Liposuction or lipoplasty is a cosmetic procedure that uses gentle suction to remove fat deposits from different areas on the body. Some of the most common areas treated include the thighs, hips, buttocks, or abdomen. Patients who undergo liposuction find that they are able to achieve a more proportionate body contour by directly treating their problem areas, which cannot be accomplished with diet or exercise alone.
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Are You a Good Candidate?
You may be a good candidate for liposuction if you are:
- Healthy and have no major medical issues.
- Near your goal weight (less than 30 pounds overweight) but have specific areas you wish to target for fat removal.
- Between the ages of 30 and 60, although liposuction has been successfully performed on both younger and older patients.
- Have good skin elasticity, which helps the body to adapt to its changing contours quickly.
- Informed about the benefits and risks.
- Have realistic expectations
Liposuction can be performed on patients who are overweight but whose weight has been stable over the past several years.
You most likely are NOT a good candidate if you are:
- In poor health, or have serious medical conditions.
- Taking certain medications.
- Planning to become pregnant or lose a significant amount of weight in near future.
- Mentally unstable
When considering liposuction, it’s important to have realistic expectations. This procedure cannot make you look like a supermodel, and will not remove every ounce of fat from your body. Patients should not think of liposuction as a fast-track to weight loss, but as a way to create more aesthetically pleasing silhouette through removing five pounds or less of targeted fat.
Let’s Start with Wetting Solutions: Why are they Used?
Before the fat is removed, wetting solutions containing saline and epinephrine are infused into the target areas. The purpose of this fluid is that it substantially minimizes blood loss and increases the safety of the procedure. It also distends the fat compartments which make it easier to suction out the fact. The following are the most common types of wetting solutions used:
- “Wet” Technique: Infusion of 100 to 300 ml of fluid into each treatment site. With this approach, 20 to 25 % of whats is suction out is blood.
- “Super-Wet” Technique: Infusion of fluid greater than the “wet” technique which results in less than 1% of what is suctioned out is blood.
- Tumescent: Infusion of 3 to 6 times (greater than “super-wet”) as much fluid as volume of fat, fluid and blood to be removed. As a result, it swells the tissues making it easier to remove fat.
After the solutions are infused, the fat is vacuumed out using liposuction.
Time to Compare the Different Ways Fat is Suctioned Out (Ultrasound, Laser, etc.)
There are many variations of liposuction, most of them designed to allow for easier or more precise fat removal. The following provides a brief overview of the different techniques used to remove fat deposits.
Traditional Suction-Assisted Liposuction (SAL)
|How it Works||A small tube (known as a cannula) is inserted under the skin into the fat layer.The surgeon moves the cannula back and forth to break up the fat layers, then suctions out the excess fat tissue.|
|Pros||It is the standard method and most widely used technique.
Ideal for targeting larger amounts of fat deposits.
Can produce very dramatic results.
|Cons||Not ideal for delicate areas such as in the face, neck and chin.
Requires larger incisions.
In general, a longer recovery period compared to other techniques.
Ultrasound-Assisted Liposuction (UAL)
Brands: VASER Liposelection, UltraSculpt, etc.
|How it Works||A special cannula that emits sound waves is used to break down the fatty tissue that is being targeted for removal.|
|Pros||Technology breaks up fat for easier removal causing less bruising and swelling.
Reduces the surgeon’s work effort so he/she can concentrate on smoothness of contour and finesse in results.
A good option on more fibrous areas such as the upper back and male breasts.
|Cons||Increased cost because ultrasound introduces an additional step in the operation and increases the duration of the procedure by 25% or more.
Since ultrasound uses high energy to melt the fat, it is possible to cause a burn of the skin or elsewhere.
Power-Assisted Liposuction (PAL)
Brands: Tickle Lipo, MicoAire PAL LipoSculptor, etc.
|How it Works||This technique uses a high-speed vibrating cannula to break up the fatty tissue which is then vacuumed out of the body. Similar to traditional UAL, but the surgeon does not need to make so many manual movements|
|Pros||Duration of the operation is shorter because the fat is suctioned more quickly by the powered cannula.
Surgeon can focus more on the sculptural aspects of the procedure and less on having to extract the fat.
Does not use heat, so there are no concerns for the accidental burning that can occur with other techniques.
|Cons||Does not help tighten skin.|
Laser-Assisted Liposuction (LAL)
Brands: Smartlipo, SlimLipo, CoolLipo, etc.
|How it Works||Involves the use of laser energy to liquify or “melt” the fat for easier removal.|
|Pros||Less invasive than some other techniques.
