Liposuction is the most popular cosmetic surgery procedure in the U.S.  In 2003 a total of 384,626 people underwent liposuction up from 176,863 in 1997 which represents a 117% increase.  New techniques in liposuction surgery have led to improved results with quicker recovery time.

Board Certified Plastic Surgeon, Douglas M. Senderoff, MD, FACS,  performs the majority of his liposuction procedures as an outpatient in his fully accredited outpatient surgical facility located on Park Avenue South in Manhattan, New York.  The type of anesthesia most commonly used is a local anesthesia solution combined with intravenous sedation.  General anesthesia is also used in selected patients.  For small areas such as under the chin local anesthesia alone without intravenous sedation can be used.

Candidates for Liposuction

The best candidates for liposuction are patients with localized fat deposits that are resistant to diet and exercise.  Liposuction can permanently eliminate or reduce the size of these stubborn areas.  Areas that are commonly treated by liposuction include the hips, thighs, abdomen, flanks, back, chest, arms, and chin.  The amount of fat that is removed during the procedure depends on several factors including the size of the fatty deposits, the quality and availability of the fat, the patient’s health and the surgeon’s judgment.

Tumescent vs. Superwet Liposuction

Tumescent liposuction refers to the administration of large volumes of liposuction solution containing lidocaine with epinephrine diluted in a liter of saline.  This solution is injected under the skin usually through a pump until the skin becomes full and tense.  With the tumescent technique no other anesthesia is given.  Superwet liposuction is similar except not as much solution is injected.  The amount of solution administered is usually about 1-1.5 times the amount of fat that is estimated to be removed.  Intravenous sedation or general anesthesia is usually used with the superwet technique.  The use of wetting solutions allows fat to removed with less bleeding and is employed in almost all liposuction procedures.

Traditional Liposuction

In traditional liposuction a cannula or hollow tube with several small openings at the end is inserted through a tiny incision in the body.  The cannula is attached to suction tubing and a vacuum device.  The surgeon then moves the cannula back and forth in an attempt to remove fat and sculpt the desired area.  Large cannula are more efficient is removing fat but can lead to oversuctioning and contour irregularities.  Small cannula in the range of 3mm are more precise but can make the surgery longer.

Power-assisted Liposuction

Power-assisted liposuction using a reciprocating cannula is very effective in removing fat in an efficient and timely manner.

Using this technique the cannula is attached to a handpiece which moves the cannula back and forth several thousand times per minute.  Power assisted liposuction is useful in stubborn areas such as the chest or in secondary liposuction with scar tissue.  There is some evidence that this technique is more comfortable for the patient during surgery and produces less bruising and swelling.  Power assisted liposuction is popular with surgeons since there is less fatigue on the part of the surgeon than with traditional liposuction.

Vaser Ultrasonic Liposuction (Liposelection)

Ultrasonic liposuction has evolved over the past several years and is now an excellent liposuction technique.  Using the Vaser which is a machine that produces ultrasound energy fat can be selectively targeted and removed after it becomes liquefied.  In this procedure liposuction solution is administered to the area that is to be treated.  Ultrasound energy is then applied to the fat under the skin for several minutes using a small ultrasound cannula.  When the fat has become emulsified the liposuction cannula is introduced and the fat is extracted using suction.  With this technique connective tissue, blood vessels and nerves are preserved while the fat is being sculpted.  Vaser ultrasound liposuction is very effective in hard to treat areas such as the chest and back and is excellent in removing fat from areas that have already been suctioned before.  Delicate areas such as the inner thigh and chin can be treated with the Vaser liposutcion which is gentler than traditional liposuction.

After Liposuction Surgery

As with all procedures there is a recovery period.   Immediately after liposuction surgery patients have minimal discomfort while the local anesthesia is still effective.  A compression garment is usually worn for several weeks to reduce swelling.  Bruising is variable and can last between a few days and a few weeks.  Sutures are removed in 7-10 days.  While many patients see an immediate improvement it may take 6 months or longer for the final shape to be evident and for the scars to fade.

 Complications of Liposuction

All surgery carries some risk.  While the risk of serious complications such as bleeding and infection are rare there are several more common complications that should be mentioned.  The most common complication after liposuction surgery is contour irregularity from either oversuctioning or uneven suctioning.  Some patients will require a touch-up several months later to correct the asymmetry.  Dehydration may occur from removing too great a volume of fat at one time.  To avoid this problem most surgeons will not remove more than 5 liters of aspirate at one setting.

Patient Satisfaction From Liposuction

Overall, the vast majority of patients experience great satisfaction from liposuction surgery.  Many patients report an increase in self-esteem and confidence within days of the surgery.  In addition, many patients are thrilled to finally be able to wear the type of clothing they could not feel comfortable in before their surgery.  Liposuction surgery can be a rewarding and life enhancing experience when performed expertly and appropriately in patients who are well informed and willing to undergo elective surgery in order to achieve their goal of a better body.