Liposuction is the procedure that can help recontour the body by removing unwanted fat from specific areas. During the past decade, Liposuction, which is also known as “lipoplasty” or “suction lipectomy,” has benefited from several new refinements. Today, a number of new techniques, including the tumescent liposuction and ultrasound-assisted liposuction are helping many patients achieve better results and shorter recovery times. Our plastic surgeon, Dr. Neil J. Zemmel, uses both of the techniques to recontour unwanted fat deposits throughout the body. Although no type of liposuction is a substitute for proper dieting and exercise, liposuction can remove stubborn areas of fat that don’t respond to traditional weight-loss methods. The anatomic areas typically involved are:
- Abdominal wall
- Hips (“saddle bags”)
- Flanks (“love handles”)
- Buttocks (“banana roll”
- Lower legs
- Upper arms
- Cheeks (“jowls”)
- Neck (“double chin”)
If you’re considering liposuction, this page will give you a basic understanding of the procedure. Dr. Zemmel will discuss your unique concerns and recommend an optimal treatment plan for you during your consultation.
Ideal Candidates For Liposuction
Good candidates for any cosmetic procedure have realistic expectations about what the procedure can do. It’s important to understand that liposuction can enhance your appearance and self-confidence, but it won’t completely change the shape of your body. Before you decide to have surgery, think carefully about your expectations and discuss them with Dr. Zemmel.
The best candidates for ultrasound-assisted liposuction are normal-weight people with firm, elastic skin who have pockets of excess fat in certain areas. These include the stubborn areas not responsive to diet and exercise. Typically these are the “love handles” for men and “saddle bags” for woman.
You should be physically healthy, psychologically stable and realistic in your expectations. Your age is not a major consideration; however, older patients may have diminished skin elasticity and may not achieve the same results as a younger patient with tighter skin. The skin-tightening abilities of ultrasound-assisted liposuction can benefit these patients most.
Liposuction carries greater risk for individuals with medical problems such as diabetes, significant heart or lung disease, poor blood circulation, or those who have recently had surgery near the area to be contoured.
Safety is Dr. Zemmel’s number one concern. All patients will undergo a rigorous pre-operative physical exam to determine whether or not they are fit for surgery.
Planning Your Surgery
During your initial consultation, Dr. Zemmel will evaluate your overall health and discuss with you at length the areas that concern you most. There are many physical details that make up the shape of your body and that can be modified. Dr. Zemmel will evaluate:
- Your height and weight
- Your trunk to abdomen to pelvis proportions
- The shape and contour of your extremities
- The thickness of your skin
- The elasticity of your skin
- The muscle tone of your abdominal wall
- The shape of your umbilicus (belly-button)
- The areas of excess fatty tissue
Depending on his finding and your goals, Dr. Zemmel will explain the body-contouring methods that will fit your unique needs.
Some patients have excess skin that will exceed the capabilities of liposuction and require an abdominoplasty (tummy tuck) to achieve optimal results. For example, if you believe you want liposuction in the abdominal area, you may learn that an abdominoplasty or “tummy tuck” may more effectively meet your goals; or that a combination of a tummy-tuck and liposuction would be the best choice for you.
Getting The Answers You Need
People considering liposuction often feel a bit overwhelmed by the number of options and techniques being promoted today. However, Dr. Zemmel can help. In deciding which is the right treatment approach for you, Dr. Zemmel will consider the effectiveness, safety, cost and appropriateness for your needs. This is called surgical judgment, a skill that is developed through years of surgical training and experience.
Preparing For Surgery
Dr. Zemmel will give you specific instructions on how to prepare for surgery, including guidelines on eating and drinking, smoking, and taking or avoiding vitamins, iron tablets and certain medications. If you develop a cold or an infection of any kind, especially a skin infection, your surgery may have to be postponed.
While you are making preparations, be sure to arrange for someone to drive you home after the procedure and, if needed, to help you at home for a day or two.
Where Your Surgery Will Be Performed
Liposuction is performed in Dr. Zemmel’s office-based operating room. Dr. Zemmel’s operating room is a critical component of the quality of his care. The facility has the full accreditation by the American Association for Accreditation of Ambulatory Surgery Facilities (AAAASF). Smaller-volume liposuction is usually done on an outpatient basis. However, if a large volume of fat (greater than 4 liters) will be removed, or if the liposuction is being performed in conjunction with other procedures, a stay in a hospital or overnight nursing facility may be required.
Anesthesia For Liposuction
Dr. Zemmel performs most liposuction procedures until sedation with local anesthesia. If liposuction is combined with additional procedures, a general anesthetic may be necessary. If only a small amount of fat and a limited number of body sites are involved, liposuction can be performed under local anesthesia, which numbs the affected areas.
