Liposuction Basics

Liposuction has become one of the most sought after cosmetic procedures done around the world. In my area, aka Beverly Hills, it is probably one of the top procedures done after Botox and Breast Augmentation. It seems as if everyone has had “a little lipo.” It’s not just for women either. More men are opting to have liposuction done on their abdomens, love handles, and necks. From tiny areas called “micro- lipo” to larger areas, liposuction is very popular amongst everyone.

First, it is important to determine if you are a good candidate for liposuction. You must be in good health and over 18 years of age. You should be within 10 to 15 pounds of your ideal body weight. Liposuction is NOT a weight loss program, or should be used to kick-start a diet. Patients who do really well are the ones who exercise, eat healthy, live a healthy lifestyle, and have realistic expectations. Also, good skin tone and elasticity are important for after the procedure is done. Liposuction does NOT reduce cellulite. In some cases, it can be made worse. It is done to redefine, reshape, and contour problem areas that will not respond to diet and exercise.  Your diet plays a huge role in having a great result and maintaining your result. Liposuction removes fat cells, however if you do not maintain you weight afterwards, weight gain can happen either in another area of your body or all over.

How is liposuction done?

Also called Lipoplasty, or SAL suction assisted lipectomy, it is the removal of localized fat deposits using a stainless steel hollow tube (cannula) with the assistance of a powerful vacuum. It can be done under general anesthesia, sedation, or under local anesthesia depending on the area treated and your doctor. Your surgeon will make strategically placed tiny incisions and use those to inject fluid prior to the actual liposuction.

The area to be treated is first injected by a large volume of solution that contains saline, numbing medicine (lidocaine), and epinephrine, which causes the blood vessels to constrict and reduce bleeding. This solution is called Tumescent Solution, and every surgeon has a different way of mixing this and different dilutions that they use. Tumescent solution is the safest way to have liposuction, is the most popular method, and also gives you the best result when having large amounts of fat removed.

What areas can be treated?

There are a lot of areas that can be treated with liposuction:

  • Chin
  • Neck
  • Arms
  • Bra line
  • Flanks
  • Back
  • Waist
  • Love Handles
  • Upper Abdomen
  • Lower Abdomen
  • Inner Thighs
  • Outer Thighs
  • Knees
  • Calves

There is definitely an art to liposuction. It takes a talented surgeon a good amount of time and energy (literally they are sweating) to achieve the best possible result. The things that you should look for when interviewing doctors are:

  • Proper training and certification
  • Scientific knowledge
  • An idea of what is beautiful
  • Perfection in his workmanship
  • Skill and experience
  • An artistic eye and finesse

I have seen surgeons do liposuction quickly and gloss over the area to be treated, and I have seen surgeons take meticulous care in making sure that there are no dents, ripples, or irregularities in the skin. Ask to see multiple pictures and ask them how long they take to do the surgery.

There are some other additional techniques with Tumescent Liposuction:

UAL Ultrasonic Assisted Liposuction:

This is done with a special cannula that has ultrasonic vibrations attached to it. The vibrations help liquefy the fat which makes it easier to remove. It is also less traumatic to the tissue so there is less bleeding and bruising.

PAL Power Assisted Liposuction:

This is done with a motor or compressed air attached to the cannula to move it faster; it is also less manual labor and easier for the surgeon.

This is a sample of other Lipo alternatives on the market:

Smart Lipo

This is done with a laser attached to the cannula, there is no suction done with this. The laser liquefys the fat and then fat is drained out of tiny incisions. It is gentler and less traumatic, so it’s good for small areas such as the face and neck. Also, the heat from the laser causes the tissue to contract, which gives you tighter, smoother skin. This can be done under local anesthesia.

Cool Lipo

This also has no suction… it is done with wavelengths that are attached to a small cannula. The wavelengths dissolve the fat and tighten the skin. This is also great for the face and neck, or smaller areas. This can be done under local anesthesia.

Pro Lipo Plus

This is a combination of laser AND wavelengths housed in a cannula. This is used in smaller areas as well or where traditional liposuction is not advised. It can be done with just local anesthesia and is used in areas that need precision and tightening.

Risks of Liposuction

As with any surgery regardless if it elective or not, there are always risks associated with it. There have been stories in the news about patients who have had severe complications from liposuction. Especially with larger volumes of fat removed, there is a lot of fluid shifting that goes on in your body. This is why it is important that your surgeon works with a qualified anesthesiologist or CRNA who is familiar with liposuction patients. His job is to monitor the amount of fluid that goes in and comes out of you. This is especially important in large liposuction surgery where they are removing fat from multiple areas. There is I.V. fluid and the tumescent fluid going into your body, and there is the volume of fat and solution, along with urine that comes out of your body. Also the dilution and amount of medicine in the tumescent fluid must be monitored by the doctors and nurses.

Some of the risks with liposuction can include:

  • Infection
  • Hematoma
  • Bruising
  • Numbness
  • Asymmetry
  • Irregularities
  • Skin discoloration
  • Sagging skin
  • Nerve damage
  • Fluid imbalance
  • Deep Vein Thrombosis

Your surgeon should discuss ALL possible risks AND benefits of the surgery in more detail at your consultation.


Immediately after, a compression garment is given to you and should be worn at all times for the first week. It is important for several reasons. It provides compression so that all of the fluid drains out of the incision sites. It helps decrease swelling and helps give you a smooth result by keeping the skin close to the muscle. The might be some drainage from the tumescent fluid…this is normal and usually goes away after a day or two.  You might have pads under your garment to absorb any drainage. Prepare your bed or chair at home with some old towels just in case you do have leakage. If you had only local anesthesia, you can drive and resume your regular diet. If you have anesthesia, you need someone to drive with you and stay with you for the first 24 hours. Drink fluids and eat a small meal to start. Do NOT diet while you are healing from any surgery that you have! Your body needs energy and good nutrition to heal quickly and properly. Also, smoking is not condoned. The nicotene in cigarettes actually blocks oxygen from getting to your surgery site, and oxygen is vital in the healing process. It is also important that you get up and walk around a bit for your circulation to avoid any blood clots.

Depending on the area of the surgery, there will be mild to moderate bruising, this is normal. Most bruises subside in 10 to 14 days. Also, you will have swelling, and the skin might feel numb. You can usually start an easy walking workout in 3-4 days. Follow all of the instructions given to you by your surgeon and read all of the information that your surgeon gives you.

Liposuction is a great way to help sculpt your body and get rid of those problem areas. If it is done safely on a healthy person by a qualified surgeon, it is a happy experience and can dramatically change your body in some cases. Make sure to do your own research and have all of your questions answered before you make a decision. Plastic surgery is not a hair cut appointment; it is still surgery and should be with seriousness and responsibility.

Sylvia Silvestri, RN