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Since the 1980s, when it was first used, liposuction (also called “lipoplasty" or "suction lipectomy”) has been improved and modernized. No longer do you go to hospital, have blood transfusions, and take months to recover.
A look at fat cells
Each of us has a certain number of fat cells. We developed that number when we were growing up, and once established, it remains about the same for our lifetimes.
If as adults we overeat, we don’t usually create more fat cells. We enlarge the ones we already have. If we then go on a diet, they’ll shrink back to their original size and we’ll have the same overall shape as we did before. Only if we gain an extreme amount of extra weight are we creating extra fat cells.
But in this beauty battle, aging fights against us. As we age, even if we don’t overeat, certain areas of the body may start retaining fat. The biggest culprits for women are the lower abdomen, upper arms, chin, thighs, hips and buttocks. For men, they’re the chest and shoulders, chin, thighs, and buttocks.
Pregnancy fights against some of us too. Carrying a baby stretches the abdominal skin and muscle and sometimes it doesn’t shrink back to its original shape, no matter how much we exercise and diet.
What kinds of liposuction are there?
There are 3 main ways of doing liposuction.
Standard Liposuction (the wet technique)
A small amount of saline fluid is injected into the area first. In this fluid are 3 ingredients: -Lidocaine, for local anesthesia; -Epinephrine, for reducing the bleeding; and -Salt, to make the fluid compatible with our saline body fluids.
This fluid has the effect of loosening fat cells, which in turn reduces the bruising afterwards, and makes the fat cells easier to remove. A cannula (small hollow tube) is inserted into the area and the fat cells are suctioned out.
Tumescent liposuction
This is the biggest advance in liposuction so far and was introduced in 1985.
“Tumescent” means “swollen”. A large amount of the same saline fluid is injected into the area – up to about 3 times the amount of fat to be removed. Besides loosening the fat cells, this large volume works to make space between the fatty tissue and the muscles, creating more room for the surgeon to move the cannula.
Tumescent liposuction takes longer than other methods because there’s a waiting period while the fluid percolates through the tissue.
There’s a modification of tumescent liposuction, known as the super-wet method. It differs in the amount of fluid injected. In this method, about the same amount is injected as the amount of fat to be removed.
Ultrasound-Assisted Liposuction (UAL)
A specialized cannula is used, which vibrates in response to ultrasound from a machine operated by the cosmetic surgeon. This vibration works on the fat cells, causing their outside surfaces to break, thus emulsifying the fat and making it easier to remove.
The ultrasound can be applied internally or externally. Applied internally, the cannula is used as just described.
Further advances in liposuction
New ideas and improvements are appearing all the time. For instance, in 1992 some plastic surgeons started using a motorized cannula, which vibrates very quickly and allows for greater precision.
Recovery period
At the end of the liposuction procedure, dressings are applied and you can go home the same day. There’ll be some swelling and your plastic surgeon will have you wear a compression garment for a few days, or perhaps a few weeks. As the swelling subsides, the size of this garment is reduced, to maintain an even pressure on the treated area. This gentle pressure increases your comfort in the recovery period. You can resume normal activities after a few days if you feel ready. Some gentle activity is better than complete rest because it helps your body drain out, and/or absorb, the fluids, for reduced swelling. It also encourages good blood circulation for quicker healing.
Whichever type of liposuction you have, the incision will be small, about one quarter of an inch long. So the resulting scar will be nearly invisible by the time it’s fully healed.
In the longer term
The suctioned-out fatty tissue is gone permanently, but that doesn’t mean their neighbors couldn’t enlarge and change your overall shape. It would be wise to stick to a healthy diet and consistent exercise, so as to avoid any need for future liposuction surgery.