Reduced swelling and bruising resulting in faster recovery.
Positive effect of tightening the skin.
Less invasive and bloody procedure than the traditional liposuction
|Cons||If the temperature becomes too hot, it could cause burning and scarring of the skin.
Unwanted fat cannot be used for fat transfer procedures.
More costly because of the additional steps involved in the operation
Water-Assisted Liposuction (WAL)
Brands: Body-Jet, AquaLipo, etc.
|How it Works||A large volume of water-based solution is used to loosen fat cells for easier removal.|
|Pros||Removes fat more gently than some other techniques.
Very little or no damage to surrounding tissues resulting in less bruising or swelling and shorter recovery period.
If desired, fat cells can be saved and used to plump up other areas of the body.
|Cons||Not ideal for individuals with large amounts of body fat.
Does not contour loose or hanging skin.
Increased cost because of the additional steps involved.
During a consultation, your plastic surgeon will cover your medical history, areas of concern and skin quality (elasticity). Based on these results and other information discussed, your surgeon will recommend the best technique to meet your goals.
Liposuction Procedure: Step-by-Step Guide
There are various approaches to liposuction and your plastic surgeon will recommend an approach depending on your preferences, body shape and prior and future treatments. The following provides a basic overview of how a typical liposuction procedure is performed.
- First, your surgeon will use a magic marker to circle the areas of your body where the fat will be removed. (See Figure A below.)
- You will then be given anesthesia.
- After you are anesthetized, the surgeon injects the marked areas with a large amount of sterile wetting solution. The solution acts as a local anesthetic and constricts the blood vessels, which reduces discomfort and lessens the bruising that follows liposuction. There are various types of wetting solutions used in liposuction surgery such as the dry, wet, super-wet and tumescent technique.
- Next the fat is removed using a narrow tube called a cannula. There are several different ways to vacuum out the fat. They include traditional suction-assisted liposuction, ultrasound-assisted, power-assisted, laser-assisted and water-assisted liposuction. (See Figure B below.)
- Once the fat is removed, the incision is stitched up and a compression bandage is applied to the treated area.
Important Safety Information
Liposuction is relatively safe however there are risks that you should be fully aware of before proceeding with surgery. Some possible risks include:
|Adverse Reactions:||Resulting from anesthesia or medications.|
|Scarring:||This can occur from the incisions that are made from which the fat tissue is removed. These incisions are typically only 4 to 10 millimeters in length and oftentimes hidden within the natural creases within the skin. In most cases, the scars should fade away within a year’s time, leaving only a thin white line as a remnant. However its something that should be considered before undergoing surgery.|
|Bumpy or Uneven Results:||These complications may detract from the desired appearance you were expecting to achieve as an outcome of the procedure. These imperfect results could be caused by a number of factors such as an inexperienced plastic surgeon, the uneven removal of fat, abnormal healing of the skin, or inadequate elasticity of the skin. These complications could be either temporary or permanent.|
|Infection:||Caused by bacteria entering the incision.|
|Loose Skin:||Older patients or people who have a relatively large amount of fat to remove are the ones who are most susceptible to this complication. This depends upon the elasticity of your particular skin. If this occurs, you may need to undergo a secondary surgery to remove the excess skin, known as a “body lift” operation.|
|Nerve Damage:||Resulting from the insertion of the cannula, which is the metal tube used to suction the fat cells out of your body. This can cause numbness in the impacted area of the body, which could either be temporary, or in rare cases, permanent. On rare occasions, a cannula may be inserted too deep into the skin, to the point where it punctures a bodily organ, requiring emergency surgery to seal the puncture.|
|Fat Embolism:||Resulting from the way the fat is suctioned out of the body. Minute particles of fat may end up being redirected into a blood vessel rather than exiting the body through the cannula. If this occurs, deposits of this fat could move through the blood into the lungs or the brain, a situation that constitutes a potentially life-threatening medical emergency.|
Depending on the type of liposuction procedure, there may be other risks involved. To reduce the possibility of complications, it’s recommended that you choose your plastic surgeon carefully.
What to Expect During Recovery Time
On average, liposuction procedures take between one and five hours to complete. Following surgery, you will be able to leave the treatment center although you will need someone to drive you home. Expect to spend several days resting before you are able to gradually return to your normal activity level.
