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Liposuction

What is liposuction?
Who is a good candidate?
Risks
Preparing for liposuction
Recovery

What is liposuction?
Liposuction -- also called suction-assisted lipectomy -- is a surgical technique designed to remove pockets of localized fat from a specific area of the body, such as the waist, abdomen, arms, thighs, ankles or small areas of the face. It's one of the most commonly performed cosmetic surgery procedures.

During the proceure, the surgeon makes a small incision near the area of fat to be removed, then inserts a cannula (hollow tube), which is attached to a suction machine. By using gentle suction and lightly moving the cannula back and forth, the physician can remove small areas of fat. The resulting scars are small (1/2 to 1 1/2 inches) and usually can be hidden, even in a bikini.

Within the last five years, plastic surgeons have developed new liposuction methods, which may be used alone or in combination with traditional liposuction.

During tumescent liposuction, the doctor injects a large amount of anesthetic into the area of fat to be removed. The anesthetic liquid causes the fat to swell (tumesce), which allows the liposuction cannula to move more smoothly while the fat is being removed. The advantages of this technique are less blood loss during the procedure and less bruising and swelling afterward. Surgeons use this technique most often for the face, neck, arms, calves and ankles, where the procedure needs to be more precise.

Ultrasound-assisted liposuction (UAL) uses sound waves to dissolve fat, which is then removed using a cannula, just as in traditional liposuction. UAL doesn't replace traditional liposuction, but is used in conjunction with it. It's most often used in body areas where a large amount of fat will be removed.

Your physician will talk to you about which method, or combination of methods, is right for you.

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Who is a good candidate?
Healthy, fit and psychologically stable men and women who have pockets of unwanted fat that remain despite dieting and exercise are the best candidates for this procedure. Liposuction can help remove "trouble spots" of localized fat in these areas:

  • abdomen
  • buttocks
  • hips
  • thighs
  • knees
  • calves
  • ankles
  • upper arms
  • above the breasts
  • neck and under the chin
  • cheeks

Liposuction is not a substitute for weight loss. If you're overweight, your plastic surgeon may ask you to lose weight before you finalize your surgery plans. This procedure is also not the most effective cosmetic surgery technique for skin that has lost elasticity. Loose or sagging skin is best removed by another surgical procedure, although under some circumstances the surgeon may perform liposuction in conjunction with other procedures.

It is importat to have realistic expectations about your surgery's results. If you want them to be long-term, you must commit to eating properly and staying fit after surgery, as well.

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Risks
Every type of surgery has risks, but you can usually help prevent complications by carefully following your physician's instructions. It's important to talk with your plastic surgeon before surgery to be sure you understand the potential risks and complications. If you don't understand something, ask!

Liposuction's risks depend a great deal on the extent of the surgery. If you're undergoing extensive suctioning or having multiple areas treated, you're at greater risk for complications. When serious problems occur, they're usually due to extensive fluid loss. Infection is also an occasional complication.

If you're having both sides of your body liposuctioned, your results may be uneven, and you may need a second procedure. Sometimes the skin over the area becomes rippled or baggy. Pigment changes, such as brown spots, may appear after you've been in the sun.

Although the liposuction incisions do leave scars, the plastic surgeon will take great care to place them where they'll be least visible. These scars usually fade over time, so they can barely be seen, if at all.

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Preparing for liposuction
Carefully follow your doctor's instructions before surgery so you're properly prepared and less likely to experience complications. In some circumstances, your plastic surgeon may ask you to lose weight before having liposuction. If you smoke, you'll need to stop at least two weeks before surgery. Aspirin and other anti-inflammatory drugs can increase bleeding, so your doctor will tell you when to stop taking them.

Most liposuction is performed under local anesthesia or local anesthesia with sedation, so you'll need to have someone to take you home afterward; if you don't, you won't be discharged. Depending on the type of anesthesia you have, your instructions will include a list of other medications to discontinue and the time you must stop eating prior to your surgery.

You'll need to undergo pre-admission testing -- screening procedures to ensure you have no illness or condition which might interfere with the surgery or your recovery. If you plan to have extensive liposuction, or if you're undergoing another procedure at the same time, you may be asked to consider donating blood well in advance of your appointment to replace what you might lose during surgery.

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Recovery
Your plastic surgeon and his or her staff will give you instructions on how to care for yourself after surgery in order to get the best results.

Depending on how extensive your surgery was, you may have had local anesthesia, local anesthesia with sedation, and -- in some circumstances -- general anesthesia. Because you've had anesthesia, you won't be discharged if you don't have someone to take you home.

Most liposuction is performed on an outpatient basis, but if you've had large or multiple areas of liposuction, your physician will have stricter requirements for rest and recovery, and may even require an overnight stay in the hospital.

For two or three weeks after the procedure, your plastic surgeon will ask you to wear a special tightly fitting elastic garment over the liposuctioned area. This body stocking helps control bleeding and swelling and also helps your body recontour itself. You may also have a tube at the surgical site to drain fluid buildup. Your doctor or nurse will give you special instructions about your body stocking and any drainage tubes.

Depending on the extent of your surgery, your doctor will allow you to return to work anywhere from three days to two weeks after surgery.

If you're patient until the bruising and swelling have improved, and you've begun to feel better, you'll realize your goal of looking more svelte. To maintain your new look, be sure to continue eating right and exercising regularly.

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