Tumescent Liposuction FAQs

Is Liposuction Right for Me?

Many people consider liposuction surgery as a means to shed a few extra pounds but Liposuction can also help women re-contour their bodies after childbirth and help others remove excess fat deposits after losing a significant amount of weight. Some frequently asked questions of people who have considered Liposuction:

• Who is a good candidate for the procedure?
• How much fat can be removed?
• Will fat come back? Does the fat go to other areas?
• Does liposuction remove cellulite?
• Is liposuction a reasonable treatment for obesity?
• Is liposuction better before pregnancy?
• Will I have loose skin?
• When do I see the results?

A Good Liposuction Candidate

Liposuction is quickly becoming the most commonly performed cosmetic procedure in the United States. Many reasons this procedure is so widely chosen by patients today is because of the new techniques offered and minimal downtime. However, before choosing your liposuction doctor you should evaluate your current medical and physical state to determine if you are a good candidate for liposuction surgery.

When considering liposuction, a good candidate would be at or near their normal weight or within about 25 pounds of their ideal weight. They would be in good health, getting regular exercise. Liposuction is not a weight loss procedure but can be used to create a slimmer overall silhouette. If you struggle with localized fat deposits due to a current weight gain, heredity or just plain stubborn areas, you most likely will achieve the most dramatic results. Also, a good candidate has realistic post surgery expectations. These expectations are discussed in detail during the initial consultation.

Finally, there is no age limit to liposuction but patients with firm, elastic skin will find that the skin will snap back and form to their smaller contour.

Furthermore, you may not be a good liposuction candidate if you have any of the following medical conditions:

• Pregnant or breastfeeding
• Obese
• Taking anti-coagulants (blood thinners)
• Living with heart, kidney or liver disease

How much fat can be removed?

How much fat can be extracted during one session of liposuction is debatable. Some doctors decide the safe amount of fat to be removed on a patient-by-patient basis while others determine fat outtake on whether the surgery will be performed in a hospital, where there is greater access to emergency assistance. In addition, some states have rules on how much fat can be extracted in ambulatory setting, such as a freestanding surgical unit or a surgeon's office.

Excessive Liposuction (the removal of more than a few pounds of fat) is considered dangerous at any rate. Fatalities have occurred because of the removal of too much fat. These deaths are rare but still occur occasionally. Thus stating, the more fat that is removed creates a greater the risk to the patient. Please remember, liposuction is not a weight-loss surgery. It is a surgery to remove a few recalcitrant pockets of fat that resist diet and exercise. The average amount of fat removed today is below 10 lb.

Technically speaking, the safe amount of fat removed for any one patient is no more than 6,000 ml (about 12 lb of fat/fluid aspirate). However, this in no way should suggest that you will lose 12lbs. It means that your fat in conjunction with your blood and infiltrated fluids will equal about this amount.

Over the past 10 years liposuction techniques have improved resulting in surgeons reducing their risk and incidence of adverse outcomes. Although complications are less frequent, many surgeons still do not recommend more than 6,000cc of fat/fluid aspirate removal during one procedure.

Procedures removing more than 6,000 ml increase other risks such as anesthesia-related problems, infection, dehydration-induced shock or conversely a build-up of too much fluid that can seriously affect breathing. The risks of blood clots, seroma, hematoma formation, a drop in blood pressure, and lidocaine toxicity are increased in longer procedures.

The bottom line is that most liposuction patients don't need to have more than 6,000 ml removed. Removal of more than 6,000 ml of fat and infusion liquid should be avoided in any one procedure.

Will fat come back?

A liposuction surgeon never removes all of the fat cells from any certain area. After liposuction you will be left with your basal fat layer (the innermost layer of the epidermis). Liposuction permanently destroys and removes unwanted fat cells. Once they have been destroyed they can never come back. And as we do not grow or develop new fat cells after puberty, the results are permanent. However, if you do gain weight after your liposuction procedure, you will notice an even distribution of the weight that was gained back. This will result in a more even fatty layer, rather than a disproportional one. It is important to insure your surgery results that the patient follow a healthy diet and exercise routine.

