Liposuction Surgical Procedure
Liposuction is a procedure in which fatty tissue is removed from a specific area of the body. Generally, people with a stable body weight choose to have liposuction surgery to target pockets of fat that persist in spite of changes in diet and exercise. Liposuction can be performed under local or general anesthesia, depending on how many areas are being treated, and takes place either in a doctor’s office or surgical facility.
The liposuction procedure can be performed using local or general anesthesia. The term anesthesia simply means “without pain,” and the difference between local and general anesthesia is how much of the process you will be aware of. In most liposuction techniques, the process itself involves the injection of a numbing solution. With local anesthesia, your doctor will only numb the area of your body being targeted, and you will be conscious during the entire liposuction surgery. General anesthesia can be administered either as a gas or through a needle injection, and will put you to sleep for the duration of the operation. Once you awaken, you will still be numb in the area of the body that has been treated, and will feel little or no pain.
The Liposuction Procedure
The concept of liposuction surgery may seem simple - the fat is vacuumed out, and you’re good to go – but it is actually a complex process just like any other surgery. A skilled physician will be well trained in all aspects of the liposuction procedure, and will be able to explain the process to you in as much detail as you wish. Following is a basic outline of liposuction surgery:
Creating the Incisions
After administering anesthesia and, in some cases, injecting fluids, the next step in liposuction surgery is to create tiny incisions in the area of the body where fat deposits will be removed. These incisions are usually quite small, ranging from a quarter to a third of an inch.
Next, your surgeon will insert a thin vacuum tube, called a cannula, through the incision and into the deep fat layer. Your surgeon will move the cannula back and forth to break up the fat cells, and, with the help of an attached syringe or vacuum pump, suction them out. Because a significant amount of blood and other bodily fluids are removed along with the fat, patients receive replacement fluids intravenously during and after the liposuction procedure.
Closing the Incisions
Depending on the preference of your physician, your incisions can either be closed with a few stitches or left open. Some doctors prefer to keep the incisions open to reduce the amount of bruising and swelling that can take place after liposuction surgery.
Visit the DocShop gallery to view liposuction before and after photos.
Photo credit: Dr. Dina Eliopoulos
Variations in Liposuction Surgery Techniques
Because there are a number of different types of liposuction surgery that are currently in use, the procedure will vary based on technique:
- In tumescent liposuction, a large amount of fluid (a mixture of salt solution, lidocaine, and epinephrine) is injected into the area to be treated. The amount of fluid is usually measured at three times that of the fat being removed. This provides local anesthetic, prevents fluid and blood loss, and makes fat removal easier.
- Super-wet liposuction is a variation of the tumescent technique that uses less fluid injection. The amount of fluid is usually equal to the amount of fat being removed. General anesthetic is required for this type of liposuction.
- In ultrasound-assisted liposuction (UAL), a special, ultrasonic cannula is used to liquefy the fat cells and remove them without the traditional suctioning. This technique is usually used as a secondary procedure when more precision is required.
- Power assisted liposuction (PAL) uses a high-powered cannula that moves back and forth about 5,000 times per minute. This variation allows for the gentler removal of fat cells, resulting in less pain during surgery and less bruising afterward.
- LipoSelection® is similar to UAL, using ultrasound waves to break up and emulsify fatty tissue. This technique allows for minimal disturbance of surrounding tissues.
- Laser liposuction techniques such as Smartlipo™, SlimLipo™, and CoolLipo™ use laser energy to liquify fat before it is removed from the body.
Immediately Following Surgery
After liposuction surgery, there is always some amount of fluid left beneath the skin. If the incisions are stitched shut, the fluid drains less easily and can lead to bruising or swelling. However, if this method is used, you will need to wear an elastic compression garment (which resembles a girdle) to force the blood vessels into absorbing excess fluid. The current “open drainage” technique allows the incisions to stay open after liposuction surgery, and the fluid continues to drain from the area for several days. You will also wear a compression garment during this time to encourage proper draining and to protect your clothing from residual blood and fluid. See our section on liposuction recovery for more information.
Find a Liposuction Surgeon in Your Area
Because there are a variety of liposuction techniques currently in use, you will want to be sure to locate a physician who is well-practiced in the type of liposuction surgery you prefer, and who is sensitive to your particular needs. DocShop has compiled a directory of highly qualified doctors who can help you decide which liposuction procedure is right for you.