Liposuction- Weight Loss Surgery

Dieting and working-out are effective and inexpensive ways to loose weight. But in most cases, it takes time to see the effects of the above two methods. It’s also not easy to get the right diet or workout regime as the side effects can be really serious, if the person is misinformed. Doctors and scientist labored for years to come up with liposuction, one of the fastest ways to remove fat. What is liposuction? This is a surgical procedure involving removal of body fat by using a hallow suction instrument called as cannula. Made of stainless steel, the cannula is introduced inside small incisions that are made in the area to be operated upon. Usually the size of these incisions is limited to one inch in diameter. The name “liposuction” is derived from the fact that a powerful suction pump is attached to the cannula which sucks out the fat globules. These globules are collected in an external device (Jar). The above procedure in performed only after the patient is placed under anesthesia which may be general (G.A) or local (L.A), depending on the case. After the fat is removed, it helps in improving the overall body contour by changing the shape of the body for better. Another way to perform this surgery is to use laser attached liposuction. In this method, laser beams cuts out the excess fat that is sucked into the jar through the vacuum pump. Liposuction is also able to get rid of cellulites, which are hard to melt away through exercises and diet. Some of the most common areas where liposuction is performed are legs, buttocks, hips, abdomen, back, upper arms and neck. Most of the liposuction procedures can be done in a day, but for multiple liposuctions, the patient may have to be admitted in the hospital. Though, this depends on the doctor’s discretion. The effects of liposuction tend to last long if the patient keeps a check on their diet and works out regularly. Most of the patients tend to combine the three to get a well sculpted body. It can also be teamed with other forms of plastic surgeries such as tummy tuck, breast reduction etc to make the body shape proportionate. Over the last few years, this form of cosmetic surgery has become highly popular in the United States and also called as liposculpture, lipoplasty, and suction-assisted lipectomy.

Types of liposuction procedures

Though the basics of the procedure involve using a cannula and suction pumps, there are various procedures adopted based on the patients needs and the desired results. The most common procedures are
  1. Tumescent liposuction
  2. Ultrasonic Assisted Liposuction
  3. Power assisted liposuction
Tumescent liposuction Tumescent liposuction is one of the most sought after liposuction procedures as it is regarded as to be the safest and the most effective. Initially, general liposuctions resulted in serious amount of blood loss due to which the patients had to undergo blood transfusion. Tumescent liposuction minimized blood loss and decreased the dependability on general anesthesia. Procedure
  1. Injection– This involves injecting a local anesthesia, epinephrine and intravenous salt solution in the targeted area. Epinephrine helps to contract the blood vessels and thus the amount of blood loss decreases. The local anesthesia (lidocaine) successfully numbs the area and usually the patient does not need to opt for any other forms of anesthesia. Combination of the two fluids helps the fat to swell up, thus it becomes easy for the surgeon to identify and remove the unwanted fat easily without harming other areas.
  2. Suction– The cannula is introduced and the fat is sucked out through the vacuum pump. The presence of IV fluid ensures that the fat is removed with ease.
The above procedures can be done in two forms:-
  • Wet technique– In this form, the patient receives anesthesia directly on the area where the surgery has to be performed. It is introduced in combination with epinephrine, directly on the tissue.
  • Super wet surgery – In this method, the patient is administered anesthesia along with the solution containing epinephrine and through intravenous injections. This is recommended when only the solution cannot anesthetize the patient fully. This usually results in completing the surgery fast as the surgeon does not have to wait for the swelling to subside. It also helps allows the doctor to perform multiple plastic surgeries.
Advantages of tumescent liposuction
  • The amount of blood loss is decreased.
  • Does not need IV replacement fluid.
  • Bacteriostatic lidocaine decreases the chances of contracting infections
  • Epinephrine results in vasoconstriction which decreases absorption.
  • Epinephrine also increases the amount of blood being pumped out due to which the hepatic metabolism decreases. Due to this the bruising and swelling is less.
  • Lidocaine toxicity– if anesthesia is not in proportion to the requirement of the body, it can become toxic as high amounts of lidocaine cannot be metabolized by the body.