Does liposuction remove cellulite?

Liposuction can diminish the appearance of cellulite but has not been medically proven to eliminate it. Cellulite is caused by many things: age, genetics, gender, and the thickness of your skin. Liposuction can improve the contour of the body, but will not necessarily rid the body of pre-existing cellulite. However, if you are looking to liposuction solely as a means of getting rid of cellulite, you should consult with your doctor for other cellulite targeted treatments. In some cases, fat cells will cover up most of the cellulite and upon remove of these fat cells cellulite is allowed to be more visible which means that after the procedure you may notice more cellulite than previous. Make sure when you go to see a doctor about the procedure that you discuss the fact that you want to also get rid of cellulite. This way the surgeon will understand your desired results and will be able to help point you to the best solution.

Is liposuction a reasonable treatment for obesity?

Obesity is an abnormal accumulation of body fat, usually 20% or more over an individual's ideal body weight. Obesity is associated with increased risk of illness, disability and usually means the presence of health concerns like high blood pressure, heart disease, and even diabetes. Obesity can also mean lifestyle restrictions and a decrease in self-esteem. Many obese people have looked to liposuction as a feasible solution to their weight problems.

Liposuction is not a good treatment of obesity. If you are unable to lose weight by diet or exercise you should consult a weight specialist. Unfortunately, people who are unable to lose weight by dieting and exercise almost always regain the weight that has been removed by liposuction ensuring undesirable post operative results for the patient and surgeon. The reasons being:

High Risk

Obese patients are already experiencing added stress to their organs and body functions. The additional trauma of anesthesia, incisions, and liposuction can sometimes be more than what the body can handle.

Health- #1 Priority

Even after removing a significant amount of fat from an obese person with liposuction, the health risks of high blood pressure, diabetes, and heart disease does not decrease. This is because the fat that makes a real difference in these conditions is the fat that surrounds the body's vital organs, which can only be reduced by diet and exercise.

Is liposuction better before pregnancy?

Because Liposuction candidates with good skin tone always get better results from liposuction, it is better to have it done before pregnancy. However, pregnancy does not permanently alter the results of liposuction. If a woman has liposuction and subsequently becomes pregnant, gains weight, gives birth and finally loses the excess weight of pregnancy, then her original liposuction improvements will return, just as if she had never been pregnant.

Will I have loose skin?

Skin type varies from patient to patient and can be affected by age, weight gain/loss, gender, nationality, and other outside factors. To determine if your skin will shrink to fit your smaller contour after liposuction you should first consult with a reputable doctor to examine the elasticity of your skin. A patient who’s skin is has good elasticity will achieve optimal results with liposuction.

A good surgeon knows that it is important to properly contour an area and leave the superficial fat intact to avoid creating deformities. If you have pre-existing deformities or laxity, this will not be improved with any particular device - in this situation, grafting and skin tightening may be needed.

When do I see the results?

The length of post-operative swelling depends on the technique of liposuction your surgeon is using to perform you liposuction.

The traditional approach uses a larger cannula which means more bruising and bleeding. After liposuction surgery, there is always some amount of fluid left beneath the skin. The traditional method also requires stitches. In this case the fluids drain less easily and can lead to bruising or swelling. Most patients begin seeing results in 4-6 weeks with the final results around 6-9 months.

The tumescent technique greatly reduces both the bleeding during surgery and bruising/swelling after surgery thus resulting in minimal post-operative recovery time. About 90% of patients can actually see at least some improvement in their silhouette by one week after surgery. However bruising and swelling usually begins on day 3 and 4 and will last up until 2-3 weeks. Week 3 -4 1/2 is when most patients report desired results. However, the final results following tumescent liposuction should not be assessed until 3 months after surgery.