What Is Liposuction or Body Contouring?
Liposuction is the removal of fat that has been stored by the human body in the space between the skin and the muscles. This fat has been created by ingesting more calories than are being burned as energy by the body.  Fat may also be stored around the internal organs of the abdomen creating what is often called a “beer belly”.  This is sometimes called brown fat.  The only way to effect the internal “beer belly” fat is calorie restriction (dieting) and increasing caloric burn (exercise).  However, the yellow fat between the skin and muscle can be evacuated by mechanical suction.  Before that can happen the area must be prepared and softened with a solution called “tumescent solution” which includes anesthetics for comfort and bleeding control.  A small number of minor (½ inch) incisions are made to give the surgeon access to the fat with a long rigid tube called a canula that is attached to a vacuum system to remove the fat by suctioning.  Recently several novel methods of dealing with excess body fat have come into the cosmetic surgery market.  The latest craze and heavily marketed system is known as Smart Lipo and Cool Lipo which, unknown to most, doesn’t actually suction anything.  It is a wand with a laser tip that has the ability to burn through a thin layer of fat.  This can be effective for contouring small areas of fatty tissue.  If a patient needs more than 3/8 inch of fat removed, conventional liposuction will also have to be used.  Vaser, and several other manufacturers use ultrasonic technology to liquefy fat cells before suctioning.  And lastly,  a number of companies have introduced LED cool laser lighting that a patient simply has to lie beneath to have body fat effected.  There are several other technologies in the pipeline not yet FDA approved that have the potential to be efficacious in the war on fat.  In our practice we have tested all the new technologies on both staff and patients  and have yet to find any appreciable differences.  To date, the gold standard of mechanical liposuction has proven to be the best all around method of removing fat from the body but we are happy to indulge our patient’s desires for a particular modality by providing access to the equipment.


Why do people choose liposuction?
Because people want to feel happy about themselves.  Many people are not satisfied with the shape of their body; women want perfect curves and many men want to be admired when their shirt is off.  Unfortunately, an unhealthy lifestyle (too much work, too much food, too little exercise) and genetics may prevent them from achieving their desired shape.  This is why liposuction has become such a popular procedure.  Liposuction is a relatively (see risks) safe way to reshape your body that can offer both men and women the ‘perfect’ body that they have always desired.  The idea that one is only a few hours away from “a perfect body” has made liposuction the most popular cosmetic procedure in America. 


Who should consider liposuction?

Liposuction is a choice for people who have tried to eat properly and follow a physical fitness regime, but have yet to be successful in reaching their fat loss or body shape goals.  Candidates are typically over the age of 18 and in good general health.  The focus for this type of candidate would be on removing the last 5-7 pounds of fat pockets found on their body.  It is, as well, an option for those that have reached a plateau in their weight loss plan.  Sometimes contouring specific body areas during an active diet and exercise program can jump-start the body into the next phase of fat burning and increase the patient’s  appreciation of the changes their body is going through to reach their personal goals.
The largest population of liposuction patients are those that have genetic patterns of fat distribution that seem to stubbornly defy exercise and diet; the outside of the thighs, the flanks (“love handles”), the upper arms, under the chin, and the lower abdomen.  These are the most commonly performed liposuction procedures.
Liposuction should not be looked at as an alternative to eating healthy and exercising.  It is not a weight loss method.  Furthermore, many physicians will not perform this procedure on men or women under the age of 18, or on those people who plan to continue to lead an unhealthy, sedentary lifestyle.
We need to make special mention of abdomens;  if the patient’s skin has lost youthful elasticity for reasons of age, pregnancy or massive weight loss this lack of skin elasticity might prevent the skin from tightening around the patient’s new shape.  If this is the case, a tummy tuck (or abdominoplasty) might be required to achieve the final desired effect.

What are the risks?
While rare, complications may present themselves with any cosmetic surgery.  The dangers associated with liposuction specifically are: reaction to anesthesia, infection, blood clotting, and fluid loss.  One must keep in mind that although this procedure does not look like surgery from the standpoint of open incisions and stitches, if large areas of the body are being evacuated, this procedure does cause a massive insult to the tissues which can cause a life-threatening electrolyte imbalance. This is why a physician counsels conservatism when a patient wants liposuction for weight loss.  Other possible reactions to liposuction may include bruising, numbing of the skin, scars, changes to skin pigmentation, and other non-life threatening complications that you must review with your surgeon. 


What is the recovery period?
Recovery time after liposuction varies depending on the patient and the specific areas where liposuction is performed.  In most cases, three days to two weeks is enough time for recovery to have progressed to the point where the patient can return to their normal life.  Immediately after the surgery and for several days thereafter, the tumescent solution and your body’s serous fluid may ooze from the small incisions created for the procedure.  Remember, for best results, a compression garment must be worn to compress the tissues during the healing process.  Final results will take several months to observe.