  • Pleural effusion – excess of intravenous fluid which is directly introduced at the site can lead to fluid accumulation in the lungs.
Ultrasonic Assisted Liposuction Ultrasonic liposuction (UAL) – This is a process that utilizes a combination of vibrations and heat which are delivered through paddles and metal rods directly into the body or externally over the skin. Due to the two different modes, there are two types of ultrasound liposuctions available, i.e. internal and external. Internal In this process, the fat is melted and collected in an external jar. The surgery involves the following processes
  • A cannula is introduced in the body, into the fatty area. Through the cannula, a special tumescent liquid is passed.
  • The cannula is also the medium to transfer vibrations and heat into the body.
  • The ultrasonic waves (sound waves) melt the fat which turns into oil. This melted fat along with the tumescent fluid is sucked out through the cannula through a suction pump and collected in a vessel. Fat melts due to the high pitched sound waves. This is useful to get rid of ‘stubborn’ fat cells which are found in areas such as chin, neck, cheeks, knees, calves and ankles. It also helps to remove a large portion of fat from an area at one time.
External In external UAL the ultrasonic energy is applied externally over the body yet it passes through the skin. Due to this the cannula of the UAL procedure is not required. This helps to avoid death of skin cells and seromas which occur during the UAL method. It also causes less pain, decreases the amount of blood loss and allows better access through the scar tissues. Advantages of UAL
  • Can treat areas that have dense fat deposit
  • Can remove high volumes of fat at one time
  • It helps in tightening the skin so it does not have a baggy, ugly look. This serves the same purpose as having tummy tucks or body lifts.
  • It involves heat and hence can cause burns, blistering and scarring and hence needs to be performed by a skilled surgeon.
  • Can lead to seroma which is a condition in which the body fills the cavity with fluid. This fluid needs to be aspirated out till the cavity closes completely.
Areas where it can be performed 
  • Stomach
  • Reduction of male breasts (gynecomastia)
  • Chin
  • Neck
Power assisted liposuction The cannula, despite being used to remove fats has it limitations. It cannot remove all the unwanted fat, as the surgeon is not able to fine tune his movements to reach every corner to effectively remove fat. To get over this hurdle, surgeons use power assisted liposuction (PAL). A PAL devise (cannula) can be connected to
  • An electric motor– This allows rapid in and out movement
  • Compressed air– the devise spins.
The surgeons who have used PAL state that this device gives them far deeper and better access to fat than cannula. The movements can be more precise as the PAL is easy to maneuver. This device produces rapid small vibrations which easily and smoothly break fat resulting in thorough fat removal. The excess fat gets sucked out through the cannula. Benefits of PAL
  • The surgeons are able to get a better control of the cannula
  • Safe removal of fat, without harming the neighboring tissues.
  • It is considered to be the gentlest form of liposuction as the surgeons do not need to used too much of force.
  • It can easily remove fat from areas that are hard to reach such as inner thighs, belly button area and male breasts.
  • Faster to perform.
  • Faster to perform.
  • Faster recovery with long term benefits.
Risks of PAL 
  • It can leave the skin loose, wrinkled though over time, it becomes a lot tighter and smooth.
  • In case of tumescent liposuction, it can cause lidocaine toxicity.
If performed by a skilled and experienced surgeon, liposuction can help loose significant inches and is one of the most popular and fastest ways of getting into shape. Areas that need Liposuction assistance – Female Men and women have different body structures. This also affects the fat distribution which is different in both the sexes. Men have android body type. This means that biologically they have thin legs and hips and tend to carry their weight on their waists. On the other hand, women have a genoid body type due to which they have heavy thighs and hips. The shape of their body can be compared to that of a fruit where the man and women have a structure similar to an apple and a pear respectively. Females- women are able to gain weight more easily than men. Post child birth and with increasing age, their basal metabolic rate tends to decrease due to which they gain weight easily. With increasing years, the fat tends to get stubborn and it’s not easy to loose the excess fat through exercise and diet. Also the time taken may be long and demotivating. For such women, liposuction provides instant relief. Some of the most common areas that come under a cannula in females are:
  1. Fatty Inner Thighs, fat outer thighs (saddle bags) and Knees– The legs have a tendency to appear fat in some of the most common parts making the women look ungainly. The fat in these areas tend to be stubborn and does no go easily despite exercising and eating well. The back of the thigh is a common place for cellulite accumulation and may show ugly dimples that refuse to go. Liposuction in the thigh helps to get rid of these three problems and helps in body countering.
