Frequently Asked Questions - Liposuction

What is "tumescent" liposuction?

The tumescent technique is a liposuction method that can reduce postoperative bruising, swelling and pain. Also, blood loss is minimized during tumescent liposuction due to the effects of the local anesthetic used. In the tumescent technique, areas of excess fat are injected with a large amount of liquid solution containing lidocaine (Novocain) and epinephrine before liposuction is performed. The concentration of lidocaine and epinephrine is extremely dilute so the risk of toxicity is minimal. The liquid causes the compartments of fat to become swollen and firm or "tumesced." The expanded fat compartments allow the liposuction cannula to travel smoothly beneath the skin as the fat is removed. This can give multiple benefits -- extra precision for the surgeon, reduced loss of blood for the patient, and extended pain relief after surgery, which can reduce the need for pain medication immediately after surgery. Tumescent technique is now the standard of care in liposuction.

Why do patients wear a compression garment after surgery?

After liposuction, swelling is expected. A compression garment helps reduce swelling and helps to reshape the tissue. Some patients see little difference or are even larger during the first week after surgery. The following week, patients usually begin to see results. After 2 months, the patient will be at about 80% of the result. Improvement continues until about 6 months after surgery when all of the swelling should be gone. I usually have patients wear their compression garments for 3 weeks after surgery.

Can I still gain weight after liposuction?

Everyone is born with a certain finite number of fat cells. During liposuction, fat cells are removed so the total number of fat cells in your body is reduced. If you gain weight after liposuction the remaining fat cells will get bigger, but you will remain proportionally smaller in the areas you had surgery. If you maintain your weight, the fat should not come back to the liposuctioned areas. If you put on weight, it will more likely to be distributed more evenly over the body and less likely to go to your ‘trouble zones’.

Will I still have cellulite or rippling after liposuction?

The aim and goal of surgery is to improve one's appearance as it relates to shape and volume. The degree and the magnitude one's cellulite and rippling prior to surgery will affect the postoperative outcome. In mild to moderate cases, the cellulite and rippling is usually improved with the surgery. In severe case some cellulite will always remain. No promises can be made in any case regarding cellulite. Liposuction improves the overall shape of the body in addition to making it smaller.

Who is a good candidate for liposuction?

The best candidates for liposuction are in good health and have realistic expectations of what liposuction can accomplish. Liposuction best treats isolated deposits of fatty tissue with good overlying skin tone. There is no definite age or weight limit for patients who are "good candidates" for liposuction. Many liposuction patients are of average size but are concerned about localized accumulations of fat.

Who is not a good candidate for liposuction?

A person who expects absolute perfection is not a good candidate for liposuction. Excessively obese patients are usually not good candidates for liposuction. A person who has a serious medical problem is not a good candidate for liposuction.

Is liposuction a reasonable treatment for obesity?

Liposuction is not a good treatment of obesity. Liposuction is not effective, even as a last resort, for people who are unable to lose weight by dieting and exercise. Obese patients almost always regain the weight that is removed by liposuction unless there is a dramatic reduction in calorie intake (by dieting) or a significant increase in calorie expenditure (by exercising). Whenever large-volume liposuction has been used in an attempt to treat obesity by surgery, there has been a significant increase in the incidence of serious surgical complications. It is not safe to remove huge amounts of fat by liposuction. It is dangerous to remove more than 8 to 10 pounds of fat by liposuction in a single day. Thus, liposuction will not be of any significant benefit for an obese patient who believes that liposuction will aid in the effort to lose weight.

On the other hand, an overweight person whose weight has been stable for many years and has certain problem-areas of fat may be a good candidate for liposuction. Liposuction in an obese patient is reasonable when the goal is to improve a troublesome body contour area. It is not reasonable to use liposuction as a surgical technique for weight loss.

What is a successful liposuction surgery?

A liposuction surgery is a success when the patient is happy with the results. The surgeon's goal is to obtain an optimal aesthetic result rather than to maximize the amount of fat removed. One of the most common causes for disappointment in the results of liposuction surgery is the removal of too much fat, which produces an abnormal or unusual appearance. The cosmetic success of a liposuction surgery is often the result of removing an amount of fat equivalent to less than a pound or two of butter from a woman's saddlebag area or from a man's love handle area. While this amount of fat is relatively small compared to a person's total body weight, it does produce a dramatic change in the patient's silhouette.

Does liposuction always remove cellulite?

Liposuction improves the silhouette of the body, but does not necessarily eliminate the pre-existing subtle "puckering" of the skin that is often referred to as "cellulite." Liposuction does reduce the degree of cellulite to a minor degree but it is unlikely to produce a significant improvement or to completely eliminate cellulite.

Does liposuction produce permanent results?

After liposuction the body's new shape is more or less permanent. If a patient does gain a moderate amount of weight after liposuction, then the figure will simply be a larger version of the new body shape. Fat cells that are removed by liposuction do not grow back. As long as the patient does not gain excessive amounts of weight, the new, more pleasing silhouette is permanent. Of course after liposuction the clock keeps ticking, and advancing age will produce the usual changes in the shape of the body associated with the aging process. If a person gains weight after liposuction, she/he will not accumulate as much fat in the treated areas as would have happened if liposuction had not been done.

Does the fat come back in other spots after liposuction?

If a patient does not gain weight after liposuction, then fat does not accumulate in other areas of the body. However, if a patient gains a significant amount of weight, say more than 10 pounds (5 kg), after liposuction, then the fat must go somewhere. In fact, the fat accumulates in every area of the body in proportion to the amount of fat cells in each area. Areas where fat cells have been removed by liposuction will accumulate relatively little fat, while areas not treated by liposuction will collect relatively more fat. For example, if a woman gains weight after liposuction of her hips, outer thighs, and abdomen, then most of the fat will be deposited elsewhere such as the woman's breasts, face, back and legs.

Does liposuction cause dimpling or indentations in the skin?

Dimpling and indentations in the skin is a known risk of liposuction. However skin irregularities are unusual in the hands of a skilled surgeon. The use of large diameter cannulas tends to increase the risk of irregularities, while the use of microcannulas (less than 2.8 mm in outside diameter) reduces this risk. The use of microcannulas and multiple adits (very tiny 1.5 mm round holes placed in the skin) allows the surgeon to make a criss-cross pattern of tiny tunnels throughout the fat which produces smoother liposuction results compared to using larger cannulas and only two or three entrance incisions. When large cannulas are used, any inadvertent passage of the cannula too close to the skin may leave a depression or furrow, whereas one pass too close to the skin with a microcannula will not leave a visible depression.

What Alternatives Are There to Liposuction?

Liposuction is never absolutely necessary. If you decide that liposuction is not for you, then you may consider the following alternatives to liposuction. Weight loss without liposuction can produce excellent aesthetic results. Weight loss can be achieved by dieting (decreased calorie intake) or by increased exercise (expenditure of calories). An alternative to abdominal liposuction is a tummy tuck.

How much will my postoperative appointments cost?

We do not charge for visits after surgery. You are our patient for life!