Liposuction Surgery: Cost, Types,
Risks, and More

As one of the most frequently performed cosmetic surgeries in the United States, liposuction surgery isn’t just for thighs anymore. With increasing frequency, it is also being used as a means to effectively “erase” double chin, jowls, and puffy neck, as well as streamline problem areas like the buttocks, hips, stomach, and waistline.

Calves, ankles, upper arms, inner knee, areas of the breast or chest, and areas of the back can also be made less fatty, slimmer, and firmer. Imagine looking and feeling 10 or more years younger in a matter of hours.

Liposuction, also known as “suction-assisted lipectomy” and “lipoplasty,” was originally performed in Italy in the late 1970s. A gynecologist by the name of Dr. Giorgio Fischer originally invented the technique in 1974; it was further developed by French physicians Dr. Gerald Illouz and Dr. Pierre Fournier. It first became popular in the United States in 1980.

Considered a risky procedure because of possible severe blood loss, and because the skin sometimes became disfigured when fatty tissue was removed, it nevertheless grew to become a popular way to rid the body of excess fat.

Now referred to as the “dry technique,” general anesthesia was used to render the patient unconscious before introducing a tube through the layers of the skin into the area to be suctioned. Excessive bleeding, blood clots, and severe bruising often resulted. In fact, nearly 30% of the tissue removed by this procedure was composed of blood. Serious anesthetic hazards also sometimes resulted.

The procedure has since been revolutionized. Assistant clinical professor of dermatologic surgery at the University of California at Irvine, cosmetic surgeon Jeffrey A. Klein, M.D., came up with the “tumescent technique” in 1985.

The Tumescent Procedure; a Safer Method of Liposuction

According to cosmetic surgery expert Dwight Scarborough, M.D., assistant clinical professor at Ohio State University, “Tumescent liposuction is safer and more predictable than traditional liposuction.”

Instead of requiring general anesthesia, tumescent liposuction requires local anesthesia and uses finer fat-removing instruments. Virtually painless when performed by experienced hands, incidents of too much blood loss and disfigurement are rare. When puckering does appear, it is more often than not the result of inattention to detail by the physician, or the use of too large a tube to remove the fat.

When properly performed, liposuction can effectively trim down hips and thighs by as much as two sizes. The visual results are immediate. It is possible to walk into a doctor’s office, exit 1 ½ - 2 hours later more shapely than before, and drive yourself home.

Besides being a quicker, more effective type of liposuction, and reducing the risk of skin disfigurement, the tumescent procedure reduces blood loss as well as complication risks associated with general anesthesia. This is due in part to smaller incisions, and the anesthetic solution introduced into the incision sites which accelerates healing time and reduces post-procedure pain, swelling, and bruising.

Defined as the removal of fat deposits beneath the skin, liposuction uses a hollow stainless steel tube called a “cannula.” Small incisions usually less than one-quarter inch are made in the area to be suctioned, and the cannula, hooked up to a powerful vacuum, is inserted. Unwanted fat is literally vacuumed away; the skin reshapes itself as it heals.

As good as this all sounds, not everyone makes a good candidate for the procedure. For instance, when it comes to facial liposuction, New York Hospital-Cornell Medical Center’s Professor of Plastic and Reconstructive Surgery, James W. Smith M.D., says persons in their 30s – 40s whose skin is still tight and resilient make better candidates than older persons whose facial skin lacks elasticity.

Persons with skin that is still elastic enough to achieve a smooth contour following surgery will obtain better results than those who do not. Sometimes when older persons with sagging skin have liposuction surgery, a skin tightening procedure is also necessary.

Liposuction is particularly well-suited for persons who are more or less of normal weight, but who have isolated pockets of fat that cause their body to appear disproportionate. Such traits, sometimes inherited, may not respond well to diet or exercise.

What type of person makes a good candidate for liposuction? Persons with problem areas on their bodies they want contoured; areas with localized fat, where liposuction is possible. And persons whose expectations of results are realistic all make good liposuction candidates.

If you are interested in the possibility of a liposuction surgery, become knowledgeable about the procedure. Learn everything you can about the various methods of liposuction surgery and the risks involved.

Various Liposuction Techniques

Some procedures inject a special solution into the areas to be suctioned. The area is suctioned after the solution has caused the fatty tissue to swell. The solution might contain a local anesthetic to numb the area, a chemical to temporarily shrink capillaries to minimize blood loss, and a drug to decrease bruising and post-surgery swelling.

Other liposuction techniques include “ultrasound-assisted lipoplasty,” where fatty tissue is broken up by ultrasound before being removed by suction, and the “super-wet technique.”

