Liposuction - FAQ
Can liposuction be used for weight loss?
While some have recommended and safely performed liposuction (suction lipectomy) in extremely large volumes during one procedure (large volume liposuction), I do not recommend it in my practice. Rather, For morbid obesity I generally recommend weight loss by a combination of exercise and nutritional counseling under the care of a physician rather than an immediate liposuction. Bariatric surgery (weight loss surgery) is also an option that can be considered for patients with morbid obesity. In some cases I recommend consultation for weight loss surgery (if patient’s weight is more than one hundred pounds overweight). Liposuction (suction lipectomy) can be done after weight loss in some patients.
Clin Plast Surg. 2006 Jan;33(1):75-7, vii
How much can be taken out by liposuction at one time?
While large volumes can be removed by liposuction, I generally recommend liposuction (suction lipectomy) in volumes five thousand (5000) cc or less during any one procedure. Any volume above five thousand (5000) cc’s has been defined as “large volume liposuction” and requires special precautions. That approximate liposuction (suction lipectomy) volume of five thousand (5000) cc’s can be thought of as the same approximate volume than is contained in five bottles that are each one liter each (for example, one liter soft drink bottles that are commonly seen in the grocery store). When thought of in this manner, one can see that liposuction (suction lipectomy) of five thousand (5000) cc’s of adipose (fat) tissue is a significant amount of adipose (fat) tissue to remove at one time.
Is liposuction safe?
Yes. While there have been adverse outcomes with liposuction, and there are always inherent risks with any surgery, it is generally considered safe. There are many factors that affect safety of liposuction that include, but are not limited to, the training and expertise of the surgeon, the suitability of the patient for the liposuction (suction lipectomy) procedure (the patient is a good candidate for liposuction), the anesthesia technique used for the liposuction surgery, the patient’s ability to follow instructions after the liposuction (suction lipectomy) procedure, and the particular liposuction technique and liposuction procedure chosen by the patient and the physician.
What areas of the body can be treated with liposuction (suction lipectomy)?
The areas of the body that are commonly treated with liposuction (suction lipectomy) include the neck, the abdomen, the flanks, the buttocks, the arms, and the legs.
How much pain can I expect after liposuction?
One peer reviewed study by Plastic surgeons concluded that liposuction (suction lipectomy) is a relatively painless procedure and that about half of patients that get liposuction do not need any pain medicine at all. In addition, after about one week after liposuction (suction lipectomy) very few patients had any pain and were able to return to normal life without any complications concerning pain.
Plast. Reconstr. Surg. 2005 May: 115(6):1715-21.
Does liposuction (suction lipectomy) require hospitalization, or is it an outpatient procedure?
Liposuction (suction lipectomy) is an outpatient procedure, meaning the patient goes home after the surgery rather than to the hospital.
How long before I can go back to work after liposuction?
In general, most patients can easily return to work in about three days after the liposuction (suction lipectomy). For small liposuction procedures, patients frequently return to work the same day or the day after the liposuction (suction lipectomy).
If I get liposuction (suction lipectomy) will the fat return?
Fat will not return to the area of liposuction (suction lipectomy) unless the patient gains weight after the liposuction (suction lipectomy) procedure. If the patient does gain weight after the liposuction (suction lipectomy) procedure, then the weight gain will be in a different pattern than before the liposuction (suction lipectomy) procedure. After the liposuction (suction lipectomy) procedure weight control by a combination of exercise and nutritional counseling under the care of a physician is important to maintain the results.
What happens if I gain weight after liposuction?
One can gain weight after liposuction (suction lipectomy), but the weight gain will generally be in a different pattern after the liposuction (suction lipectomy) procedure since the localized areas of fat have been removed.
What is tumescent liposuction?
Tumescent liposuction technique is a is a technique whereby local anesthetic, similar to that used by a dentist, is injected with large volumes of fluid. This technique for liposuction (suction lipectomy) was first used over twenty years ago and is still used today. If tumescent liposuction (suction lipectomy) performed by a trained Plastic surgeon it is safe and effective.
Clin Plast Surg. 2006 Jan;33(1):39-46, vi.
Will liposuction get rid of cellulite (skin irregularities)?
No. In general, liposuction does not effectively treat cellulite.
Is SmartLipo® more effective (gives better results) than conventional (traditional) liposuction?
According to one peer reviewed study, SmartLipo (trademark) was no better than conventional (traditional) liposuction (suction lipectomy), but was felt to have potential for more risks.
This peer reviewed study by Plastic surgeons was titled “A prospective, randomized, double blind, controlled clinical trial comparing laser- assisted lipoplasty with suction-assisted lipoplasty” was done to compare SmartLipo® with conventional liposuction.”
This study found that “No major clinical differences for suction-assisted lipoplasty versus laser-assisted lipoplasty (SmartLipo®) were found. Higher concentrations of free-fatty acids after laser-assisted lipoplasty must alert us to the possibility of hepatic and renal toxicity.”
