Liposuction Explained

Liposuction is a very simple surgical procedure that permits the removal of body fat (usually stubborn fat) between the skin and the muscle of patients. Fat can be removed from many body parts, including the chest, abdomen, buttocks, neck…etc. For many, this might seem as a dream come true: a wonderful surgical procedure that eliminates the great affliction of the modern age, obesity. Yet, this is not necessarily the case. Several factors limit the amount of fat that can be removed from a patient.

The Principle

The principle of liposuction is quite simple. It involves a small incision at the site where removal will be done, insertion of a cannula (a hollow tube) attached to a suction pump. Through controlled movements of the cannula, the surgeon will dislodge the fat deposits which are then removed using the suction pump. Alternatively, the cannula will be used to inject a fluid into the fatty tissues to encourage fat to liquefy, thus facilitating its removal.

The techniques

In general, the techniques of liposuction are classified according to the amount of fluid injected into the fatty tissues. The following techniques are available:

i. Dry liposuction—no fluid injected; seldom used today.
ii. Wet liposuction—a small volume (usually less than the volume of fat to be removed) is injected. The fluid contains lidocaine (an anesthetic), adrenaline (that causes blood vessels to contract) and a saline solution.
iii. Super wet liposuction—the amount of fluid equals the amount of fat to be removed.
iv. Tumescent liposuction—a large amount of very dilute lidocaine and epinephrine is injected directly into the subcutaneous fat. With this method there is no need of general anesthesia.
v. Ultrasound assisted liposuction—this can be performed with wet liposuction methods. It involves bombarding the fatty tissue with ultrasound waves so that they can be more easily dislodged and absorbed by the suction pump. However, with earlier generation ultrasound liposuction equipment, there were risks of tissue burns. Newer equipment is much safer.
vi. Laser Assisted Liposuction—low energy laser waves are directed to the surgical area. The waves penetrate the skin and weaken the cell membranes that hold the fat, which then oozes out of the cells’ perimeter. The fat is then sucked out by the suction pump and cannula. The advantage of this method is that the recovery period is very short. Swelling and bruising is reduced to a large extent. The need of pain medication is reduced considerably.

Risks and Complications

Besides normal surgical risks such as infection and hematoma, liposuction carries the following specific risks:

i. Excessive liposuction—too much fat removed from targeted areas can result from problems such as dents, lumps and sagging skin. Under normal circumstances, the amount of fat removed should not exceed 6% of the person’s bodyweight. This may be increased for people who are grossly obese.
ii. Minor complications—bruising, scarring, discolored skin, necrosis, numbness…etc.
iii. Major complications—allergic reactions to medicine, internal blood clots, nerve damage. These are quite rare but do have a possibility of occurring.