LIPOSUCTION AT POWER PLASTIC SURGERY

When you ask what comes to mind when considering the term “liposuction”, many people automatically think “weight loss”. Unfortunately this is not the case! Liposuction is a technique for improving contour and adding definition. It may be used to target focal areas of persistent fatty tissue that linger no matter how many crunches are performed. Liposuction is one of the most common plastic surgery procedures. Ideal candidates are close to their ideal body weight with focal areas of adiposity that are unresponsive to diet and exercise. The procedure is performed for body contouring, not weight loss, and skin elasticity is important for skin retraction and tightening after surgery.

"The biggest hurdle for a lot of women is coming in for the consultation. Many do not want to appear vain or they feel guilty about finally spending money on themselves."

- DR. STEPHANIE POWER

Common areas for liposuction include the abdomen, hips, buttocks, thighs, knees, neck (submental), and face (cheeks, jawline). Liposuction is performed in the operating room. Depending on the body region and anticipated duration of surgery, it is performed either under general anesthetic, most commonly, or conscious sedation for limited regions.

Post-operative compression garments are recommended to decrease swelling and aid in skin retraction. Liposuction is performed as out-patient surgery – unless combined with another surgery, such as tummy tuck – and patients are generally able to return to work within one week. It is necessary however, to refrain from strenuous activity or heavy lifting for one month.

What are common concerns of patients considering liposuction?

Patients considering liposuction commonly express concern regarding localized regions of fatty tissue that are unresponsive to diet and exercise. They seek contour improvement of challenging body regions as opposed to reduction of overall body weight. Liposuction may be a useful tool to address focal areas of excess fullness. It is not an effective technique for weight loss.

Who is a suitable candidate for liposuction?

A suitable candidate for liposuction expresses concern regarding localized fat deposits that are unresponsive to lifestyle modifications. It is important for patients to have reasonable goals when seeking liposuction and understand limitations of the surgery. Liposuction will not result in significant weight reduction. It may achieve sculpting and increased definition by removing localized fat deposits.

Body weight is one of the most important considerations when determining whether a patient may benefit from liposuction. If over 10% of one’s ideal body weight, liposuction may be less successful in body contouring. Based on clinical examination, Dr. Power may recommend a regimen to achieve weight reduction through diet and exercise before surgery in order to optimize aesthetic outcome.

In addition to localized fatty deposits, it is critical to have normal skin elasticity if considering liposuction. Once excess fat is suctioned, contour improvement depends on the ability of the skin to contract and tighten following fat removal. If performed on a patient with decreased skin elasticity, the aesthetic outcome may worsen since redundant skin will be more apparent following liposuction. For these cases, different surgical techniques may be more effective depending on the body region (for example, tummy tuck or neck lift surgery).

What are the different types of liposuction?

Liposuction may be categorized based on adjunct technology that is employed, including suction, ultrasound, power source, or laser. The most common technique for liposuction includes an external source of suction. Ultrasound assisted liposuction has also been developed, which may be effective in removing fat within fibrous body areas or if previous liposuction or other surgery has been performed at the site. Although it may liquefy fat before suctioning, ultrasound assisted liposuction carries risk of thermal injury to skin. Power assisted liposuction is driven by a small motor and is an effective technique, particularly when treating large body regions. Despite many different types of liposuction, there is no proven benefit of one technique over the others.

What to expect after liposuction?

You will wake up in the post-operative recovery area and will be wearing a compression garment. This applies gentle pressure to the surgical site and reduces the risk of bleeding, swelling, and fluid accumulation. Gauze dressings will be applied under the compression garment, which will collect any drainage from the surgical site.

Fluid is injected prior to liposuction, which serves to partially break down fat cells before suctioning and to reduce risk of bleeding and bruising. This wetting solution will continue to drain over the first few days following liposuction.

Instructions will be given regarding dressing changes. You will be able to resume showering starting the day after surgery. Prescription pain medication may be required for the first few days following liposuction and patients are then able to transition to Tylenol plain or extra-strength as needed.

What are potential complications of liposuction?

A comprehensive list of potential liposuction complications will be discussed in consultation. The majority of complications are minor, most commonly infection, fluid accumulation (seroma), or contour irregularities. The most common major complication following liposuction is venous thromboembolism – deep venous thromboembolism (DVT) or pulmonary embolism (PE).

Precautions are taken during surgery to reduce the risk of blood clot formation, including compression stockings on the lower legs and sequential compression devices. These devices decrease venous pooling in the lower legs during surgery. If additional risk factors are identified which place a patient at increased risk of developing venous thromboembolism, surgery may not be recommended. It is also important for patients to begin mobilizing early after surgery. Walking short distances after liposuction also increases blood flow and decreases risk of complications.

What to expect on the day of liposuction?

It is important to begin fasting at midnight prior to surgery. Your appointment details will be provided in advance regarding the date and location to present for surgery.
You will be admitted and given a locker for your personal belongings.

