Introduction:

Liposuction is a plastic surgery procedure that sculpts the body by removing excess fat deposits from specific areas. Through a tiny incision, a narrow tube is inserted and used to vacuum the fat layer that lies deep beneath the skin. The cannula is then pushed and pulled through the fat layer, breaking up the fat cells and suctioning them out by a vacuum pump or a large syringe. Liposuction is not a substitute for dieting and exercise, but it can remove stubborn areas of fat that do not respond to traditional weight loss methods.

Best candidates for liposuction:

The best candidates for liposuction are people who are within 30% of their ideal weight and have firm, elastic skin with pockets of excess fat in certain areas. You should be realistic with your expectations and in good physical and mental health. Individuals with certain medical conditions may not be suitable candidates for liposuction.

Anesthesia for liposuction:

Your cosmetic or plastic surgeon will choose the type of anesthesia that is most suitable and safe for your surgery. Liposuction can be performed under local or twilight anesthesia, which numbs only the affected areas only if small amounts of fat and a limited number of areas are involved. Local anesthesia is typically associated with the tumescent method. Local anesthesia is given by needle or probe. General anesthesia is generally used for more extensive procedures. General anesthesia produces a state of unconsciousness with absence of pain sensation over the entire body. General anesthesia is administered through several different ways. Two of the most common ways are inhalation (through the lungs) and intravenously (through the veins). In such cases the anesthesiologist makes sure you are completely asleep during the procedure.

Preparing for surgery:

Prior to your surgical procedure, your liposuction surgeon will perform a complete health history and physical examination to evaluate your overall weight, your skin and muscle tone and overall distribution of fat deposits. Knowledge of your allergies, medications and previous surgeries should be brought to your surgeon's attention at this time. Specific instructions to assist you in preparing for this procedure will be given to you after the health history and physical are complete. Instructions will be given that include guidelines regarding your diet, alcohol intake, smoking and which medications to take and avoid. You should also make arrangements ahead of time for someone to drive you to and from your procedure and to assist you with your daily activities during your recovery period.

The surgery:

The length of time needed for liposuction surgery varies considerably, depending on the area size, the amount of fat removed, the anesthesia and techniques used. The fluid lost is replaced during the surgical procedure to prevent shock. The patient is under careful observation throughout the procedure and receives intravenous fluids during and after surgery.

Techniques used in liposuction:

The basic technique of liposuction surgery is used on patients undergoing this elective procedure. A medicated solution is normally injected into the fatty areas before the fat is removed. The fluid is a mixture of intravenous salt solution, epinephrine (a drug that contracts blood vessels) and lidocaine (local anesthetic). This solution helps remove the fat easily, reduces blood loss and provides anesthesia during and after surgery.

Tumescent technique:

Large amount of fluids are injected in this technique. The technique is performed on patients who need only a local anesthetic. The procedure takes 4 to 5 hours. Tumescent liposuction is accepted as the safest and most effective form of liposucton by cosmetic and plastic surgeons.

The super-wet technique:

In this technique, lesser amounts of fluids are used. Usually the amount of fluid injected is equal to the amount of fat removed. It is performed under general anesthesia and takes one or two hours of surgery time.

Ultrasound-assisted liposuction:

This technique uses a special cannula that produces ultrasound energy. As the cannula passes through the fat areas, the energy ruptures the fat cell walls which then liquefies the fat. The fat is removed by a suction pump. The fibrous areas of the body like the upper back or enlarged male breasts can be treated effectively with this type of technique.

Recovery:

Don't expect to feel or to look great following your surgery. Even though the newer techniques are believed to reduce post-operative discomforts, you may still experience some pain, burning, swelling, bleeding and temporary numbness. To control swelling a compression garment will be worn for several weeks. Your surgeon will prescribe antibiotics to prevent infection. You may experience some initial discomfort, swelling, and temporary numbness. All of this will subside with time; depending on the amount of liposuction, normal activity can be resumed anywhere from 10 days to several weeks. You may also experience some drainage from the incisions sites for a day or two following surgery. Pain can be controlled with medication prescribed by your plastic surgeon, though you still may feel stiff and sore for several days.

Precautionary measures to be taken:

Healing will be a gradual process. You should start walking around to reduce swelling and to help prevent blood clots from forming in your legs. Drink sufficient water to avoid dehydration. Avoid alcohol for a few days. Avoid submerging in bathtubs or swimming pools. More strenuous activity should be avoided for several weeks to a month, as your body continues to heal. By eating a healthy diet and getting regular exercise, you will help maintain your new shape. Although most of the swelling and bruising usually resolve in the first four to six weeks, final results of surgery may not be fully realized for six months or longer after surgery.

Possible complications:

Though the complications are rare, they can occur as with any surgery. The risks are higher when treated areas are very large or large amounts of fat is removed.

• Infection at the punctured site and delay in healing.
• Damage to skin, to avoid wounding the skin the surgeon works at deeper levels of fat.
• The formation of fat clots or blood clots, which may migrate to the lungs and cause death.
• Excessive fluid loss, which leads to shock.
• Fluid accumulation which has to be drained.
• Friction burns or either damage to the skin or nerves of performance injury to the vital organs.
• Drug reaction
• Skin necrosis
• Lidocaine toxicity.
• The skin may be irregular
• Numbness may occur.