  1. Medial thigh deformity– In this, the thighs are fat from the lower region, just above the knees. This does not result in saddle bags and the rest of the leg, including the waist has normal size. But the thigh appears bulky and curvy.
  1. Abdominal and waist fat- The most common area which equally affects both the sexes is the abdomen. This problem is more common in women post child birth as the stomach may not retract back easily and continuous to look bulky. Added to that, the fat distribution tends to reach the waist and it appears large, growing in diameter. This makes the body appear large and wide. Liposuction can reduce the size of the stomach and create a thinner waist so that the stomach does not hang in an ugly mass, over the belt.
  1. Bulky arm– As women age, they tend to have bulky arms. The arms have a tendency to accumulate cellulites which are hard to get rid of, even after working out regularly or following a diet. Liposuction can get rid of the excess fat. This should be performed by an experienced surgeon as the arms have lymph nodes which can get ruptured, causing lymphedema.
  1. Submental fat (double chin)– Some people have a tendency to develop a double chin even on gaining a little bit of weight. Submental fat is hard to get rid of. Liposuction along with face lift can help to remove the excess fat as well as tighten the skin. Having a good jaw line gives an effect of having lost weight and makes a person look thin. People with a broad, sunk in neck can opt for liposuction coupled with platysmaplasty which is a form of neck lift.
Males- Areas that need Liposuction assistance Initially only women were undergoing liposuction to loose excess fat. With growing awareness, men have also taken to surgical removal of fat. Also, the vanity factor has become equally important in both the sexes, with men also wanting to look their best. Liposuction gives them a safe and fast option to get their body in shape and look their best. With increasing competition in professional world, men understand the importance of looking fit and young. Men have a bigger affinity to smoke or drink than women. Due to this, the basal metabolic rate decreases and alcohol adds excess weight because of which men tend to sport beer bellies. Otherwise also, they tend to gain weight in the torso, flanks, abdomen and back. They also have fatty deposits in the pubic mounds. The bodies of certain men have a tendency to accumulate fat in the chest region leading to state called gynecomastia. Some of the most common areas that come under a cannula in males are:
  1. Protruding stomach and flanks– This is the most common area that afflicting men. As men age, they tend to have a paunch. Biologically also, their body has a tendency to accumulate fat over the abdomen. Besides this, they also tend to gain weight in the flank region. Through liposuction, lower abdomen and flank can be slimmed into proportion.
  1. Tire– Fat distribution can expand to the back giving rise to ugly ‘tires’. This can cause formation of layers of tire which are ugly in appearance. Tires can be removed through liposuction.
  1. Abdomen and pubic mound protuberance– The fat in the abdomen can reach the pelvic area. The upper part of the fat, which can be pinched can be subjected to liposuction and be removed. This is called as the subcutaneous fat. The fat that lies deeper is called as visceral fat and cannot be removed through liposuction as it can damage the surrounding organs. Some men have a tendency to put on fat just over the pubic region, just above the male reproductive organ resulting in pubic mounds. This fat can be removed through liposuction.
  1. Double chin– After the abdomen, men have a tendency to put on weight under the chin, resulting in double chin. Depending on the extent of fat deposition, liposuction can be performed singly or in combination with facial cosmetic procedures. This can also be done along with neck lift so that the man appears over all thin.
Unlike women, men do not have a tendency to put on weight in their lower region. So the shape of the legs and buttocks remains normal. This happens in general state. In case of obese men, they may have heavy thighs and calves but such a body type is uncommon. Correcting deformities Dieting and exercising can help in weight loss. But there are certain deformities that can occur in the body, which can’t be corrected only through these two traditional forms of weight loss. In such cases, liposuction provides quick and long term relief.