You will meet the anesthesiologist who will be administering either your general anesthetic or conscious sedation if a smaller body region is being treated with liposuction. Dr. Power will see you pre-operatively to answer any remaining questions and to review the surgery and post-operative instructions. She will also perform surgical markings in the pre-operative waiting area before your surgery. Your blood pressure and other vital signs will be checked and then you will be taken to the operating room.

A surgical checklist will be performed in accordance with Health Quality Ontario standards to confirm patient and surgery details. You will then be placed under general anesthetic or conscious sedation, depending on the extent of planned surgery and your discussion with Dr. Power pre-operatively.

What is the anticipated recovery after liposuction?

Most patients are able to return to work or academic programs within a week of liposuction. It is important to wear the compression garment as directed, most commonly for one month following surgery. If submental liposuction is performed (under the chin), Dr. Power recommends the neck compression garment be worn full-time for 1-2 weeks following surgery. It may then be worn outside of work hours for an additional 2 weeks as tolerated.

It is important to refrain from exercise, heavy lifting, or strenuous activities for one month following liposuction. This reduces the risk of bleeding, blood or fluid accumulation within the tissues (hematoma or seroma, respectively), and swelling.

How much discomfort is to be expected following liposuction?

Most patients do not report significant discomfort following liposuction. It is a superficial procedure involving removal of fatty tissue through limited skin incisions. The tumescent fluid that is injected at the beginning of the case provides analgesia over the first few hours post-operatively. Patients may require prescription pain medication for a couple of days following surgery. They are generally able to wean quickly to Tylenol plain or extra-strength and then to completely discontinue all analgesia within a few days. Cold compresses are also beneficial for 48 hours post-operatively to reduce discomfort and swelling.

Liposuction FAQs

Are you put to sleep for liposuction?

Small areas for liposuction may be done under local anesthetic. You will be put to sleep under general anesthetic for larger areas.

Can I get liposuction if I am overweight?

You may be able to get liposuction if you are overweight, but your results will be better if you achieve weight loss before surgery.

Can visceral fat be removed?

Visceral fat cannot be removed using liposuction. There is no substitute for diet and exercise in reducing visceral fat.

Does a tummy tuck remove fat?

A tummy tuck removes excess skin and fat of the lower abdomen below your belly button. It is also a type of body contouring surgery and is not effective for weight loss.

How can I lose tummy fat fast?

You may be able to lose tummy fat quickly, but it is unlikely that you will be able to maintain results. Crash diets and other ways to lose fat quickly are generally not healthy or sustainable.

How can I reduce my stomach fat?

You can reduce stomach fat by making lifestyle changes and focusing on a healthy diet and regular exercise.

How dangerous is liposuction?

If liposuction is considered dangerous for you after discussing with a board-certified plastic surgeon, you should not undergo surgery. Risks are low if performed on a healthy non-smoker of appropriate body weight and by limiting the amount of liposuction performed in one surgery.

How do I prepare for liposuction?

You may prepare for liposuction by achieving a healthy body weight. Liposuction is most effective when performed on fatty areas of fatty tissue that do not respond to diet and exercise. You should also quit smoking for at least one month before and after surgery.

How long do you need off work after liposuction?

Most patients are able to return to work within a few days after liposuction.

How much does it cost to get liposuction on your stomach?

The average cost of liposuction on your stomach is $5000.

How much does liposuction cost without insurance?

The fee for liposuction is generally $4-5000 per area treated.

How much fat can lipo remove?

Liposuction can remove focal areas of fatty tissue and result in contour improvements. It will not affect your body weight significantly as the amount of fat removed is typically less than a few pounds.

Is there a weight requirement for liposuction?

The recommended weight requirement for liposuction is to be within 10% of your ideal body weight.

What can you eat after lipo surgery?

You may resume a normal diet after liposuction surgery. Keep in mind that you will be less active during your recovery, so it important to not accidentally gain weight during this time period.

What do they do with liposuction fat?

Liposuction fat is usually sent for medical waste disposal. If you are undergoing fat grafting at another site (e.g. fat grafting of your breasts or a Brazilian buttock lift), the fat may be prepared for injections at these sites.

Who is good candidate for liposuction?

A good candidate for liposuction is a healthy non-smoker at an appropriate body weight, ideally within 10% of your ideal body weight. It is important to have normal skin elasticity so that skin retracts and tightens after fat removal.

Does fat come back after lipo?

That fat that was removed from liposuction does not recur. You will still have remaining fat cells at these sites, which may enlarge over time with weight gain. It is a myth that you will never regain fat at sites treated with liposuction.

Does liposuction get rid of cellulite?

Liposuction does not get rid of cellulite. It is effective in reducing focal fatty deposits to improve contour, but in some cases liposuction may increase the appearance of cellulite.

Does liposuction really work?

Liposuction really works to remove focal fatty deposits that persist following diet and exercise. It is not effective for weight loss.

How can I avoid weight gain after surgery?

During early healing, it is important to closely follow your diet and weigh yourself periodically to ensure a stable weight when you are less active. You are able to resume exercise by one month post-operatively.

How do you shower after liposuction?

