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Liposuction

 

No matter how determined you are with your diet and exercise, excess fat in certain places sometimes just will not budge. These annoying budges can become a big source of frustration with hindering clothing options and fashion choices. 

According to the American Society for Aesthetic Plastic Surgery (ASAPS), more than 364,000 people decided that their exaggerated contours and unwanted fat pockets turned to liposuction in 2008.

Common names for Liposuction:

  • lipoplasty

  • lipectomy

  • liposculpting

  • bodysculpting

 

The advancements in the latest technology and technique during the last decade has made liposuction more effective than ever. Plastic surgeons can target both large or very localized treatment areas with more precision and less trauma. Liposuction has become an ideal complementary surgical technique to various procedures from face-lifts, neck lifts to body-lifts. Liposuction is one of the most popular cosmetic procedures because it works so well. 

 

As with any procedure, choosing your plastic surgeon is the most important step. Surgeons across the country will agree that the key to an optimal outcome lies in the skill and experience of the physician performing the procedure. 

 

 

 

 

                                

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Liposuction also known as suction assisted "lipectomy" and "lipoplasty" was  originally performed in Italy in the late 1970's by the name of Dr. Giorgio Fischer - who originally invented the technique in 1974. This procedure was furthered developed by French physicians Dr. Gerald Illouz and Dr. Pierre Fournier. It become popular in the United States in 1980.

Liposuction was initially developed in 1974 to surgically remove fat using specialized  surgical instructions and vacuum suction.  Since that time, the procedure has evolved. In the 1980's  "tumescence liposuction" was introduced to improve the procedure safety and results of liposuction. In the 1990's , the advent of ultrasound assistance aimed at fat that is more dense and fibrous - which further improved liposuction.

Today doctors have refined techniques and defined standards. Certain methods may work better for different areas of the body - but one thing remains constant - today's innovations to technology and techniques yield better results with less scarring.

 

 

 

 

 

Liposuction is not a weight-loss alternative. It is a treatment for packets of fat resulting from heredity and aging that are unaffected by weight loss and exercise.  

A good candidate for liposuction for reshaping those pockets, bulges and overhangs are:

  • 18 years of age

  • You are within 30% of the ideal body weight for your height and frame

  • You are generally healthy and physically active 

  • Age is generally not a factor - except regarding elasticity of the skin

  • Having good skin tone

 

Following liposuction, the skin must mold itself to your new contours. If it does not, the resulting loose and droopy skin can be unattractive. If your skin lacks elasticity, a body lift or abdominoplasty (tummy tuck) in addition to liposuction may be an option.

Before deciding on which liposuction technique is right for you, your plastic surgeon must assess:

  • Your overall health

  • Skin quality

  • Body mass

  • Estimated volume of fat to be removed

  • Number of sites that need to be treated

Liposuction involves three-dimensional sculpting of tissue.  The patient's anatomy plays a significant role in the ultimate outcome but so does the surgeon's technique.

 

 

                                  

                                         2010 Copyright ASPS & ASAPS - Used with permission  

                               Before Liposuction                                Liposuction Procedure

 

 

 

Liposuction is not intended for weight-loss. Patients who are very overweight or who have large areas of fat deposits are not good candidates. Your physician will let the patient know if they need to lose weight first and reduce the fatty area that are contributing to their body shape. If weight loss is problematic for the patient and they cannot do this by themselves, then your physician might recommend gastric bypass.

Losing a large amount of weight will leave the patient with an excess of skin, which either an abdominoplasty, panniculectomy (to remove an apron of fat) or a full body lift will be recommended. Either of these procedures will help remove the excess tissue - tighten up muscles and liposuction can be done at the same time to remove excess fatty deposits. 

An overweight patient whose weight has been maintained and stable for many years - and has problem areas of fat, can be a good candidate for liposuction. This procedure in an obese patient is reasonable when the goal of the surgery is to improve certain body contour areas. Liposuction however as a method for weight loss is not reasonable, as it is not safe to remove large amounts of fat - such as 8 to 10 pounds of fat by liposuction in a single day.

 

You are NOT a good candidate for liposuction if you have:

 

 

 

                                         

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                                                                 How Liposuction is Performed

 

 

 

Zoning in on problematic areas and what you can expect from the more popular zones of fat reduction. 

 

                                         

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Liposuction works exceptionally well for the mid-section. With very small incisions in the navel, over the hip or in the "netherlands" - your plastic surgeon can minimize love handles or a bulging tummy. 

 

Saddlebags be Gone! To slim the outer thigh areas, incisions are place above the swimsuit line, in the lower buttock crease, or both. The inner thigh is much harder to treat than the outer thigh.  This area tends to retain fat that is looser simply because the skin is flabbier. Positive results can be seen if there is good skin tone in that area.