The time required to perform liposuction may vary considerably, depending on the size of the area, the amount of fat being removed, the type of anesthesia and the technique used.
There are several liposuction techniques that can be used to improve the ease of the procedure and to enhance outcome.
Liposuction is the procedure in which localized deposits of fat are removed to recontour one or more areas of the body. Through a tiny incision (about ¼ inch long), a narrow tube or cannula is inserted and used to remove the excess fat that lies deep beneath the skin.
If several sites are being treated, Dr. Zemmel will then move on to the next area, working to keep the incisions as inconspicuous as possible. Dr. Zemmel will hide the incisions under underwear lines and in natural creases.
Fluid is lost along with the fat, so it’s crucial that this fluid be replaced during the procedure to prevent dehydration. For this reason, Dr. Zemmel and the Anesthetist will carefully monitor you throughout and immediately after surgery.
The basic technique of liposuction, as described above, is used in all patients. However, as the procedure has been developed and refined, several variations have been introduced. These techniques are used by most Plastic Surgeons today.
First, Dr. Zemmel injects a medicated solution the areas undergoing treatment. The fluid is a mixture of intravenous salt solution (saline), lidocaine (a local anesthetic) and epinephrine (a drug that contracts blood vessels). This helps the fat be removed more easily, reduces blood loss and provides anesthesia during and after surgery. Fluid injection also helps to reduce the amount of bruising after surgery. Dr. Zemmel uses the fluid injection technique called Tumescent liposuction.
The next step is the actual removal of fat with small cannulas through the incisions. The cannulas are passed back as forth and the fatty tissue is removed. Each area is meticulously checked for symmetry and smoothness. Dr. Zemmel with take great care in making sure all areas blend in together.
All Surgery Carries Some Certainty Some Uncertainty And Risk
Liposuction is normally safe, but Dr. Zemmel selects patients carefully. Again, you will undergo a thorough pre-operative evaluation to determine if you are healthy enough for the procedure. Dr. Zemmel cannot stress enough that safety is his primary concern.
Though they are rare, complications can and do occur. Risks increase if a greater number of areas are treated at the same time, or if the operative sites are larger in size. Removal of a large amount of fat and fluid may require longer operating times than may be required for smaller operations.
The combination of these factors can create greater hazards for infection; delays in healing; the formation of fat clots or blood clots, which may migrate to the lungs and cause sickness or in extremely rare cases death; excessive fluid loss, which can lead to low blood pressure or fluid accumulation that must be drained; friction burns or other damage to the skin or nerves or perforation injury to the vital organs; and unfavorable drug reactions. In the tumescent fluid technique, the anesthetic fluid that is injected may cause lidocaine toxicity (if the solution’s lidocaine content is too high), or the collection of fluid in the lungs (if too much fluid is administered).
The scars from liposuction are small, and Dr. Zemmel strategically places them to be hidden from view. However, small imperfections in the final appearance are not uncommon after lipoplasty. The skin surface may be irregular, asymmetric or even “baggy,” especially in the older patient. Numbness and pigmentation changes may occur.
After Your Surgery
To control swelling and to help your skin better fit its new contours, you may be fitted with a snug elastic garment to wear over the treated area for a few weeks. Dr. Zemmel will also prescribe antibiotics to prevent infection.
Don’t expect to look or feel great right after surgery. Even though the newer techniques are believed to reduce some post-operative discomforts, you may still experience some pain, burning, swelling, bleeding and temporary numbness. Dr. Zemmel will also prescribe pain control medications. You may also still feel stiff and sore for a few days.
Getting Back To Normal
Healing is a gradual process. Dr. Zemmel will encourage you to begin walking right after surgery to reduce swelling and to help prevent blood clots from forming in your legs. You will begin to feel better in a couple of days, at which point you can begin you normal daily activities. Most people return to work in 3 to 5 days or even sooner if they are up to it. The small stitches are removed in one week.
Strenuous physical activity (running and weight lifting) should be avoided for about a month as your body continues to heal. Although most of the bruising and swelling usually disappears within two weeks, some swelling may remain for three months or more.
Dr. Zemmel will schedule regular follow-up visits to monitor your progress.
Your New Look
You will see a noticeable difference in the shape of your body quite soon after surgery. However, improvement will become even more apparent after about four to six weeks, when most of the swelling has subsided. After about three months, any persistent mild swelling usually disappears and the final contour will be visible.
If your expectations are realistic, you will be very pleased with the results of your surgery. You may find that you are more comfortable in a wide variety of clothes and more at ease with your body. And, by eating a healthy diet and getting regular exercise, you can help to maintain your new shape.