You may resume showering the day after liposuction. Gently wash the surgical sites with soap and water and replace your surgical garments afterwards.

How does fat transfer work?

Fat transfer works by gently suctioning fat from donor sites with undesired fatty tissue. Oil and water are removed and then the purified fat is injected into the areas of desired contour change (e.g. face, breasts, buttocks). The injected fat must establish a new blood supply to survive at these sites.

How does Lipo work?

Liposuction works by first injecting tumescent fluid into the site through a small incision. This fluid helps to break down fat, minimize bleeding and bruising, and provide pain control during early recovery. After a few minutes, a cannula is then used to suction redundant fatty tissue to the desired contour.

How long do you drain after lipo?

The small incisions after liposuction usually drain for a few days.

How painful is liposuction recovery?

Liposuction is not very painful for most patients. The level of discomfort depends on the number and location of sites. If you are able to avoid sitting or lying on the treated area during early recovery, this may reduce discomfort.

Is it easier to lose weight after liposuction?

Liposuction generally does not affect your ability to lose weight after surgery.

Is Lipo permanent?

The results from liposuction should be long-lasting if you maintain a stable weight.

Is liposuction an outpatient procedure?

Liposuction is an out-patient procedure if performed for volumes less than 5L. Most surgeons prefer to limit liposuction well below this upper limit for patient safety.

What types of liposuction are there?

There are many types of liposuction, including suction-, power-, laser- and ultrasonic-assisted.

What is the best type of liposuction?

Recommendations regarding the best type of liposuction will vary for each patient based on aesthetic goals and clinical presentation. I prefer to use suction- and power-assisted liposuction in most cases as they are quite effective in removing fatty tissue while minimizing risk of burns during the surgical procedure.

Are antibiotics required following liposuction?

Antibiotics are not routinely required post-operatively as prophylaxis to lower risk of infection. Risk of infection is quite low following liposuction in patients who are otherwise healthy and non-smokers.

How long does swelling last after liposuction?

The majority of swelling resolves over the first 2-3 months following liposuction. It may take up to one year for final results to become apparent as more minor swelling resolves and scar tissue matures. Wearing a compression garment is often helpful over the first month following liposuction to reduce excess swelling and to provide gentle compression as the skin begins to retract. Positioning during early recovery may also help to reduce swelling at specific sites. Following submental (under the chin) liposuction, for example, it is recommended to sleep with your head elevated on 2-3 pillows over the first month as tolerated. For liposuction of the lower extremities (knees, for example), elevation may also be beneficial over the first few weeks when able. Compression garments are particularly important following lower extremity liposuction, as well as avoiding prolonged standing and ambulation during early healing. These positioning maneuvers may reduce swelling following liposuction.

When may I resume exercise after liposuction?

It is recommended to refrain from exercise for one month post-operatively. This will lower the risk of bleeding, excess bruising, and swelling. Patients often ask if it is possible to continue exercise if the workout is modified to avoid targeting the specific body region. For example, would it be possible to avoid core exercises following abdominal liposuction and to continue running on the treadmill? Unfortunately not. Any type of exercise that increases heart rate and blood pressure may increase the risk of bleeding and increased swelling during early healing. Since surgery is being performed electively for aesthetic concerns, it is always recommended to closely follow post-operative activity modifications to optimize aesthetic results and to lower the risk of surgical complications.

How many areas may I have treated with liposuction during one procedure?

This answer will depend on the specific body regions, anticipated volume of aspirate, and length of general anesthetic. Limiting the volume of aspirate to less than 5L is associated with lower risk of complications. Generally 2-3 areas may be treated in one procedure. Dr. Power will discuss this in detail during your consultation based on your aesthetic concerns and clinical presentation.

How much weight will I lose after liposuction on average?

As previously mentioned, liposuction is not an effective technique for weight reduction. The amount of fat actually removed is quite minimal, generally less than 1-2 lbs. It is an effective technique for adding definition and removing persistent fatty deposits that are unresponsive to lifestyle modifications.

When may I return to work after liposuction?

Many patients are able to return to office-based work within a few days of liposuction. Jobs with more strenuous responsibilities may require a period of modified duties up to one month post-operatively if heavy lifting is required.

May liposuction be combined with other surgeries?

Yes. Liposuction is commonly performed of the flanks during tummy tuck surgery, as well as the lateral thoracic region (under the arms) during breast lift or reduction. Submental (under the chin) liposuction is another common site during neck lift. There may be increased risk of complications when liposuction is combined with other surgeries, which will be discussed during consultation. It is imperative to ensure that surgery is planned and executed safely given that combined liposuction may affect the blood supply at certain sites, lengthen the time under general anesthetic, as well as potentially increase risk of thromboembolism.

How much weight can you lose with liposuction?

You will generally only lose a few pounds or less from liposuction. It is not effective for weight loss. Liposuction is a powerful technique for reducing fatty deposits that persistndespite following a healthy diet and exercise routine. Liposuction is intended for people with close-to-ideal body weight who want a specific area contoured, rather than as a weight loss solution.

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