 

This area is increasing in popularity for liposuction. The buttock area can be sculpted through a small incision in the hip or under the buttock crease. Your plastic surgeon may redeposit fat into other areas of the buttock to improve the overall shape and avoid a saggy appearance.  This is called a Brazilian Buttock Lift.

 

Knees:  A very small cannula is used with a small incision  - just behind the inner aspect of the knee in the crease. Liposuction can make a dramatic difference in the knee area and can get rid of the handful of fat in the inner knee. The biggest issue with knee liposuction is that, because it is a major flexion area, stiffness in the knee can be expected for 4 to 6 weeks after surgery when bending. 

 

Calves:  Liposuction is very effective at decreasing the size of the calves and ankles. Some people tend to store excess fat in these areas - which on top of highly developed muscles can give the leg a "thicker look". Using very small cannulas, these areas respond to re-contouring - but it is utmost importance that there is not too much fat taken away too quickly.

Liposuction on the calves needs to be performed with extra caution - as this area contains a lot of muscles and is near important nerves and blood vessels. Liposuction on the calves could possibly cause streaks or surface irregularities. 

Liposuction of the calves and ankles is one of the most technically challenging liposuction procedures. It requires a lot of skill, finesse and experience. It is a very unforgiving area in terms of the risk of creating permanent superficial contour abnormalities. The results of calf and ankle area liposuction have a lot more to do with surgical technique than surgical technology.

 

Possible complications of calf liposuction include:

  • permanent damage to the nerves or blood vessels

  • excessive leg pain and swelling

  • blood clots in the leg veins

  • permanent scars from the incisions

  • infections

  • bad reaction to the anesthesia and drugs

 

Ankles:  The area of ankles primarily consist of muscle and bone. Liposuction of the ankle area is performed with tiny cannulas to avoid muscle or vein damage and scarring.  Because ankles are prone to swelling, sometimes small drainage holes are made to remove excess fluid. Improvements will continue for at least six to nine months in the calves and ankle area. Support hose is recommended to help contour this area during recovery.

 

Liposuction can be used in addition with traditional breast reduction surgical procedures to improve the results. Fat in the outer areas of the breast is commonly treated with liposuction.

 

Women often opt to sculpt the area under the armpit and where the bra strap falls on the back for a smoother silhouette. Ultrasound assisted liposuction may be beneficial on the fibrous fat on the back and love handles.

 

This procedure is a common solution for flabby arms, and is especially popular with women. A skilled surgeon can contour arms into a more desirable shape, creating a balance between fat and muscle tone. Liposuction is commonly added to the traditional arm lift or brachioplasty procedure.

 

With aging, many patients develop jowls of the lower face and fat around the neck. These areas can respond successfully to liposuction.  Chin and neck liposuction purpose is to remove the fat that can cause a double chin or a diminished chin.  It also can decrease the appearance of chipmunk cheeks and or jowls.

Neck liposuction in general can remove fat from a much larger area - creating an overall appearance of weight-loss. However, sometimes loose skin can become a byproduct of having this procedure done. Laser resurfacing is used commonly to tighten the neck area skin. 

The results from liposuction of the chin are very impressive and consistent. With good technique from the surgeon and the appropriate patient - the change in appearance of this area is phenomenal. Most patients wear a neck band compression bandage for two weeks which helps reduce the swelling and help with the skin adhering to its new shape.

 

 

 

 

Limits to how much fat can be safely removed are relative to the patient's health and size. The standard that defines "Large Volume Liposuction" - is the removal of more than 5 liters of fat and fluid or 5,000 ccs. during one procedure. If this greater volume is removed, then an overnight stay at a hospital or an accredited surgical center is recommended so that the patient's health can be closely monitored. In some cases, your surgeon might recommend that the liposuction be done in more than one procedure.

 

   

                              

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The loss of fat cells is permanent from having liposuction - with the patient having a smoother contours without excessive bulges. 

  • If the patient gains weight after the procedure the remaining fat cells will grow in size.  The areas that were treated with liposuction should remain proportionally smaller.

  • Tiny scars ranging in size from 0.25 - 0.5 inches in length at the site of the incision is normal. Your surgeon will normally pick areas of the body that can conceal the incisions, such as skin folds, etc.

  • In some cases the skin may appear rippled, wavy, or baggy after surgery. 

  • Pigmentation spots on the skin can develop.

  • The re-contoured area may be uneven - occurring in 5 - 20 percent of the cases. This is quickly remedied with a second liposuction procedure that is less extensive than the first surgery.

 

 

 

 

 

                                           Liposuction Surgical Tools (Cannula)

                                             

                                             

The cannula is the most widely known surgical instrument in a liposuction procedure.
Cannula instruments are hollow metal tubes which are made out of titanium or stainless
steel - which can range in length from 26 - 36 cm. These surgical tools are also anywhere
from 1.4 to 5 mm in width - with some cannula being larger.

The different size cannula are used anywhere from large volume liposuction down to the
procedure of micro-liposuction.  Each size cannula has a specific target area.

 

                              

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