What is liposuction?

Liposuction removes fat from your body using suction. During the procedure, small, thin, blunt-tipped tubes (cannula) are inserted through tiny cuts in the skin. Fat is suctioned out through these tubes as the doctor moves the tubes around under the skin to target specific fat deposits.

In recent years, improved techniques have made liposuction safer, easier, and less painful.

Liposuction is usually done as an outpatient procedure in a properly equipped doctor's office, ambulatory surgery center, or hospital. In general, it does not require an overnight hospital stay unless a large volume of fat is being removed. Local anesthesia is used in some cases. And you may or may not be given a sedative to help you relax. If a large area or volume of fat is being treated, general anesthesia or deep sedation with a local anesthetic may be used.

Techniques include:

Tumescent liposuction.

A local anesthetic is used to numb the area of your body where the tube will be inserted. Next, a large amount of an anesthetic solution containing lidocaine and epinephrine is injected into the fatty tissue before traditional liposuction is done. Tumescent liposuction may not require general anesthesia (which makes you sleep through the procedure).

Ultrasound-assisted liposuction.

This technique uses ultrasound to liquefy the fat, which makes it easier to remove. This technique may be particularly helpful in removing fat from the neck, upper abdomen, sides, and back.

Laser-assisted liposuction.

This technique uses low-energy waves to liquefy the fat, which is removed through a small cannula.

Activity

• Rest when you feel tired. Getting enough sleep will help you recover.
• Try to walk each day. Start by walking a little more than you did the day before. Bit by bit, increase the amount you walk. Walking boosts blood flow and helps prevent pneumonia and constipation.
• You will probably be able to return to work within a few days.
• Avoid strenuous activities, such as bicycle riding, jogging, weight lifting, or aerobic exercise, until your doctor says it is okay. This may be in 2 to 3 weeks.

Diet

• You can eat your normal diet. If your stomach is upset, try bland, low-fat foods like plain rice, broiled chicken, toast, and yogurt.
• Drink plenty of fluids (unless your doctor tells you not to).

Medicines

• Your doctor will tell you if and when you can restart your medicines. Your doctor will also give you instructions about taking any new medicines.
• If you stopped taking aspirin or some other blood thinner, your doctor will tell you when to start taking it again.
• If your doctor prescribed antibiotics, take them as directed. Do not stop taking them just because you feel better. You need to take the full course of antibiotics.
• Take pain medicines exactly as directed.
  • If the doctor gave you a prescription medicine for pain, take it as prescribed.
  • If you are not taking a prescription pain medicine, ask your doctor if you can take an over-the-counter medicine.

Incision care

• You may have bandages under your compression garment. Your doctor will tell you when to remove the bandages and just use the compression garment.
• You may use light gauze under the compression garment if the cuts are draining a lot.

Hygiene issues

• You may shower 24 to 48 hours after surgery, if your doctor okays it. You may remove the compression wraps when you shower. Pat the cuts (incisions) dry.
• Do not take a bath for the first 2 weeks, or until your doctor tells you it is okay.

Liposuction is usually very effective at removing fat deposits in small areas. But if you regain weight after having liposuction, the fatty bulges that were removed are likely to return or may appear in a different place.

Some improvement in body contour is usually noticeable right after surgery. And improvement may continue for several weeks or even months as the swelling goes away. The full effects of having liposuction may not be visible for several months to a year.

Liposuction (except for laser liposuction) generally does not tighten the skin over the treated area. After fat has been removed, the skin around the area may be somewhat loose. It may take up to 6 months for the skin to tighten around the treated area. Some people's skin is very elastic and retracts more quickly than other people's skin. Younger skin tends to have greater elasticity than older skin.

People who expect liposuction to help them lose weight are usually disappointed.

Surgery can be stressful. This information will help you understand what you can expect. And it will help you safely prepare for surgery.

Preparing for surgery

• Be sure you have someone to take you home. Anesthesia and pain medicine will make it unsafe for you to drive or get home on your own.
• Understand exactly what surgery is planned, along with the risks, benefits, and other options.
• If you take a medicine that prevents blood clots, your doctor may tell you to stop taking it before your surgery. Or your doctor may tell you to keep taking it. (These medicines include aspirin and other blood thinners.) Make sure that you understand exactly what your doctor wants you to do.
• Tell your doctor ALL the medicines, vitamins, supplements, and herbal remedies you take. Some may increase the risk of problems during your surgery. Your doctor will tell you if you should stop taking any of them before the surgery and how soon to do it.
• Don't smoke. Smoking can delay recovery. Stop smoking for at least a month before surgery. If you need help quitting, talk to your doctor about stop-smoking programs and medicines. These can increase your chances of quitting for good.
• Make sure your doctor and the hospital have a copy of your advance directive. If you don’t have one, you may want to prepare one. It lets others know your health care wishes. It’s a good thing to have before any type of surgery or procedure.