In the days to follow, you can expect the treated area to feel sore and tender. Many patients describe it as being similar to a large bruise. In some cases, a visible bruise may also develop. Typically, the skin is red for a few days. If large areas of the body have been treated, pain medication may be prescribed to reduce your discomfort. Patients who undergo tumescent liposuction, which requires the injection of large volumes of saline solution, this liquid may drain from the incision sites for a few days. The area will also be swollen; depending on the amount of swelling and the volume of fat removed, you may not be able to see a size difference following liposuction until the swelling subsides. You can expect these side effects to last up to two weeks during your recovery period.
Tips to Reduce Swelling after Surgery
Many patients find swelling to be the most prevalent side effect following liposuction. Because this side effect can obscure the full results of the procedure, here are a few tips for reducing swelling:
- Stay hydrated
- Maintain a proper, low-sodium diet
- Get adequate rest and avoid returning to your normal activity level too quickly
- Gently massage the area to encourage circulation
- Avoid medications that may interfere with fluid balance, and be sure to tell your doctor about any medications you are taking
After most liposuction procedures a compression garment is worn over the treated area for several weeks. This garment provides support for the treated tissues, helping the skin to adjust to the reduction in fat.
Compression garments also help to decrease swelling, so that you can enjoy the results of your liposuction procedure faster. Wearing the compression garment as directed may reduce the risk of complications such as skin looseness as the body adjusts to the contours created through liposuction.
Follow your doctor’s instructions regarding drainage tubes, compression garments, or medications. If you use these as instructed, the liposuction recovery time will become shorter, and the chances of a successful procedure become higher.
Getting Back to Your Daily Routine
The initial side effects usually last around two weeks, depending on the extent of the procedure. In general, patients typically return to work and other daily activities in a week or less, although the treatment of larger body areas may require a slightly longer recovery period. With less extensive liposuction procedures, some patients are able to return to work in as little as two days. It is important to be patient for your figure to be revealed, as you may not see the expected results right away. The full results of liposuction are typically visible within six months, as the tissues gradually adjust to their new contours.
Liposuction should be seen as the beginning of a journey, not the end of one. Patients undergoing this procedure are advised to follow a healthy diet and exercise plan to prolong the results. Liposuction permanently removes fat cells, which cannot regrow after the treatment. However, it will not prevent you from regaining weight elsewhere on the body. The success of your treatment depends greatly on how you care for your body’s new contours.
What Does Liposuction Cost?
The cost of liposuction can vary widely depending on a number of factors such as the size of the area being treated, the volume of fat removed, technique used, type of anesthesia and the plastic surgeon you choose. Because of this, it is one of the most difficult procedures for estimating cost. This makes obtaining an accurate quote over the phone nearly impossible. When researching the cost, its important to take these variables into consideration.
With most surgical procedures, there are three basic fees involved:
- Surgeon’s fee
- The anesthesia fee
- Hospital or surgical facility fee
On average, you can expect to pay between $2,000 and $4,000 for the surgeon’s fee and $1,000 to $1,500 per hour for the anesthesia and facility fees. In some cases, you may also incur additional expenses for prescription medications, compression garments and other post-treatment care.
There are other factors that can affect the cost as well, such as your choice of plastic surgeon, extent of procedure, geographic location and the area of the body where the procedure is being performed.
The following is an average cost you can expect to pay for each part of the body:
|Cheeks, Chin, Neck, Jowls:||$1,500-$4,500|
|Anterior Thighs & Knees:||$1,500-$5,000|
|Inner Thighs & Knees:||$1,500-$5,000|
|Upper & Lower Abdomen:||$4,000 – $8,000|
The surgeon you choose will greatly affect the cost, as well as the outcome of your procedure. Highly qualified, board-certified plastic surgeons are able to command higher fees than those less experienced. However, most patients who choose these surgeons find the additional expense to be well worth it as an experienced surgeon will ensure that the most appropriate techniques are used to reduce the risk of complications and provide a successful result.
There are also variables related to the procedure itself that determine the cost of liposuction. These include the number of areas being treated, size of the patient, anticipated degree of difficulty and the amount of fat being removed.
Liposuction pricing can vary greatly between rural areas and major cities as well. In many cases, even within the same metropolitan areas some surgical centers may have higher fees than others. Large metropolitan areas like New York City and Los Angeles tend to be more expensive than smaller cities as the demand for liposuction is much greater.
Covered by Insurance?
As with most cosmetic treatments, liposuction is not covered by health insurance. However do not let this keep you from considering it. Today, many plastic surgeons offer flexible financing options such as affordable monthly payments. If the cost is an issue, be sure to bring up the question of financing during your consultation. If they do not offer financing themselves, they should be able to direct you to service that offers financing for cosmetic surgery.