Steve Fallek (Plastic Surgeon & Medical Director, Face Focus Medical Spa, New York City) gives expert video advice on: What are the risks and complications associated with liposuction?; What incisions or scarring should I expect with liposuction? and more...
What is "liposuction"?
Liposuction is a procedure that was developed in the mid 80s where small incisions are made in the skin in areas of fat. A cannula, liposuction cannula or tube is placed into the incision and into the fat areas and the fat is withdrawn. Now what happens is when the fat is withdrawn during liposuction the fat and tissues leave a honeycomb impression so you need to wear a garment after liposuction to compress those areas so that your results take place.
What is "tumescent liposuction"?
Tumescent liposuction is a technique where tumescent fluid--this is normal saline with epinephrine and other drugs is infiltrated or added to the fatty areas. What this has done is it's limited or diminished the amount of blood loss that's associated with liposuction. Almost all liposuction done in this country now is done by tumescent technique.
What is "power liposuction"?
Liposuction is performed pretty much the same way by most doctors. Power liposuction is just a technique where a vibrating cannula is used by the plastic surgeon. Nothing is infiltrated into the skin. By vibrating, the cannula will allow the plastic surgeon to do less work and remove more fat at the same time.
What is "ultrasound-assisted liposuction"?
In the mid-90s, there was a push for ultrasound stimulation of the fatty cells and fatty tissues, and what they were hoping was that the ultrasound stimulation would rupture the fat and therefore make it easier for the liposuction to be performed and for more fat to be removed. There are two types of ultrasound: external and internal ultrasound. In both of these cases, ultrasound stimulation heated up the tissues and made it easier for the tissue to be removed. There were some concerns about potential burns involved in this radiation or energy being applied to the skin and the fat, but with some of the newer devices it has been proven to be safe and effective. Ultrasound liposuction pretty much works in the same way as regular liposuction. It just makes the plastic surgeon's job a bit easier.
What are fat injections?
Patients often come into my office and ask, "What can I do with that fat once you've removed it?" For many years, we probably couldn't do a lot with it. Now, many plastic surgeons are doing fat injections into the face area, specifically around the mouth area and the nasal labial folds, and also in the upper face area. What's very common now is to inject that liposuction fat into the buttock area to give what is called a Brazilian butt-lift, or a buttock augmentation. This has become very popular, thanks to Jennifer Lopez, who has really made accentuation of the buttock area very mainstream.
Who can get liposuction?
I always tell people that liposuction is not a dieting technique. It doesn't meant that you can have liposuction and then eat like crazy, have Haagen Dazs every night. Liposuction is a very good treatment for patients that have excess fat in areas that can be treated. It's also very good for patients that have a stubborn area of fat which, even with exercise, they can't get rid of. For patients that have concerns about fatty tissue in their body, liposuction is an excellent choice. If you have excess skin after significant weight loss, liposuction may not be the best alternative. Only your plastic surgeon will determine that.
Who should not get liposuction?
Liposuction works very well. Liposuction works for isolated fatty deposits. Liposuction works for patients in relatively good shape that have extra fat deposit in their bodies. Liposuction doesn't address skin or wrinkles or cellulite. So if you're a patient that has excessive fat, small amounts of fat, liposuction is a good option for you. But remember, liposuction is not a dieting technique. And if you have a small amount of fat and you're eating like crazy, liposuction's probably not a great choice for you.
On what parts of my body can I get liposuction?
Liposuction is really used almost anywhere on the body. We use it in the chest area, in the belly area and the flanks. We use it in the neck area: the small amount here is very common in men. There can be facial liposuction. Also, classically, for women, they get what we call the "saddlebags," or fullness on the side and in the leg area. Other areas that can be treated by liposuction that are less common are in the calf area and in the arm area.
What are the risks and complications associated with liposuction?
I spend a large amount of time talking to patients about the risks of liposuction, because the media has really made death from liposuction one of their more interesting topics. These are very high profile deaths that have taken place throughout this country. In general, if a patient is having liposuction preformed by a board certified general surgeon, in a safe environment - that's either a hospital surgeon center or a credentialed office - liposuction should be safe and effective, and the risks from liposuction itself are rather minimal. Some of the other concerns have been about liposuction patients who had significant amounts of fat that were removed in an office setting, and had complications without being noticed. For plastic surgery the requirements are that for any patent having over five liters of fat removed, liposuction should be done in a hospital.
Can I die from liposuction?
You shouldn't die from liposuction. I spend an inordinate amount of time talking to young healthy patients about the risks of liposuction. There have been a lot of high profile cases involved in liposuctions with not great outcomes. Many times these were patients that were having liposuction done by non plastic surgeons, done in an office, and they got into complications and didn't realize it. For patients who have liposuction done in either a surgery center, a hospital or an accredited office, done by a plastic surgeon, the risks are rather minimal.
Is liposuction painful?
I tell my patients that liposuction is the equivalent of doing three or four hundred sit-ups. That's an area that's going to be addressed. You have significant bruising. You feel like you were punched or kicked, and there is a fair amount of bruising, but medications and pain medications should take care of those areas after liposuction.
What incisions or scarring should I expect with liposuction?
What's great about liposuction is that the liposuction cannulas are placed through tiny incisions. So, in general, I'm never that concerned about the scars involved in liposuction. Again, liposuction scars are tiny and they should heal fine. We also try and limit where the liposuction scars are placed and hide them in areas that are not noticeable in the bikini or underwear lines and around the belly button.