This study failed to demonstrate any clinical advantage of laser-assisted lipoplasty (suction lipectomy) over traditional (conventional) liposuction. In other words, this study concludes that in this series of patients, that using SmartLipo® was not better than conventional (traditional) liposuction, and that SmartLipo® may pose a greater health risk to the liver and kidneys due to higher concentrations of fatty acids in the body after surgery when compared to conventional (traditional) liposuction.
Plast. Reconstr. Surg. 2006 Sep 15;118(4):1032-45.
Further prospective, randomized, double blind, controlled clinical trials comparing laser- assisted lipoplasty with suction-assisted lipoplasty are needed to determine if this new technology is in fact better than conventional (traditional) liposuction.
Can liposuction tighten skin?
The suggestion that liposuction will tighten skin is considered by many to be dangerous. If the skin contracts from damage to the dermis (skin), then that same damage could also cause unwanted scarring and actual loss of the skin.
Plast. Reconstr. Surg.1998 April 101(4): 1089.
The skin can “shrink” after liposuction in some patients, and in general, the younger the patient, the more the skin will shrink after liposuction. Skin shrinkage is related more to the general health of the skin, and not liposuction technique or liposuction technology.
Is ultrasonic liposuction more effective that conventional (traditional) liposuction?
For most areas of the body, ultrasonic liposuction (suction lipectomy) is not more effective, and in fact ultrasonic liposuction has unique and serious risks not present with conventional (traditional) liposuction. In a few areas of the body where there is dense fibrous tissue, ultrasonic liposuction may be better, but still carries unique and serious risks not present with conventional (traditional) liposuction (suction lipectomy). An example of an area of the body where ultrasonic liposuction (suction lipectomy) may be better is the male breast.
Plast. Reconstr. Surg 1998 April 101(4): 1103-1116.
Plast. Reconstr. Surg 1998 April 101(4): 1117-1119.
Ultrasonic liposuction heats the tissue as it works. Dr. Yves Gerard Illouz who invented liposuction in 1977 wrote the following regarding ultrasonic liposuction. Below is a quote published in 2006 by Dr. Illouz in Clinics in Plastic Surgery, Lipoplasty. “I started to study ultrasound in 1988 after seeing an ophthalmology device that simultaneously pulverize and aspirated the lens.” “I was in favor of the idea, but was always afraid of the heat of the machines and the present results. Now, 15 years later I have not changed my mind; the devices on the market are either dangerous or useless.”
Clin. Plast Surg. 2006 Jan:33(1): 129-163.
While other surgeons and researchers may draw different conclusions, many feel that ultrasonic liposuction is most appropriate in specific areas of the body, carries no special benefits in most areas of the body, and does add extra risks to the liposuction procedure not present with conventional (traditional) liposuction.
Plast. Reconstr. Surg 1998 April 101(4): 1103-1116.
What is power assisted liposuction?
Power assisted liposuction (PAL) is a technique used for liposuction (suction lipectomy) that utilizes an instrument that mechanically removes fat by a reciprocating device. As a result of ease of use, the liposuction procedure can be done more efficiently and more accurately. Some surgeons feel that the power assisted liposuction device is also safer for the liposuction procedure (suction lipectomy) because of the ease of use. The power assisted liposuction device is commonly used in all areas of the body where liposuction is performed.
Clin Plast Surg. 2006 Jan;33(1):91-105, vii
Is power assisted liposuction more effective than conventional liposuction?
Power assisted liposuction may be more effective than conventional (traditional) liposuction in that the procedure is easier to perform and therefore may be more precise. This premise may also be true for ultrasonic and laser-assisted liposuction (a liposuction device that is easier to use may be more precise). In one study of power assisted liposuction the recovery period was faster and less painful. In this same study the complications were less that those with conventional (traditional) liposuction.
Dermatol Clin. 2005 Jul; 23(3): 383-391.
I have read a lot about liposuction, and I have talked with several physicians, and I am very confused with all this conflicting information.
Medical opinions will vary from doctor to doctor. When opinions vary, it generally does not mean that one is right, and one is wrong, but rather that based on study and personal experience, surgeons have different opinions and recommendations. Reasonable physicians can have differing opinions, and those differing opinions should not be cause for undue concern. It is very important for patients to be well informed before making any decision about any surgical procedure, and in that process it is commonplace to get differing opinions from physicians. It is very important to know that your surgeon is properly trained, which increases the likelihood of getting a mainstream opinion. While it is impractical to review the entire medical literature on this web site, the previously mentioned scientific articles do represent respected opinions in this area of plastic surgery.
Any other issues you have questions about will be discussed with you at the time of your liposuction (suction lipectomy) consultation with Dr. Herring.
If you have any questions about Liposuction or Lipoplasty, contact Cape Fear Plastic Surgery in Fayetteville, NC.
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