The most critical statement about liposuction surgery is that it is not a weight loss technique that can substitute for dietary and exercise control of excess weight. Obesity, in fact, is a contradiction to liposuction surgery. The ideal candidate for this procedure is a young, healthy, physically active person with a normal weight who has a localized area of accumulated fat tissue resistant to any other method of removal.
Heredity plays a large role in determining patterns of fat accumulation. Patient selection remains a key part of achieving satisfactory results. Some patients will not be helped by this surgery and will be turned down. The most common finding that prevents using liposuction is loose and in-elastic skin at the same area as the fat tissue. Both the skin and fat must be removed which will require more extensive surgery.
Liposuction surgery can be done on almost any area of the body that is appropriately accessible. The most common areas treated are under the chin, arms, chest, waist, abdomen, inner and outer thigh and inner knee. Local anesthesia can be used alone in very small cases, but most patients are done using general anesthesia. The procedures are almost always done outpatient at a local hospital or surgery center. Small incisions just large enough to admit the catheter are made in skin creases to hide them. They are eventually closed with one or two stitches.
The amount of fat to be removed is determined by your surgeon prior to surgery. The very largest amounts of fat will require multiple procedures over time. Often, this indicates that the patient would be better served by weight loss and not liposuction.
After surgery, an elastic tape dressing or an elastic garment is applied. This is worn 24 hours a day for several days. Elastic compression of some sort is used as needed in individual cases for one to three weeks, or more. Activities are restricted appropriately to allow the tissues to heal. Light duties may begin soon after surgery and everyday activities are possible in several days, but full exercise is often held off for four to six weeks. Pain is controlled with oral medication.
Risks and Complications
As with all surgery, liposuction is subject to possible risks and complications. The most frequent problem relates back to patient selection. Too much or too little fat may be removed and the appearance may not be what was anticipated. Irregularities of the surface such as lumps or depressions may occur, especially if the overlying skin is not able to conform to the new contour. Bleeding with excess bruising sometimes results. Infections can occur. Some patients may experience problems with anesthesia. Areas that have had suctioning can be numb, although this is usually temporary. Many complications can be corrected by more intense post-operative treatment such as massage or ultrasound therapy. Further exercise or weight control can improve a less-than-perfect result. Additional surgery is sometimes required to further contour the fat or adjust the skin.
Liposuction is often considered cosmetic surgery. As such, insurance, HMO's, and other third party payers do not cover the costs associated with cosmetic surgery. In unusual cases, especially after an injury or accident, liposuction techniques can be used to great advantage to improve bad outcomes. These cases are usually authorized prior to the procedure.