Liposuction is a medical procedure in which surgeons physically remove fat from subcutaneous deposits. There are a number of different liposuction techniques generally employed. The process typically involves sucking out the fat deposits with a device called an aspirator through a tube called a cannula. Physicians often inject fluid or otherwise emulsify the fat deposits for easier suction.

There are many different types of liposuction available. So-called “dry liposuction” is rare, since wet and tumescent surgeries have proven easier, safer, and more aesthetically sound. Tumescent, laser-assisted, ultrasound-assisted, and water-assisted liposuction therapies may also be considered.

Liposuction can be performed under general or local anesthesia. Ideally, patients are locally anesthetized to limit the possible side effects and complications of general anesthesia. In a number of wet liposuction techniques, fluid is injected subcutaneously to emulsify the fat to make it easier for aspiration. This fluid often contains an anesthetic (such as lidocaine), a vasoconstricting agent, such as epinephrine, and a saline solution to ensure a static osmotic balance in the body.

In laser-assisted surgery, a laser beam emulsifies fat via electromagnetic radiation. In ultrasound-assisted liposuction, high energy sound waves bombard the area to be treated and literally smash fat cells open, liquifying their contents. Ultrasound liposuction was initially a very popular alternative to traditional wet liposuction. However, studies found that ultrasound liposuction created a higher risk of fluid pocket formation.

In preapring for the procedure, most patients are forbidden from taking anticoagulants for 14 days prior to surgery. Patients who must undergo general anesthesia are typically prohibited from eating in the hours prior to surgery, as well. Finally, liposuction patients must forgo smoking and nicotine gum for several weeks before surgery, since nicotine can have an adverse effect on both circulation and tissue functionality.

On the day of surgery, the patient will sign a consent form, take antibiotics, and discuss last minute preparations with the surgeon. A sedative is then given — either intravenously or orally — and the surgeon then makes an incision to drain the adipose tissue. Most patients under local anesthesia report feeling some sensation at the area of suction — typically a scraping feeling — but ordinarily go home the same day. Complications from liposuction are relatively rare — one out of every 200 patients experiences a minor complication and only one out of every 500 patients experiences a major complication, according to a published report in the trade journal, Dermatologic Surgery.

Following surgery, patients may experience a number of side effects, including reduced ability to move, slight scarring and swelling, bruising at the site of surgery, pain and numbness, and some dizziness. If you experience severe symptoms that don’t respond to over-the-counter medications, contact your doctor right away. Incision areas are often left un-sutured for a day or two to drain whatever fluids remain. Swelling, numbness, and bruising can persist for a few weeks to several months after the operation. For patients who have large adipose deposits, several liposuction surgeries may be required to ensure satisfactory results.

Controlled tumescent liposuction can be a safe and effective way to combat the long-term complications of obesity, such as diabetes, arthrosclerosis, and heart disease. However, liposuction patients should also school themselves on the physiology of obesity. Contrary to what many in the public (and medical establishment) believe, the notion that obesity is caused by a combination of overeating and underexercising is but a hypothesis. In fact, this hypothesis has not stood up very well against the data collected over the past hundred years. Epidemiologists and physicians have found again and again that obesity and malnutrition coexist both in populations and patients. In other words, contrary to all that we’ve been taught by dietary authorities, fat regulation may not, in fact, be determined by “caloric balance.”

Fat tissue does not simply act as a “bag.” Adipose tissue is complex, and it is regulated by the body’s hormonal system. The competing hypothesis to the “caloric balance” idea (which has pervaded every aspect of our medical culture) is the idea that obesity is caused by the dysregulation of fat tissue. In other words, something causes us to get fat, and then our body remembers this “set point” and returns our fat levels to that set point, regardless of how much we exercise or how many calories we intake.

The important insight here is that liposuction alters the body’s regulation of adipose tissue by literally removing some of it. The key to safe and effective weight loss, according to this alternative hypothesis of why we get fat, is to avoid doing whatever caused the fat dysregulation in the first place. And mounting evidence suggests that, for the vast majority of the obese, simple carbohydrates in the diet may be at fault. To read up on this alternative hypothesis, check out award winning science journalist Gary Taubes’ book, Good Calories, Bad Calories.

A diet low in simple carbohydrates and sugars combined with carefully performed liposuction therapy can permanently and positively transform your body. Whether you consider the health benefits of primary importance or just a nice fringe benefit along with your physical transformation, you will, in fact, reduce your risks of developing any number of debilitating conditions.



Thanks to Joel A Allen for contributing this article to our Plastic Surgery blog:

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Even though liposuction is considered cosmetic surgery it still has some of the same risks as any other type of surgery. A good Manhattan liposuction specialist can make all the difference in the outcome of your liposuction procedure. You want the best results possible and here are some tips for choosing the right Manhattan plastic surgeon.

Where - Lipsuction can be done in a variety of places, from a cosmetic surgeons office up to a major hospital. The right setting is important, but not nearly as important as the cosmetic surgeon doing the procedure.

What Cosmetic Surgeon - Honestly any doctor can perform liposuction, so make sure you’re working with aboard certified plastic surgeon for the very best results. There are no laws regarding the type of training that needs to be done prior to performing liposuction. Do your research and make sure that your cosmetic surgeon is both trained and experienced. They should have the knowledge and skills to ensure that your liposuction is successful.

The Cosmetic Surgeons Role - The cosmetic surgeon should do a complete evaluation prior to agreeing to accept you as a patient. This should include a review of your general health as well as your reasons for having liposuction. The doctor should inquire about any past medical history as well as any medications you may be taking currently. Naturally he will evaluate your current body fat percentage as well as the elasticity of your skin. Your cosmetic surgeon should then be able to make a determination of your best liposuction technique to ensure great results.

What to do if you choose the wrong doctor - Mistakes do occur, even to the most vigilant of us. There are a very low percentage of liposuction patients who have serious complications, but if you choose the wrong doctor your chances of a poor surgery increase dramatically. Even if you don’t have complications there is an increased chance that you’ll have a result you didn’t want and aren’t happy with.

Choosing the right liposuction surgeon - These are my 4 tips to choosing the right liposuction surgeon.

Check out the facilities that your cosmetic surgeon will be using for the liposuction procedure. They should be in good repair, clean and sanitary. Ask for a tour prior to the surgery. Any good plastic surgeon will be happy to show you the facilities and answer any questions you might have.

Educate yourself about liposuction. You don’t need to be an expert, but you should have a basic understanding of the different types of liposuction and how it works. This will also aid you in asking the right questions when searching for a liposuction specialist.

Don’t just pick the first plastic surgeon you talk to, take the time to speak with several before making a decision. If there are people that you trust who’ve already had liposuction or another plastic surgery get their opinion. Your primary care physician could be another good source of information about good plastic surgeons.

Research the doctor’s background and history. Make sure they are well trained and experienced and hopefully board certified to practice liposuction.

New York is a large diverse city and finding a great liposuction doctor should be easy. Just take your time when choosing a Manhattan liposuction surgeon and you shouldn’t have any trouble. Just keep in mind that you’re dealing with your health and appearance and you should be able to make a good decision.



Thanks to Steven Walters for contributing this article to our Plastic Surgery blog:

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