Liposuction is a very popular cosmetic surgery procedure. Why? For starters, it works. Also, there are very few small incisions, making it hard to know if you've had lipo. With newer treatments such as CoolSculpting, SmartLipo and Laser Lipo getting the spotlight in recent years, standard liposuction doesn't get as much attention but in our experience it's still one of the most effective body contouring options. Liposuction works by permanently removing fat cells from areas where you would rather they not be. Removing these fat cells can be used to decrease the overall volume of an area or it can be used to shape areas. Oftentimes, we start a procedure with both of these as our goals.
The Nature of Fat Cells
Let’s talk more about those fat cells. When you are about 18 years old, you will have made all of the fat cells you are ever going to make. We don’t make new fat cells as we age, we just make the ones we have get bigger or smaller as our weight changes.
Each person has a genetic code determined by their parents that tells their body to store more, or more stubborn fat in certain places. These tend to be the problem areas that drive people in to see us and to get help. Liposuction sucks out those fat cells and they do not regrow. Some fat cells are always left behind, however, and if a person gains weight after liposuction, the fat will get stored somewhere. That’s why we urge people who have liposuction to maintain a healthy lifestyle.
The Lipo Procedure
We perform almost all liposuction procedures here in our surgery center. The procedure begins by making small incisions and using them to fill the tissues we intend to treat with a special mixture of fluid called tumescent. Tumescent has a mixture of IV fluid, numbing medicine (lidocaine) and Epinephrine. This causes fat cells to swell and blood vessels to shrink. As a result, very little blood is lost in the stuff that gets sucked out. This is a picture of what that looks like at the start.
The tumescent fluid is given a little bit of time to work and then the action of sucking out the fluid and fat begins through the same small holes made previously. This is usually done from a couple of different directions and points and follows a map made preoperatively by the surgeon with the patient standing. The picture below shows the left side treated but the right side not treated. You can see the dramatic results that can happen with liposuction in this setting. The color of the skin is changed because of the effect of the epinephrine in that tumescent fluid.
When the entire area we intend to treat is completed, the areas that were suctioned out are smoothed internally with a special tool called a basket cannula. Loose sutures are often put into the incisions to help them heal quickly and postoperative garments, in this case a girdle, are put on before the person wakes up. The picture below shows both sides treated before the girdle is placed.
The most that can be removed at one time as an outpatient (where the patient gets to go home afterwards) is in the vicinity of 5 liters. It is certainly possible to remove more than that but I prefer to do that in the hospital and ask the patient to spend one night if we do. That’s rarely needed, though, as 5 liters is a lot and can, by itself, provide dramatic results.