Liposuction

Liposuction is a type of cosmetic surgery that removes excess fat from specific body areas. This may help improve the way the body looks. There are several different types of liposuction. They include ultrasound-assisted, laser-assisted, suction-assisted, and traditional with tumescent fluid injections. Although the fat removed will not return, liposuction is not a substitute for eating right and exercising. Also, removing a large amount of belly fat doesn't change risk factors for such conditions as diabetes or heart disease. For lasting results, you will have to control your weight, even after liposuction. Discuss your treatment goals and what long-term lifestyle changes you need with your healthcare provider. They can tell you more about what to expect, as well as the method of liposuction that will be used for you.

Getting ready for surgery

Prepare as you have been told. Also:

• Tell your healthcare provider about all medicines you take. This includes herbs and other supplements and any illegal or illicit drugs. It also includes any blood thinners, such as warfarin, clopidogrel, certain anti-inflammatory medicines, and daily aspirin. You may need to stop taking some or all of them before surgery.

• If you smoke, stop smoking before surgery. Smoking reduces the blood flow in the skin and increases the risk for wound healing problems. Nicotine from cigarettes, e-cigarettes, patches, or chewing tobaccoslows healing. Join a stop-smoking program to improve your chances of success. Your healthcare provider may delay your surgery if you are smoking.

• Follow any directions you are given for not eating or drinking before surgery (If you have been told to take medicines, take them with a small sip of water.)

The day of surgery

Before the procedure, you will be asked to sign an informed consent form. This form has information on the liposuction procedure. It will also list the risks, benefits, and alternatives to liposuction. You can ask questions before you sign the form. Make sure all of your questions are answered before you sign the form.

The procedure can take 1 to 5 hours, depending on how many areas are being treated and the method used. You may go home the same day. Or you may stay 1 or more nights in a hospital or a outpatient surgical center.

Before the procedure begins

• An IV line is put into a vein in your arm or hand. This line delivers fluids and medicines.

• You will be given medicine to keep you pain free during surgery. This may be general anesthesia, which puts you into a state like deep sleep. A tube may be inserted into your throat to help you breathe. In some cases, sedation is given instead. This medicine relaxes you and makes you sleep lightly. If you have sedation, local anesthetic will be used to numb the areas being worked on. The anesthesia provider will discuss your choices with you.

• The skin over the sites to be worked on is marked with a sterile pen.

During the procedure

• Tumescent fluid is injected into the surgical areas. This makes it easier to remove fat. The fluid also contains medicine to numb the site and reduce pain and bleeding.

• The healthcare provider will make 1 or more small cuts (incisions) in the skin over the marked sites.

• The provider will put a thin metal tube (cannula) through an incision into the fat layer under the skin. The cannula is attached to a small vacuum or syringe. As the cannula is moved back and forth, excess fat is suctioned out. The provider may also use ultrasound, laser, or mechanical tools. These help loosen or remove fat.

• When the procedure is done, the cannula and other tools are removed.

• Incisions are closed with stitches. These may dissolve on their own. Or they may need to be removed at a later date. In certain cases, incisions are left open to heal. The surgical sites may be bandaged.

After the surgery

You will be taken to a room to wake up from the anesthesia. You may feel sleepy and nauseated. If a breathing tube was used, your throat may be sore at first. You will be given medicine to help prevent infection and manage pain. You will also likely be given compression garments to wear. These reduce swelling and help form a smooth shape. When you’re ready, you will be released to go home. Have an adult family member or friend drive you.

Recovering at home

For the next few weeks, expect to have pain, swelling, and bruising. Once at home, follow the directions you have been given. Your healthcare provider will tell you when you can return to your normal routine. Be sure to:

• Take all prescribed medicine as directed. Take pain medicine on time. Don't wait for pain to get bad before taking it.

• Don’t shower for 72 hours after surgery, or as directed by the surgeon. Don't swim, take a bath, use a hot tub, or do other activities that cause incisions to be covered with water until your healthcare provider says it’s OK.

• Care for your incisions as directed by your surgeon. This includes keeping your bandages and incisions dry when bathing or showering.

• Wear compression garments as directed. Doing so is important for a good cosmetic result.

• Walk at least a few times daily. But don’t push yourself too hard.

• Don't lift anything heavy or do strenuous activity, as directed. Talk with your healthcare provider about light exercise, such as walking that you can do to maintain your weight until you’re fully healed.

• Don’t drive until you are no longer taking prescription pain medicine and your healthcare provider says it’s OK. When riding in a car, carefully position the seatbelt so that it doesn’t compress the body parts that had liposuction.

When to call your healthcare provider

Call your healthcare provider right away if any of the following occur:

• Chest pain or trouble breathing (call 911)

• Fever of 100.4° F ( 38°C ) or higher, or as directed by your healthcare provider

• Symptoms of infection at an incision site, such as increased redness or swelling, warmth, pain that gets worse, or foul-smelling drainage

• Irregular heartbeat

• Pain not relieved by pain medicine

• Numbness and tingling that does not go away within a week after the surgery

• No urination within 24 hours

• Bleeding from the surgical site (some pink-tinged discharge is normal)

• Pain, swelling, redness, or warmth in your leg, calf, or thigh

Follow-up

You will have follow-up appointments so your healthcare provider can check how well you’re healing. If you have stitches that need to be removed, this will be done during a follow-up visit. You and your healthcare provider will also keep track of the cosmetic results of your procedure. If you have trouble starting or maintaining the needed lifestyle changes, ask your provider for help.

Risks and possible complications

Risks and possible complications include:

• Bleeding or infection

• Blood clots

• Fat clot (embolism)

• Excessive scarring

• Poor wound healing

• Changes in sensation, such as numbness or pain

• Skin discoloration

• Abnormal collection of fluid (seroma)

• Death of fat cells deep in the skin (fat necrosis)

• Injury to nearby nerves, blood vessels, muscles, and organs

• Contour (body shape) problems, loose skin, or cellulite that gets worse

• Not happy with cosmetic results

• Risks of anesthesia. The anesthesia provider will discuss these with you.