>By Wesley Hyatt, Senior Editorial Assistant
>Goal of Procedure:
>To remove unwanted fat tissue by a suctioning technique.
>It is better to think of liposuction not as weight removal but as a contouring procedure. In women, common areas for liposuction are the hips, thighs, stomach and neck. In males, common areas are the "love handles" (male flanks), stomach, chest and neck.
>Liposuction does not cure obesity. A limited amount of fat tissue can be removed safely from the human body. Liposuction can actually damage an obese person's looks, as the removal of a portion of fat from the body can give an unbalanced or unnatural appearance.
>What It Involves:
>There are several methods. The tumescent technique can reduce postoperative bruising, swelling and pain. Before liposuction is performed, areas of excess fat are injected with a large amount of a saline fluid containing a dilute solution of adrenaline and local anesthetic. This minimizes blood loss. Tumescent liposuction requires three times as much injected fluid as what is aspirated. This fluid causes the sections of fat to become swollen or firm and allow the liposuction cannula to travel smoothly beneath the skin as the fat is removed.
>Tumescent liposuction offers fewer skin irregularities, less bleeding, reduced bruising and a faster recovery than other liposuction methods. It is performed as an outpatient procedure for four to five hours. Since the patient is awake under local anesthesia during the operation, he or she can sit or stand during the procedure, which allows the surgeon to check the status of the patient and the progress of the contouring. The drawbacks are that while fluid overloading is relatively safe, it can result in congestive heart failure. Toxic effects of the adrenaline and / or local anesthesia can occur. However, it has been proven to be safer than traditional liposuction techniques.
>Super-wet liposuction is similar to tumescent, but less fluid is used, usually the same amount of fat that will be removed. Approximately 8 percent of the fluid lost through super-wet is blood versus only 1 percent being blood lost in tumescent. The procedure takes one to two hours to perform, and since there is less chance of too much fluid being introduced into the body, super-wet liposuction is safer than tumescent.
>Ultrasonic assisted liposuction (UAL) uses ultrasound high frequency waves to break up the fat prior to its removal. Ultrasonic energy delivers a combination of vibratory mechanical energy and thermal energy to subcutaneous fat. Currently, this procedure is still undergoing long-term studies as UAL has been associated with increased risks of complications including skin burns, fluid accumulation and burning pain. However, given the large amount of fat that can be handled in the process, some patients favor it.
>Power-assisted liposuction (PAL) uses advanced instruments used to perform the surgery (the "power" in its title). Power-assisted liposuction uses a mechanical cannula that efficiently removes fatty tissue with increased precision, less bruising and a faster healing time. It's used in conjunction with super-wet or tumescent techniques. According to medical experts and patients alike, power-assisted liposuction is gentler than traditional liposuction and is preferred by patients. Surgeons have also found that this procedure is easier for them to perform and leads to better results.
>Length of Procedure, Recovery Time and Possible Complications:
>Recovery depends upon the liposuction method, but most require a compression garment either to help close the incision sites to prevent scarring (as in traditional liposuction) or absorb fluids draining from the incision areas (as in tumescent liposuction). A compression garment is tight fitting and holds the area of the body firmly. It should fit comfortably and allow the use of absorptive pads underneath. For the first three days after surgery, it must be worn typically for 24 hours. Often, more than one compression garment is needed. A patient is responsible for getting a compression garment as his or her recovery product.
>With the discomfort, bruising and swelling the first three days after surgery, the compression garment helps to prevent the formation of seromas, or collections of the watery part of the blood. Depending on the procedure, most patients return to work after three to four days.
>To assist in recovery and to avoid dehydration, patients should drink plenty of non-alcoholic fluids. They should not use bandages, ice packs or heating pads over the liposuction area. They should take it easy the first week to prevent exhaustion and get help when first removing a compression garment or taking a shower. To avoid infection, patients should not soak their body in water for at least a week after surgery.
>Liposuction patients' skin will naturally reshape and tighten over the sculpted area. This is part of the healing process. Depending on the technique used, there may be slight waviness or visible scars.
>Beside previous complications given, liposuction has a risk of blood clot formation in the legs. The removal of too much fat can result in excessive blood loss and create an unnatural and undesired appearance.
>Some patients have liposuction on more than one body area at a time, for cost, convenience and other reasons (a patient needs only one vacation from work for recovery, results in a more balanced and natural look, etc.). But there are definite risks: a prolonged exposure to general anesthesia; the removal of too much fat from the body, leaving skin sticking to underlying structures and looking unnatural; a significant amount of blood loss and surgical trauma to the body; and a prolonged and more painful recovery process. Someone considering multiple procedures should speak with a doctor for more information.
>Waiting Time From Procedure Until Diving:
>"That varies so much," Dr. Golembe says. "It's the amount of lipo removed that affects it." Dr. Potkin concurs. Dr. Golembe recommends a minimum of three weeks to up to three months, the longer period obviously for those doing large amounts of liposuction.