

Liposuction is one of the most commonly performed procedures in Plastic surgery. According to ASAPS last year close to 455,489 liposuctions were performed, topping all other cosmetic procedures. Although most of the patients were females, the number among the male population has been on the rise for the past several years.
Various esthetic changes occur due to excessive deposit of fatty tissue. Unfortunately excess fat deposit in our society is very common from overeating. Even a small amount of weight gain (5-10 lbs) will result in unsightly bulges.
Women tend to develop fat deposits over the lower abdomen, hips and outer upper thighs (“saddle bags”), areas that are very difficult to eliminate with exercise. The leading areas of concern in men are: the abdomen, the chest and love handles, also referred to as the “spare tire”.
Fat is usually divided into two types, superficial and deep. Superficial fat is light in color and much more compact whereas deep fat is yellowish in color and much looser in arrangement. It is latter that is mostly targeted during liposuction. Superficial liposuction if performed should be done very cautiously as surface irregularities are more likely to occur.
Generally, liposuction is performed under general anesthesia but smaller areas may be addressed with intravenous sedation. There are various techniques used to perform liposuction. Almost every physician uses a technique which involves infiltration of solution containing local anesthetic into the tissues. This greatly reduces the amount of blood loss during the procedure.
Traditional liposuction is performed by using small cannulas attached a suctioning machine. These cannulas are introduced through small incisions which are placed in well concealed areas. Other methods used are PAL (power assisted liposuction) and UAL (ultrasound assisted liposuction).
In PAL the suctioning cannula is attached to an electrical motor which oscillates at a very high speed and helps to break up the fat, thus making it easy to remove. This technique is less physically demanding for the surgeon and helps the surgeon to pay more attention to contouring the affected area.
Ultrasound liposuction is another technique used by many surgeons. The ultrasound energy emitted through the cannula melts the fat thus making it easy to suction. There are a few precautions that must be exercised with the ultrasound as it can burn the skin if used too close to the skin. These issues should be discussed with the surgeon during consultation.
Patients usually go home the day of surgery and are advised to wear a compression garment for several weeks to allow the tissues to shrink effectively. It takes several (6-9) months for the patients to see the final result. It is common to have some bruising after surgery which gradually resolves. The skin is felt to be numb by some patients but that too is only temporary and takes care of itself.
Although liposuction is a very commonly performed procedure, it should not be taken lightly. Significant complications can occur if not performed by a qualified professional. The key to avoiding complications is a thorough medical history, physical examination and patient education.
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