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Plastic Surgery

Plastic Surgery

Getting the facts on body contouring

Photo of women exercising
Dr. Wong recommends for general weight loss, diet and exercise are still the best solution.

Does it seem like everyone is getting liposuction these days? It's not surprising. Liposuctions are the most commonly performed cosmetic procedure in the nation. They have more than doubled in the past eight years, with over 400,000 procedures performed in 2006.

If you are thinking about liposuction, Thomas Stevenson, professor and chief of the UC Davis Division of Plastic Surgery, urges people to learn all they can about it first before deciding whether it is appropriate. Here are some questions Stevenson says prospective patients should consider:

What exactly is liposuction? Liposuction — which is also known as "lipoplasty" or "suction lipectomy" — is a surgical procedure to remove excess fat. Along with aesthetic techniques such as the tummy tuck, thigh and upper arm lifts, it is one of several procedures used by UC Davis plastic surgeons for body contouring and image enhancement.

For lipsuction, a doctor makes a small incision in the skin, and then inserts a sharp-edged tube that cuts the fat and vacuums it out of the body. Fluid containing anesthetic and blood-clotting medicines is injected under the skin as part of most procedures. This decreases bleeding, reduces pain, and makes the fat tissue easier for the surgeon to work with.

Photo of Dr. Michael Wong "Liposuction is most appropriate for someone who is of normal or nearly normal weight with areas of disproportionate fat accumulation."
— Michael Wong, UC Davis plastic surgeon

Sometimes an ultrasound device is used instead of the conventional, sharp-edged tube. It vibrates extremely rapidly, liquefying the fat before vacuuming it up. Ultrasound assisted liposuction (UAL) is most appropriate for areas where fat is especially difficult to remove, such as when it is deposited in fibrous tissue in the upper abdomen, back or male breast. Because the tube is larger, it carries the disadvantage of requiring a larger incision and it may cause burns.

Who is the ideal candidate? Liposuction is not a good weight reduction technique and will not make an obese person slender, adds Michael Wong, an assistant professor of plastic surgery at UC Davis.

“For general weight loss, diet and exercise are still the best solution,” says Wong, who is the director of the health system's Body Contouring after Weight Loss program and specializes in body contouring surgery for patients who have lost significant amounts of weight. “Liposuction is most appropriate for someone who is of normal or nearly normal weight with areas of disproportionate fat accumulation. We typically treat women who have excessive fat in their abdomen, hips or thighs, and men with too much fat in their breasts.”

People under 35 years who have elastic skin tend to fare better because their skin can conform to the new body shape. For older people, those who must have a great deal of fat removed or who have areas with loose skin, excisional procedures sometimes must be combined with liposuction for best results.

Will my fat come back? Once fat cells are removed, they will not regenerate. However, fat cells that remain can increase in size. After liposuction, new weight gain should be more evenly distributed throughout the body and no longer concentrated in the area where the fat was removed. People with the best results control their weight with diet and exercise following surgery.

What is recovery like after surgery? Usually the patient can go home on the same day as the procedure. You will need someone to drive you home and may want some help for a few days.

“Most people feel a bit stiff, achy or numb for awhile,” says Wong, “but they can return to normal activities within a few days.”

UC Davis recommends wearing a special elastic undergarment for support for three weeks. Results of the surgery may not be fully apparent for a few months, when the added fluid is absorbed and the swelling resolves.

What are the risks? Liposuction is generally a safe procedure, but knowledge of the risks is essential. Deaths have occurred, especially in situations where a great deal of fat (or smaller amounts in multiple locations) was removed. Chance of blood loss, combined with the large amounts of anesthetic and fluid involved in a procedure, can make surgery in those situations especially risky. People who need a lot of fat removed should be treated in a hospital rather than office or outpatient setting. Irregularity of the overlying skin can also occur.

How should I choose a surgeon? Doctors from a variety of specialties perform liposuction. Be sure to choose one certified by the American Board of Plastic Surgery. This is extremely important in ensuring that the procedure will be carried out safely and in accordance with the standards of the profession.

Also keep in mind liposuction is not an appropriate way to get rid of extra pounds accumulated during summer vacations or seasonal holidays. Both Wong and Stevenson say that for someone who has bothersome areas of fat that don't respond to traditional weight loss methods, liposuction can be a good solution. Every person is different. But if you're trying to sculpt your body into better shape, and other techniques haven't worked, then liposuction is certainly a procedure to consider.