Liposuction, or sometimes called lipoplasty or simply lipo is a procedure to remove fat from specific parts of the body. Common areas where liposuction is performed include the tummy, upper legs, arms, back & neck.
There are several techniques to perform liposuction, but in its most basic form a tube made from stainless steel (cannula) is inserted in the area to be treated. The cannula is connected to a powerful suction pump. Parts of the fatty tissue will be literally sucked out. After the procedure, the surrounding parts will collapse into the removed parts resulting in weight-loss and a slimmer contour.
Often a liquid is injected in the area to be treated to loosen or liquefy the fat before removal. There are several different techniques discussed below. Differences exist between the amount of liquid to be injected or the cannula.
Variations of the procedure
Dry liposuction
The original liposuction uses no liquid at all. It is no longer in use today because of blood loss and a higher risk for complications.
Tumescent Liposuction
This is probably the most common form of liposuction today. High doses of a solution of a local anesthetic (often lidocaine) and a liquid to make the blood vessels smaller (often epinephrine) are injected directly in the fat.
The main benefit of this technique is that is performed under only local anesthesia. The down side is the high amount of lidocaine used: this can lead to licodaine poisoning if used on a large area.
Wet liposuction
A small amount of solution is injected into the fat. This amount is less than the amount of fat to be removed. The solution consists of a local anesthetic, saline to reduce bruising, and adrenaline to constrict blood vessels. The solution is injected to loosen the fat cells, which are suctioned out with the cannula.
Super wet liposuction
This technique uses a similar solution as with wet liposuction. However larger amounts of solution are injected, about the same amount as the volume of fat to be removed. This technique is favored for large volume removal. Often the patient gets IV anesthesia in addition to the local anesthetic in the solution.
Ultrasonic Assisted Liposuction (UAL)
This technique uses tumescent fluid in combination with a special cannula. The cannula sends out ultrasound vibrations. Those tiny vibrations liquefy the surrounding tissue. This technique is often used on more solid or fibrous areas like the upper back.
VASER
Vaser or LipoSelection is a more modern technique that uses ultrasound vibrations. It has less risks of complications compared to traditional UAL.
Power Assisted Liposuction (PAL)
PAL is another version of UAL. In this case the cannula mechanically moves around in either a pulsating or rotating fashion. This makes the procedure easier for the surgeon, since he or she does not need to manually move the cannula as much.
External ultrasound-assisted liposuction (XUAL or EUAL)
Yet another form of UAL, however in this case the ultrasound isn’t applied through the cannula, but externally outside the body. This technique was developed, since traditional UAL has the risk of leading to skin necrosis or creating pockets of bodily fluids. There appear to be many benefits to this method, however it is not widely used yet.
Laser assisted liposuction (LAL)
LAL uses photo-energetic and thermal energy to generate heat. This heat helps to emulsify or liquefy the fat cells. Since this technique only affects the fat cells it leaves the muscle intact, reducing bleeding and damage to nerve tissue.
Water Assisted Liposuction (WAL)
WAL uses a pressurized thin beam of tumescent liquid to loosen the fat structure. Instead of emulsifying the fat cells it dislodges them, leading to a gentler removal. This type of liposuction leads to little scarring and does not require general anesthetics. It is, however, not widely used yet.
Other techniques
There are several techniques that go by other names, but are usually trademarked names for similar procedures mentioned above. Ask you surgeon about exact details about the procedure.
Recovery after the procedure
After the procedure and the incisions are small often the incisions are not closed with sutures so any fluids can drain. Other times sutures are placed 1 or 2 days after the procedure.
You will get a compression garment on the affected area. This garment can easily be replaced by the patient and have to be worn for a couple of weeks.
Bruising, swelling and pain after the operation are to be expected. Pain can be controlled with over the counter pain killers. Pain and bruising can last for a few weeks, while swelling can last as long as 2 months.
Depending on the type of procedure and the amount of fat removed the patient can usually go back to work any time between 2 days until 2 weeks after the procedure.
Risk
As with any surgery there is a risk of complications. The risk increases with size of the treated area and the amount of fat removed. As always discuss your personal situation with a qualified physician before starting treatment. Make sure to mention any medication you might be taking.
Some complications reported to be related to liposuction are listed below.
- Fat or skin necrosis
- An inexperienced surgeon might puncture an organ with the cannula
- Infection or allergic reactions to the components of the tumescent fluid
- Burns
- Fluid imbalance (either too much fluids removed or too much tumescent fluid remains after the procedure)
- Licodaine overdose
Who are candidates for liposuction?
Usual candidates for liposuction are people who have lost weight through dieting and exercise, but still have fat pockets in certain areas. In general liposuction is not an alternative to dieting and exercise. Patients need to be at least 18 years of age.
People with heart disease, diabetes, infections and some other diseases are not eligible for liposuction.
