When we gain or lose weight, we are not adding or subtracting fat cells, but are changing the amount of fat within each cell. Fat cells lie beneath the skin throughout the body, but accumulate in greater amounts in certain areas. It is not surprising, therefore, that many people find in spite of weight loss; they are left with bulges or fat deposits in certain areas on the body. Liposuction is a surgical technique in which special probes, attached to a high suction pump, are passed through tiny punctures made in inconspicuous places around the body. Fat cells are then suctioned out, allowing the surgeon to shape and contour various parts of the body.

In 1982, removal of fat from the body by suction technique was brought to this country from France. Today, it has proven to be a safe and effective surgical technique that can result in a better body contours, with minimal scarring. This procedure gives the best results when used to remove localized areas of undesirable fat, after one has reached an appropriate weight with diet and exercise. It is a suitable operation for both men and women. Liposuction can be performed on virtually any area of the body, and is particularly useful in the neck, abdomen (tummy), waste, hips and thighs. In addition, it can be used on the arms, buttocks, calves, and ankles. In men, liposuction can be used to correct gynecomastia (enlarged breasts), and is frequently used to reduce excessive fat around the waist. Age is not a factor if the patient is in good general health. Liposuction is considered a contouring procedure, and is not specifically intended for the treatment of obesity. It can however, be an adjunct to diet and physical conditioning in the management of over-weight patients, where contour problems play a distinct role. If very large volumes of fat are to be removed, it may be necessary to carry out more than one operative procedure over time.

Except in instances where only a small amount of fat removal is desired, this procedure is generally performed under general anesthesia. However, it can be performed almost uniformly as an outpatient procedure. The length of the procedure varies depending upon how much fat is removed. The following technique is commonly used in performing liposuction, although individual surgeons may vary the sequence, extent, and technique of each operative step. A small one half-inch incision is made in the area of fat to be removed. A long fine needle is introduced, and a special liquid is infiltrated. The infiltration of liquid is called is called the "tumescent technique". Tumescence makes it easier to remove the fat, with less bleeding, postoperative bruising and pain. Patients recover quicker and are back to their usual activities sooner as compared to older techniques. After infiltration of the fluid, a thin, blunt tipped cannula is inserted under the skin, through the same incision, and carefully manipulated through the fat tissue. The probe is attached to a high vacuum hose, which suctions out the unwanted fat cells. After the desired amount of fat is removed, the incisions are closed and dressings applied. Intravenous fluid replacement is generally not needed for tumescent liposuction surgery. The patient is usually instructed to wear a pressure garment, to reduce swelling and aid in the healing process. In spite of this, there will be some swelling and discoloration, which will subside over a period of several weeks. The swelling may take many months to completely go away.

All surgical procedures carry certain risks. Fortunately, serious complications are very uncommon after liposuction. While there have been reported cases of perforation, skin loss, severe scarring and even death, these are extremely rare. Other complications such as infection, and blood clots in the lungs have also been reported, but again are rare. Minor problems, including serum filled pockets, or collections of blood under the skin, will resolve with time. The most common problem is a waviness or sagging in the skin, resulting from irregular fat removal or inadequate skin shrinkage over the newly contoured areas. Cellulite (dimpling) and other surface irregularities that were present before surgery will still be present after the procedure. Postoperative dimpling is more common in patients with poor skin elasticity. This problem can be minimized by faithful use of elastic garments for a few weeks following surgery, as per your plastic surgeon's recommendations. The area is frequently numb for sometime after surgery, but normal sensation usually returns after a period of time. Sometimes, minor secondary procedures are required to achieve the best results.

Ultrasonic liposuction
This technique is a useful innovation in cosmetic surgery. This procedure uses sound waves to break up fat cells before the fat is suctioned from under the skin. This technique utilizes ultrasound energy to break up the fat cells, and converts the fat to oil so that it can be removed more easily. The ultrasonic generator is attached to a special cannula. Tumescent fluid is introduced into the area from where the fat is to be removed. The ultrasound energy then breaks up the fat cells. The emulsified fat is then suctioned out through the hollow cannula. With ultrasonic liposuction, it is possible to remove fat from difficult areas such as the upper abdomen, flanks, hips and back. It is also possible to remove more fat in an area that is re-operated upon. Ultrasonic liposuction is not a replacement for traditional tumescent liposuction, but used in conjunction, allowing the surgeon to remove fat from more difficult areas. The results of ultrasonic liposuction are similar to traditional liposuction. There is, however, the possibility of more complications. If you're planning to have liposuction, make sure you discuss this in detail with your surgeon. Ultrasonic liposuction is a fairly new technique, and there are surgeons that may not be completely comfortable using it.

Suction lipectomy is a safe and effective procedure for removal of unwanted body fat. Patients are usually very happy with the results. Liposuction is the most common cosmetic surgery procedure performed in the United States.