach for you, Dr. Patterson will consider effectiveness, safety, cost and appropriateness for your particular needs.