You've done everything you can to lose weight - - you've exercised and you've watched your diet. In fact, you have taken off excess pounds - - the scale doesn't lie. But there are certain areas of your body that still look fat or out- of- proportion with the slimmer, new you. And no matter how hard you try, these trouble areas don't seem to want to go away.
If this is the case, liposuction - - or suction- assisted lipectomy - - may be able to help you. This is a cosmetic surgery procedure that can solve body contour problems caused by unwanted fat deposits in specific body areas, including your abdomen, buttocks, hips, and thighs; and your knees, calves, and ankles. In my experience, liposuction produces most satisfying results when used to contour the buttocks, hips, and inner thighs, but it can make a positive difference elsewhere in the body as well.
Liposuction is a popular procedure. In fact, according to the American Society of Plastic and Reconstructive Surgeons, it's the one most commonly performed after eyelid surgery and rhinoplasty (nose jobs). Many of my patients who had liposuction tell me that they feel more comfortable in a wide variety of clothes and more at ease with the appearance of their bodies.
Liposuction is not designed to take someone down from a size 16 to a size 2, nor is it designed for overall body fat reduction. Liposuction doesn't take the place of appropriate health measures, including eating right and regular exercise. Rather, it's a method of removing localized fat that doesn't respond to these measures. The best candidates for liposuction are of relatively normal weight, with pockets of excess fat in particular areas. Also, if you have firm, elastic skin, the final results of the procedure will generally be better.
The surgeon makes a small incision, just large enough to insert the "cannula," a hollow tube attached to a machine that creates a strong vacuum. The surgeon moves the cannula within the fat layers under the skin, breaking up the fat and suctioning it out. Sometimes additional incisions are needed to remove all areas of fat. Liposuction normally takes an hour or two, but that depends on how much liposuction is done.
Liposuction technique has improved vastly in recent years by the use of smaller cannulas, which reduce trauma to surrounding tissue while giving greater artistic control to the surgeon. In fact, many plastic surgeons today use the term "body sculpting" to describe the liposuction technique. Another relatively recent advance is the "distension technique," which involves instilling a special solution into the liposuction site before the procedure. This allows surgeons to remove more fat more easily, with less fluid loss to the patient.
If your procedure is not too extensive, liposuction can be performed under local anesthesia, which numbs the area. You'll probably be given a sedating medication, so you'll be awake but relaxed and feel minimal discomfort. Some surgeons may instead use an epidural block, similar to the anesthesia used in childbirth. If your doctor plans to perform liposuction on a large area, or to treat several sites, you'll probably have general anesthesia, which means you'll sleep through the operation.
Your surgeon may ask that you wear a snug- fitting elastic dressing, girdle, or body stocking over the treated area to control swelling and bleeding, and to help your skin shrink to fit your new contour. You may need to wear this garment continuously for five to six weeks, then just in the daytime for a few weeks more. Your surgeon may also prescribe antibiotics to prevent infection.
The scars from liposuction are small and the surgeon tries to place them so they're hidden from view, even if you wear a bikini. However, other cosmetic problems may occur, including rippling or bagginess of the skin over the treated area, and pigmentation changes (such as brown spots). Asymmetry (uneven contour or shape) sometimes requires a second procedure.
Actually, liposuction is relatively safe nowadays, as long as patients are carefully selected, the operating facility is properly equipped, and the surgeon is adequately trained in body contouring as well as general surgery.
There aren't many complications associated with liposuction unless the procedure is combined with major surgery like a tummy tuck or some other big, long procedure. With these larger surgeries, there is a potential risk of embolism (obstruction of a blood vessel by a blood clot or fat globule) or phlebitis (inflammation of a vein resulting from a blood clot). If, however, too much fat is removed too quickly with liposuction, it can cause a dangerous drop in blood pressure. You will lose some fluid along with fat during the procedure, so it's essential that this fluid be replaced to prevent your body from going into shock. You'll be given fluids intravenously and may also receive blood transfusions (almost always the blood you've donated in advance).
You probably won't look or feel great after the surgery. You'll even be a little heavier for a while, because of the extra fluids you've been given. The suctioned areas will be swollen and bruised, and you may feel a burning sensation. The pain can be controlled by medications prescribed by your surgeon.You may temporarily lose all feeling in the suctioned area, but it should return.
Healing is gradual. Your surgeon will probably advise you to start walking around as soon as possible (to help prevent blood clots from forming in your legs), but to avoid more strenuous activity for two to four weeks. The stitches will be removed in five to ten days or dissolve, and you should be back at work within 2- 3 days to two weeks after your surgery. When you resume activity depends on the extent of your procedure, how you feel, and what your doctor recommends.
While most of the swelling and discoloration will be gone a month or two after surgery, some swelling can remain for six months or more. Your surgeon will schedule follow- up visits to monitor your progress and to see if any additional procedures are needed.
Liposuction doesn't mean permanent fat removal in all cases. Some people may get the fat back in the same place or elsewhere, depending on their overall body metabolism. One can't say, "Well, have liposuction and you won't have to worry...you can eat anything you want," because that's just not true. You do have to modify your diet and watch what you eat...because it's entirely possible to get fat again.
The results vary from woman to woman. In general, women who exercise regularly and follow healthy eating habits after surgery will benefit most from liposuction. Not too long ago, I co- authored a study at The University of Colorado Health Sciences Center, Denver, Colorado USA, which assessed the effects of liposuction in women over a period of time. The study showed that the localized effects are maintained for 6 to 12 months after the operation, with the best cosmetic results at 3 months, especially if weight reduction through diet and exercise begins after the procedure.
However, some of the women in the study gained the fat back after only three months. The final results seem to depend on successful, maintained weight reduction.
Looking in the phone book under "liposuction" is not the best way to find a doctor who is well- trained in this technique.You'd be well- advised to contact the American Society of Plastic and Reconstructive Surgeons at 1- 800- 635- 0635 or (708)228- 9900 for referral to board certified plastic surgeons in your area.. I also recommend that you consult with the surgeon, ask questions of him or her, and talk to patients who have used this doctor in the past. See if they were satisfied with the way they were treated. Don't be rushed into any surgery. Do your research and consider your options and be aware of all the risks and benefits. Then, make up your own mind based on what you think is best for you.
If I can answer your questions about liposuction or any other plastic or reconstructive surgery procedure - - or provide an objective consultation - - please don't hesitate to call my office. My telephone number is (303) 320- 8618.
The preceding article has been provided as a public service by
Christine M. Rodgers, M.D.
Board Certified Plastic Surgeon
4500 E. 9th Avenue, Suite 160
Denver, Colorado 80220 USAPhone: (303) 320- 8618.
The article originally appeared in the third issue of Dr. Rodger's educational patient newsletter, "Reflections for a better You."
©1994, Christine M. Rodgers, M.D.
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