Liposuction done by an experienced doctor in a properly equipped facility is usually safe. Having more than one area treated, or having a very large area treated, may increase the risk of complications during or after the procedure.

Common side effects of liposuction include:

• Temporary swelling, bruising, soreness, and numbness in and around the treated areas.
• Irritation and minor scarring around the incision sites where the cannulas were inserted.
• Baggy or rippling skin. The skin will usually tighten and retract after a few months. But in some people the skin may remain somewhat loose.

Less common side effects include:

• Permanent color changes in the skin.
• Uneven skin surface over the treated area.
• Damage to the nerves and skin. The heat generated during ultrasound-assisted liposuction may burn the skin or damage the tissue under the skin.

If you gain weight after having liposuction, your body may store the new fat in a different place than where you had fat cells removed. New fat can grow deep inside your body, around your organs, such as your heart or liver. This type of fat can be more harmful to your body than fat that is stored near the surface of your body, such as on your hips or thighs. So people who have liposuction need to be careful not to gain extra weight.

Dangerous complications

Although death is very rare with liposuction, it can happen. If you are having a large amount of fat removed, are obese, or have health problems, your risks go up. Possible complications include:

• Excessive blood and fluid loss, leading to shock. But this is extremely unlikely.
• Fat clots or blood clots, which may travel to the lungs (pulmonary embolism) and become life-threatening.
• Buildup of fluid in the lungs (pulmonary edema). This is most likely to occur when a large volume of fluid is injected into the body.
• Infection. In some cases, antibiotics may be given before or after liposuction to help prevent infection.
• Toxic reaction to the injected solution (lidocaine toxicity), especially if large areas or many areas are treated at one time.
• A puncture into the cavity containing the abdominal organs or damage to an organ such as the spleen.

Liposuction should not be done in people who have severe heart problems, who have blood-clotting disorders (such as thrombophilia, a disorder in which the blood clots easily or excessively), or during pregnancy.

After the procedure, the area of the body that was treated will be covered with a compression garment or elastic bandages. This helps to reduce swelling, bruising, and pain. Wear them all the time, except when taking a shower, for as long as your doctor says. Expect a lot of bruising and swelling for at least the first 7 to 10 days.

Fluid may drain from the incision sites for several days. You may be given antibiotics to reduce the risk of infection.

Most people are able to get up and move around as soon as the treatment is finished and after the effects of the anesthesia and any sedation have worn off. You can return to your normal activities as soon as you feel comfortable. This may take several days to a few weeks. Most people can return to work within a few days. Recovery may take longer if large areas were treated.

After liposuction, the area will be wrapped to help reduce swelling, bruising, and pain. The wrap may be a compression garment or elastic bandages. You may have to keep this wrap on for 3 to 4 weeks. If fat was removed from your calves or ankles, you may need to wear support hose for about 6 weeks.

Fluid may drain from the cuts (incisions) for several days. The fluid will be bloody at first, but will turn clear in a few days.

The area will probably be bruised and swollen for at least 10 to 14 days.

You will be able to return to your normal activities as soon as you feel comfortable. This may take several days to a few weeks. Most people can return to light work within a few days. It may take longer to get back to normal if a lot of fat was removed.

• Follow the instructions exactly about when to stop eating and drinking. If you don't, your surgery may be canceled. If your doctor told you to take your medicines on the day of surgery, take them with only a sip of water.
• Take a bath or shower before you come in for your surgery. Do not apply lotions, perfumes, deodorants, or nail polish.
• Do not shave the surgical site yourself.
• Take off all jewelry and piercings. And take out contact lenses, if you wear them.

At the hospital or surgery center

• Bring a picture ID.
• The area for surgery is often marked to make sure there are no errors.
• You will be kept comfortable and safe by your anesthesia provider. The anesthesia may make you sleep. Or it may just numb the area being worked on.

The main purpose of liposuction is to reshape one or more areas of your body, not to reduce body weight. Liposuction is typically used on "problem" areas that have not responded well to diet and exercise. These areas are often on the outer thighs and hips on women and the waist and back on men. The face, neck, abdomen, back, buttocks, legs, and upper arms are all commonly treated areas.

Liposuction is sometimes used in combination with other cosmetic surgery procedures, such as a "tummy tuck" (abdominoplasty), breast reduction, or face-lift.

Liposuction may also be used to treat certain medical conditions, including:

• Benign fatty tumors (lipomas).
• Abnormal enlargement of the male breasts (gynecomastia or pseudogynecomastia).
• Problems with metabolism of fat in the body (lipodystrophy).
• Excessive sweating in the armpit area (axillary hyperhidrosis).

Liposuction is not used to treat obesity. It will not get rid of cellulite or stretch marks.