Liposuction

Description

In just ten years, liposuction has become popular in the war against aging. Its use is directed against fat that refuses to budge and skin that is beginning to sag. When diet and exercise have not been able to send saddlebags packing or to deliver slim hips, a flat tummy, or taut underarms, the prospect of surgically eliminating recalcitrant pockets of fat is appealing. More than 40,000 women each year are resorting to liposuction.

Liposuction is just what the name implies - a procedure that eliminates fat (lipos is the Greek word for fat) by sucking it away. The technique has been used for two decades in Europe, but has been embraced in the U.S. by plastic surgeons only since 1982.

The principal advantage of liposuction is that it not only eliminates fat from certain parts of the body, but it also offers assurance that the fat will stay off those spots. This is because once fat cells are gone, they will not be replaced.

Fat distribution is determined by heredity and diet, and deposition is completed by puberty. From then on, the number of cells remains constant. When we lose weight through diet or exercise, we merely deplete the fat content of these cells; the cells themselves lie in wait, to be refilled by the next dietary indulgence. Thus, even after weight loss, the areas of the body with the greatest concentration of fat cells will still be proportionately heavier. The only way to remedy this situation is to eliminate the excess fat cells permanently.

Although liposuction can do this, it is not a panacea for figure problems. It is not recommended for people who are generally overweight, but is reserved for those of normal weight who have small areas of stubborn fat. It is also suggested only for people whose skin is elastic enough to contract after the underlying fat has been removed - a factor that can eliminate women over age 50 and younger women whose skin is damaged by the sun.

Risks

As with any surgical procedure, liposuction is not risk-free, The chance that a healthy woman will die due to complications from general anesthesia is about 1 in 10,000. Infection is also a distinct possibility but is probably quite rare.

During the procedure's early days, there were some reports of low blood pressure or shock, generally in women who had large amounts of fat removed and lost too much blood and fluid during the procedure. As physicians have gained more experience with liposuction they have come to estimate the volume of fat to be removed more accurately. As a result, they can infuse replacement fluids during the procedure and be prepared to transfuse blood if necessary.

Even when liposuction is a technical success, some women are disappointed with the results. In many of these cases, the change may have been less dramatic than they had wished. In others, the region treated may not be perfectly smooth. The skin may sag somewhat or the contour look slightly bumpy.

At best, the benefits of liposuction are primarily psychological, producing an improved body image. Yet it may not have that effect. By eliminating one perceived "defect," it may merely shift self-criticism to other cosmetic "flaws."

Procedure

The procedure typically takes from 45 minutes to 2 hours, depending on the number of areas that are treated and the amount of fat removed. Incisions are made in the areas to be treated and the liposuction device is used. The incisions are closed with staples or sutures, and a pressure dressing may be placed over the treated area.

Although liposuction does not usually require an overnight hospital stay, the recovery period may last several weeks. To minimize swelling and bruising, it may be necessary to wear a support garment resembling an extra-firm panty girdle for 2 to 3 weeks and to avoid vigorous exercise during that period.

Many women also have considerable pain, which can usually be treated with oral analgesics, but are able to return to work within a week or so. Liposuction on the lower legs requires longer immobilization.

Questions to Ask Your Doctor

What improvement in appearance can be expected?

What are the risks of the procedure?

Will the liposuction be done on an outpatient basis; will hospitalization be necessary?

Will there be blood loss requiring a transfusion?

What is the risk of infection?

How much swelling and bruising can be expected?

Will there be pain?

What will the results look like afterwards?

When can normal activities be resumed?