  1. Violin deformity-This is more common in women than in men. In this condition, the upper hip area appears full but the mid hip area is small and is accompanied by saddlebags. The formation resembles that of a violin, as there is decreased fat at the hip level.
  1. Fatty calves-This deformity is again more common in women than in men. Patients with fatty calves have heavy calf muscles, which is usually from childhood and cause a lot of embarrassment to them. A small incision in the calf can easily remove excess fat and ensure that the calf immediately gains shape.
  1. Gynecomastia-The deformity is only found in men. Gynecomastia is a condition in which there is excess fat present in the chest, due to which the breast tend to protrude and hang out resembling a female breast. This can be a cause of embarrassment in men, as even heavy padding of clothes cannot hide enlarged breasts. It can be caused due to steroids, hormonal imbalance or could be hereditary. This excess fat can be removed through liposuction.
Risk Factors Risks before the surgery Before a person goes for liposuction, there are certain risks involved that the patient needs to be aware of. A patient has to undergo a complete examination before entering the operation theatre. Some of the most important preoperative measures that need to be taken are
  • Cardiovascular disorder– Patients who have a history of heart problems need to double check with their physician before going for the surgery.
  • Hypertension– Patients with extremely high blood pressure are usually not advised for such surgeries.
  • Diabetes– High sugar level interferes with the healing of the incision through which liposuction is performed. The blood sugar has to be in control before heading for surgeries.
  • Allergies– The patients may react to the medications.
  • Pulmonary diseases
  • Addicted to smoking, alcohol or drug abuse
Risks involving liposuctions The patients are advised to understand the procedure and the risks involved before they have a liposuction performed on them. Though, liposuction is basically a safe form of surgery, it does have the rare chance of having complications. Some of the most common risks associated with liposuction are-
  • Infection- Very rare, but can happen if the instruments are not cleaned well, or if the patients does not keep the area where the incision was caused clean.
  • Healing time- In case of patients who are suffering from diabetes, or have aged, the incision stitches may take some time to heal.
  • Reactions- Some patients may react to the medications or anesthesia
  • Fat or blood clots may travel to the lungs and cause death though this is a very rare case
  • Excessive loss of fluid can lead to shock or may prove to be fatal.
  • Fluid accumulation leading to edema
  • May damage the surrounding nerves or organs
  • May cause friction burns.
  • If the surgeon removes excess fat in a single operation or all of it in one day, it can lead to dents, dimpling or sagging of the skin. To avoid this, the patient must have gap of few day, if undergoing multiple liposuction or can have excess fat removed in several sittings.
  • Post liposuction they can be some minor complications such as scars, lumpy appearance, discolored skin, fainting post surgery, focal skin necrosis, numbness and minor drug interactions.
  • In rare cases, there can be severe complications which can occur due to reaction of the anesthesia, cardiac arrthymia, blood loss due to excessive bleeding, sever drug reactions, allergy to certain medications, seizures, internal bleeding and blood clots or severe damage to the brain due to over dose of anesthesia.
These problems can be minimized by selecting an experienced surgeon to perform the operation. The hospital should have state-of-the art facilities and should be reputed. It’s also important to discuss that the patient discusses the previous medical history with the physician so that the medico is well informed. It’s also important that the patient discusses all this doubts and fears regarding the surgery with the doctors.   Diet – before and after surgery It’s wise to check on the diet at least a month before the surgery. This gives the body ample time to become healthy and get prepared for the stress and pressure that it will be subjected to. There are different diets that are recommended before and after the surgery. Before- The body has to be fit and strong as it has to be healthy enough to flush out the toxins that that are produced by the anesthesia and at the same time it should be able to absorb the active ingredients of all the medications. It will also ensure the person does not feel weak post the surgery and the chances of fainting or going into a shock are minimized. Besides, it helps to build the immunity, keeps the body hydrated, maintains electrolyte balance and keep the condition of the muscles healthy. An enriched balanced diet helps the body fight the stress and the sudden demand for nutrients and energy supply. Some of the most common nutrients that is required by the body are
  • Vitamin C- Vitamin C improves the immune system of the body and hastens the healing of cuts caused due to liposuction. It helps the body fight infections and safeguards against allergies. Since it also acts as an antioxidant, it helps to eliminate toxins from the body. It helps in repairing damaged capillaries and decreases the chances of blood clots in the veins. This vitamin improves circulation of blood and helps in absorption of iron.