The super-wet technique is similar to the tumescent, except that less fluid is injected; the amount is usually equal to the amount of fat removed. This technique requires IV sedation, or general anesthesia.

Tumescent micro-cannula liposuction uses extremely small tubes to sculpt the fat, sometimes requiring smaller skin incisions. This technique takes out smaller amounts of fat with each extraction, offering more control.

In addition to the local anesthetic in the tumescent solution, some doctors offer intravenous sedation. General anesthesia should be avoided when possible because it carries a greater risk.

Plastic surgeons may use more than one type of procedure when performing a liposuction. This might include a dry or tumescent technique, along with other variations of liposuction.

If a surgeon requests a client to donate blood prior to surgery, chances are he or she will use either a technique other than tumescent or other liposuction techniques in addition to it. According to Dr. Klein, the request for blood may be in anticipation of a blood transfusion.

There are also various instruments that can be used during the procedure. Many doctors use a traditional cannula — about the diameter of an adult’s little finger. When performing a facial liposuction, using a smaller cannula (1/8-inch or smaller) may increase overall surgery time, but incisions will be smaller and the risk of skin disfigurement greatly reduced. Puckering and other blemishes to the skin are mostly the result of the use of a larger-size cannula, frequently used during total-body liposuction to decrease surgery time.

Finding a Qualified Plastic Surgeon

Use online resources, and advertisements under the “plastic surgeons” or “cosmetic surgery” sections of the yellow pages; referrals from trusted medical personnel and by persons who have had a successful liposuction are all good ways to find a qualified doctor.

Be aware that even if a doctor goes by the title of “plastic surgeon,” that does not necessarily mean they have had adequate training in the art of plastic surgery. Anyone can call themselves a plastic surgeon.

Look for someone who is certified by a recognized board, such as the American Board of Plastic Surgery or the American Board of Medical Specialties — both of which take years of education with careful testing of skills. Be sure, too, that the area of plastic surgery they are board certified in includes liposuction.

Preparing for the Consultation

Once you have found a qualified, experienced plastic surgeon doctor you feel comfortable with, make an appointment for a personal consultation.

Have a list of questions you would like answered, and specifics about the procedure you would like addressed. Ask what realistic results you can expect; also ask about possible risks, and possible side effects to any drugs you may be given during surgery or after. Ask about medical costs and what insurance may or may not cover.

It is important to tell the doctor about all the medications you take, and any health complications you may have. Answer all questions as honestly and thoroughly as possible.

Some medications taken before liposuction surgery can increase bleeding. Aspirin, ibuprofen, Motrin, Advil, certain arthritis medications, and warfarin are common culprits. Vitamin E, red wine, and some herbal remedies can cause prolonged bleeding. Cigarette smoking can inhibit wound healing.

Be aware that some risk factors are involved, even though thousands of people each year undergo liposuction without serious mishap, and are thrilled with the results. Risk of bleeding, infection, prolonged skin numbness, skin discoloration, and contour irregularities do exist, however small.

Severe complications are very rare. These complications include: blood clots in the leg or lung, injury to internal organs, excessive blood loss, hypothermia, allergic drug reactions, aspiration pneumonia, cardiac arrest, permanent nerve damage, seizures, and more.

Before agreeing to a liposuction procedure, understand that the procedure won’t make an obese person thin. It should not be considered a substitute for overall weight loss. It is also not an effective treatment for cellulite.

Liposuction can be performed on several areas of the body at the same time; it can be performed in conjunction with other aesthetic plastic surgeries. It is also an effective way to treat “gynecomastia,” a male breast enlargement condition that can occur among teen and adult males.

Preparing for the Procedure

If after consulting with a qualified doctor you are still interested in having a liposuction, ask the doctor to explain what to expect the day of surgery. Also ask what the procedure itself will entail.

During the surgical procedure, medications to aid comfort are given; decide with your doctor what medications and what type of anesthesia are right for you. For your safety, monitors will be used to keep track of your vitals while you are sedated.

Shaving or otherwise removing hair from the areas to be treated on the day of surgery should be avoided to remove the risk of ingrown hairs. The doctor will tell you to eat nothing after midnight, so that you arrive for surgery with an empty stomach.

The doctor may instruct you to wear loose fitting clothing after surgery, which either opens in the front or pulls over easily. This will make it easier to put clothes on over the pressure garment and dressings after surgery.

Summary

Everyone wants to look as good as they can for as long as they can, and have as shapely a body as possible. Liposuction can be a viable solution to puffy, fatty tissue areas of the body. With proper education as to the techniques involved, and after careful research in locating a qualified doctor, you help insure that your liposuction is a much-welcomed success.