Checkup on Health: Is liposuction for me?
By Thomas R. Stevenson, M.D.
Does it seem like everyone is getting a liposuction these days? It’s not surprising. Liposuctions are the most commonly performed cosmetic procedure in the U.S. They have increased by an astounding 264 percent since 1992, with more than 172,000 done in 1998.
If you are thinking about liposuction, learn all you can about it first to decide whether it is right for you. Here are some issues you should consider:
What exactly is liposuction? Liposuction is a surgical procedure to remove excess fat. The doctor makes a small incision in the skin, 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. In most cases, putting the patient to sleep is unnecessary.
Sometimes an ultrasound device is used instead of the conventional, sharp-edged tube. It vibrates extremely rapidly, liquefying the fat before vacuuming it up. It may cause burns, and because the tube is larger, it carries the disadvantage of requiring a larger incision. 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 and the male breast.
Who is the ideal candidate? Liposuction is not a good weight reduction technique and will not make an obese person slender. For general weight loss, diet and exercise is still the best solution. Liposuction is most appropriate for someone who is of normal or nearly normal weight with areas of disproportionate fat accumulation. I typically treat women who have excessive fat in their abdomen, hips or thighs and men with too much fat in the breasts.
Those under 35 years and who have elastic skin fare better, because the skin must conform to the new body shape. For older people, for those who must have a great deal of fat removed, or for areas with loose skin, other surgical procedures must sometimes be combined with liposuction for best results. Because of such issues, liposuction by itself is not an appropriate procedure for breast reduction for women.
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.
Dr. Thomas Stevenson
Dr. Stevenson is a professor and chief of plastic surgery at UC Davis Medical Center, Sacramento.
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, but can return to normal activities within a few days. I recommend 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 are essential. Deaths have occurred, especially in situations where a great deal of fat or smaller amounts in multiple locations were removed. Chance of blood loss, and the large amounts of anesthetic and fluid involved, makes 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.
How should I choose a doctor? Doctors from a variety of specialties perform liposuction. But 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 in accordance with the standards of the profession.
Liposuction is not a good way to get rid of those extra holiday pounds! But for those who have bothersome areas of fat that don’t respond to traditional weight loss methods, liposuction can be a good solution.