  • Iron- It is an important part of the red blood cells and helps in growth of the body. It also delays fatigue and helps to fight anemia.
  • B-complex- They are instrumental in repair of tissues, help in normal functioning of the nervous system and bring relief from pain. They also help to avoid mental disorders like anxiety and depression and promote growth of healthy skin and nails. They are also important for blood circulation and help to avoid water retention.
  • Zinc – accelerates healing and promotes growth and repair of tissues. They also keep the person mentally alert and decrease the rate of deposition of cholesterol. Zinc also helps in fat metabolism.
  • Vitamins such as A, B1, B2, B3, Br, B12, K and E are also important.
  • Minerals such as calcium, chromium, copper, selenium, magnesium and manganese are equally important.
Usually the patient is told to refrain from smoking or alcohol, a week before the surgery so as to minimize the level of toxins in the blood. After Liposuction- Post liposuction, the patient has to follow a different diet as the body undergoes a change after removal of fat.
  • The patient has to decrease the consumption of triglycerides such as LDL (low density lipoproteins) and VLDL (very low density lipoproteins). Along with that the person should start consuming increased amount of HDL (high density lipoproteins).
  • Prescribed nutrients- The doctors also put the patient on prescribed nutrients which the patient has to take along with a balanced diet. This helps the wound to heal fast and also helps to avoid infections.
  1. What is liposuction?It is a surgical form of weight loss where the excess fat is removed from the body, instantly making the person loose a few inches. It is also helps in sculpting the body and getting the desired shape. It is a simple procedure and may take a few hours to an overnight stay at the hospital, depending on the surgical requirements. The operation is performed using a liposuction cannula which is connected to a suction tube which acts as an exit point for the fat. The cannula is inserted into small incisions which heal fast post the operation and slowly fade away.2. Is liposuction a good way to loose weight? It is a good way to loose “inches” especially in people who are obese as it acts as the motivating factor for further weight loss. It’s important to consult a cosmetic surgeon before deciding to go for this surgery. 3. Does liposuction tighten skin? Liposuction effectively removes fat due to which the skin hangs down. Once the fat is removed, the skin may become a little more firm. But this depends on the elasticity of the skin. If they already have loose skin, liposuction may make it baggier. In such cases, surgeons usually combine liposuction with a face lift, tummy tuck, abdominoplasty or thigh lift. 4. Can the fat come back? Liposuction ensures fat loss for a long period of time. This means that if the person checks his diet and works out regularly, then chances are that the fat will not come back. But if the person indulges in fat rich food, the fat can come back over time 5. Is it a painful experience? During the surgery the patient is anaesthetized. Post the surgery, the incisions may pain a little but these wounds heal fast. 6. What is the recovery period post the operation? The recovery period differs in individuals. But the general pattern is
  • For the first week, the person is on strong medications so as to fight the pain. During this period the patient cannot drive or exercise and is advised to rest at home.
  • In the second week the patient can resume work, start driving, go for walks and do light exercises but should not start jogging, weight lifting or doing any strenuous exercise.
  • Post the third week, running and aerobics can be done.
  • Post the forth week, the person can bounce back to his previous routine.
  1. Can I go for liposuction?If you are in fairly good health and have realistic expectations of liposuction results, then you can opt for liposuction. Even if you have excess weight in one area or are obese, you will benefit from liposuction. It will not give you a perfect body, but will help you hide your imperfections well.8. Who shouldn’t go for liposuction? People who expect that they will get the physique of a model and look great over night should not go for liposuction. Also people with serious medical disorders should refrain from going for this surgery. 9. Does liposuction remove cellulite? Liposuction can reduced the “dimpled” effect of liposuction but it cannot completely eradicate it. 10. What are the alternatives to liposuction? The best way to loose weight is stay natural. Working out combine with a balanced diet will help loose weight, though the results may show only over a period of time.
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