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In the Spotlight

March 21, 2000

Liposuction: Is It For You?

By Lee Phillips, M.D
Personal MD.com Advisory Board

 

For some people, even though they've reached a desirable weight through diet and exercise, a few stubborn fatty areas refuse to go away. Liposuction is a type of cosmetic surgery designed to sculpt the body, selectively removing areas of fat.

Liposuction can be performed on almost any area of the body; most commonly, the arms, love handles, buttocks, hips, thighs, and knees. This might explain why liposuction is so popular. Today both men and women are choosing liposuction as a way to attain their ideal body shape.

Liposuction
Surgical removal of local fat deposits (as in the thighs) especially for cosmetic purposes by applying suction through a small tube inserted into the body.

Who is it for?

Liposuction is best for healthy people, close to their ideal weight, who have a specific part of their body that is out of proportion to the rest of their body.

People who are overweight probably won't benefit from liposuction, because it is not a method of weight loss, even though with improved techniques up to twenty pounds of fat can be removed in one procedure. The fat cells removed by liposuction do not grow back over time. If the weight is later gained back, it tends to be redistributed over the entire body proportionately.

What happens during liposuction?

Liposuction is usually performed as an outpatient procedure, with the patient under mild sedation. The length of the surgery depends on how much fat is removed, but generally it lasts from two to three hours. A small incision is made, than a small hollow tube, called a cannula, is inserted under the skin.

The cannula is moved back and forth, creating Swiss cheese like tunnels through the fat tissue, and suctioning the loosened fat into a vacuum. Afterwards, elastic garments are placed around the surgical area, collapsing the tunnels that were made during surgery. This helps the skin shrink and conform to the new shape. The best results are seen in younger people who have more elastic skin and therefore better skin tone.

There are two common types of liposuction performed currently. In the tumescent technique, a saline solution, containing the anesthetic lidocaine, and adrenaline is injected into the area of the body where the fat is to be removed. The tumescent solution numbs the fat under the skin and constricts blood vessels for several hours, allowing fat to be removed with little blood loss.

The amount of tumescent fluid used, as well as the amount of fat that can safely be removed at one time, is calculated based on body weight and other factors. This method is best for removing fat from areas below the waist and from the head and neck.

The ultrasonic liposuction method uses an ultrasonic probe to produce sound waves that pulverize the fat cells, breaking them apart, allowing the fatty fluid to be suctioned out. The ultrasound liposuction technique works well on areas where the fat is more dense and fibrous like the back, flanks, and male breast tissue.

How safe is liposuction?

People should be cautious when considering liposuction because it is surgery, and can involve rare, but serious complications. However, when done properly by a board-certified plastic surgeon, liposuction is a very safe surgical procedure. Be aware, that any doctor with a medical license can perform liposuction, even non-surgeons. To find a board-certified plastic surgeon in your area, you can contact the American Society of Plastic Surgeons at http://www.plasticsurgery.org/.

It's important to ask your surgeon what procedure he or she is using, and if you're a good candidate for liposuction. People with poor circulation like those with diabetes, heart disease, and peripheral vascular disease are not good candidates because of possible non-healing and infections. The risks of liposuction increase if multiple sites are treated during one procedure or if a large amount of fat is removed.

The most common problems following liposuction are skin imperfections, sagging of the skin if it is not elastic enough to shrink after the procedure, or asymmetric appearance due to uneven fat removal. If cellulite is present before liposuction, it will probably exist after the procedure as well.


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