About liposuction

In liposuction, a defined deposit of fat is aspirated and removed from the body. The technique commonly in use today is termed tumescent liposuction.  It is performed under local anesthesia on an outpatient basis and has an excellent safety profile when performed by experienced practitioners.

In tumescent liposuction, a mixture of saline solution and dilute lidocaine and epinephrine (0.1% lidocaine with 1:1,000,000 epinephrine) is first infused into the area to be aspirated, resulting in both local anesthesia and vasoconstriction, which reduces blood loss.  This technique is attributed to Klein, a dermatologic surgeon, who also introduced small cannulae into his procedures.

Who should get liposuction?

Liposuction is best performed for the reduction of focal fatty deposits in otherwise healthy people who are able to maintain a regimen of diet and exercise after the procedure to maintain the results.  It should not be used to achieve general weight loss. Patient expectations must be realistic, and their motivations sound. Commonly treated areas are the upper and lower abdomen, flanks (love handles), inner and outer thighs, knees, arms, neck, ankles, calves, and back.  Liposuction has also in some cases been used to achieve breast reduction.

How is liposuction performed?

First your dermatologist or plastic surgeon will take a complete medical history and photographs of the proposed treatment site. When it is time for the procedure, the area to be treated and the sites for cannula insertion will be marked. The field is prepared in a sterile fashion and then the insertion sites are infiltrated with local anesthetic using standard injection technique. An entry is created, typically with a #11 blade or a small punch instrument, and a small tunnel created with a hemostat or other instrument.  A blunt cannula is then inserted and the tumescent mixture infused, typically with a pump.  The liposuction cannula is then inserted and the fat aspirated, either with machine suction (suction-assisted liposuction) or a syringe.  Following the procedure the insertion site may be either sutured or left open to assist with drainage. Compression garments are worn for several days to several weeks postoperatively, depending on the site and the surgeon’s preference.  Normal activities can be resumed within a few days.

What is laser-assisted liposuction?

Recently, a number of laser devices have been introduced to “improve” on standard tumescent liposuction.  In most cases, a clear advantage to laser-assisted liposuction has not been demonstrated, despite the marketing hype.

What are the potential complications from liposuction?

Tumescent liposuction has an excellent safety record.  Adverse effects have been associated with general anesthesia (if used), conscious sedation, and fluid shifts in larger volume aspirations. Mortality has occurred when liposuction has been coupled with other procedures, such as abdominoplasty.  Other reported adverse events, occurring in a small percentage of cases, include: toxic shock syndrome, infection, contour irregularity, hematoma, seroma, unacceptable scarring, sensory nerve damage, and contact dermatitis.

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