Liposuction

What is Liposuction?

Liposuction is a surgical procedure whereby localized fat deposits are removed using a suction device through small, well-hidden incisions to provide improved body contouring to the treated area. Liposuction is not a method of weight loss. While higher volume liposuction does remove a lot of fat in local regions, the overall amount of weight lost is relatively modest, and certainly not as much as patients would like to see.

Liposuction can be done on most parts of the body where excess fat accumulates, but some areas respond better than others. Common areas treated are the abdomen, the flanks (“love-handles”), the thighs including “saddle bags,” around the knees, the chest (gynecomastia), the upper arms, and under the chin.

Who is a good candidate for Liposuction?

Individuals who are good candidates for liposuction are generally at, or close to their ideal weight, but who are still bothered by problem areas, such as the abdomen, the flanks (“love-handles”), the thighs including “saddle bags,” around the knees, the chest (gynecomastia), the upper arms, and under the chin.

Liposuction Procedure

Depending on the extent of a procedure, liposuction can be done safely with straight local anesthesia, local anesthesia with sedation (“twilight sleep”), or with general anesthesia. The procedure begins with the application of a wetting solution called “tumescent anesthesia”. This solution is used to numb the area and help reduce bleeding, providing a smoother result with less risk of dents or furrows.

After the wetting solution is administered, the next step is to create small incisions in the preferred area to remove fat. By approaching from different angles, if possible, a more even result is obtained.  Patients can be repositioned as needed to treat all areas.  Incision sites are usually closed with a suture or two, but sometimes the incisions are left option to drain.  Band-aides and compressive garments are then put on afterwards.  Compression is worn for 4 – 6 weeks to control swelling and help with shaping after the surgery.

Liposuction Surgery Before and After

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Liposuction Surgery Recovery

After the liposuction procedure, patients wear a compressive garment for 4 to 6 weeks at all times except when showering. Over the first week, patients should take it easy—nothing strenuous that might raise heart rate or blood pressure. This is to avoid bleeding or development of a fluid collection, and the first week is the most critical from this perspective.

After a week, I encourage my patients to proceed with cardio activities, generally low-impact, in order to recondition themselves after a big surgical procedure and a week off. After two weeks, I allow patients to go ahead with resistance training, and they advance this as they tolerate it over the subsequent four to six weeks.

As for work, many patients can have surgery Friday and be back to work on Monday, presuming they have non-strenuous jobs. Those whose jobs are more physical may need to take a week or two off of work if they’re able to.

Liposuction Results

Results of liposuction vary from person to person, but generally, the goal is improved contour in the areas treated. Patients may see some loss of weight, but this is usually in the five to ten pound range, and patients should be reminded that this isn’t a weight loss procedure, but rather a contouring procedure. In some cases, time is required to allow for skin retraction and tightening, and for resolution of swelling.

Preliminary results are obvious immediately in most cases, and after swelling resolves, somewhat normal appearance of the improved area will be observed within six to eight weeks post-op. Continued healing will allow for the skin to tighten and smooth out. The results of liposuction are long-lasting if patients maintain a prudent diet and exercise regimen and avoid weight gain. Should a patient gain weight after surgery, the distribution of that weight gain may be different with less going to the areas treated and more fat going to other areas that weren’t treated.

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Liposuction VS Tummy Tuck

There is a big difference between liposuction and a tummy tuck, in that liposuction removes fat but not skin, and this is done through very small incisions that are barely perceptible afterwards. A tummy tuck may include liposuction as part of it, but the primary difference that large areas of skin are removed with a tummy tuck in order to tighten the abdominal wall. This results in a large scar across the lower abdomen, which is very different from liposuction.

Your Liposuction Consultation

When you come for your consultation, your history will be reviewed, including previous weight gain and weight loss history, other health problems and previous surgery. A physical examination will be performed and photographs of the specific body parts will be taken. The surgery will be reviewed in detail including risks and benefits, and you will have the opportunity to ask questions about the procedure and view photos. Payment and scheduling options will be reviewed. Afterwards, you can proceed with scheduling and you’ll be on your way to improved contour!

Liposuction Risks and Safety

Prior to Liposuction, patients should avoid supplements or medications that might cause bleeding, such as aspirin or other NSAIDs, fish oil, and fat burners.  Patients should be aware of limitations after the surgery and plan accordingly, whether it’s making preparations at home or arranging for absence or adjustments in work schedule.

Liposuction, when done properly in an appropriate setting is very safe. There are risks associated with any surgical procedure, and it’s important for patients to understand that liposuction is a surgical procedure, in spite of the fact that incisions are very small and the surgical sites are hidden under the skin.

Risks include any associated anesthetic risks, which are generally minimal for young, healthy patients typical of those undergoing liposuction. Surgical risk includes bleeding and infections, though these are quite rare as well. There is typically sensory alteration in the sites treated, but most of the numbness resolves over time. Fluid collections (seromas) can occur post-operatively, and these are usually easy treated with aspiration using a needle and syringe. Long-term issues are mostly related to contour irregularities from under- or over-suction, and these might require a secondary or “touch-up” operation.

How much does Liposuction cost?

Liposuction cost will vary from location to location with higher prices in high cost of living areas. In the Boston area, the cost for most liposuction procedures focusing on one area (abdomen/flanks or thighs, for example) is approximately $6000 – $8000 total cost (including hospital and anesthesia fees). Combining areas will cut overall cost per area, but this must be done in a manner which is safe and avoids excessive volume of aspirate.

Liposuction FAQ’s:

Will I Be In Pain After Liposuction Surgery?

Liposuction is painful to some degree in all patients, though tolerance varies. In very extensive procedure, patients may require pain medication for several days post-operatively, as compared to smaller procedures, where minimal medication is needed.

Will I Need Medication Before or After Surgery?

There are no specific medications that I recommend prior to liposuction surgery, though there are various homeopathic remedies, such as arnica, which may be popular. I don’t recommend anything specific, but in most cases, I’m okay with patients who use such medications.

When Can I Return to Normal Activities?

This depends on what you refer to as normal activities. Most patients can resume most activities within a few days, other than very strenuous exercise or labor. Most patients are nearly completely back to normal within 4 to 6 weeks after surgery. Check out our “Getting Back to Training Instructional Sheet” for more information.

Does Liposuction Treat Cellulite?

Liposuction doesn’t not treat “cellulite.”  There are different theories of what causes cellulite, but liposuction doesn’t remedy, and in fact, it can worsen the condition. Patients should be reminded that Liposuction is not a method of weight loss.  While higher volume liposuction does remove a lot of fat in local regions, the overall amount of weight lost is relatively modest, and certainly not as much as patients would like to see.

Schedule a Consultation

If you are interested in learning more about liposuction, call our office at (617) 965-9500 to schedule a consultation with Dr. Rick Silverman.