Liposuction

Dr. Fisher co-authored one the first articles on liposuction, published in 1980. The removal of circumferential body fat gives a more even postoperative result. Liposuction in limited areas is effective for localized fat deposits, while total body liposuction is more effective in reducing total body size. More information is available on the publications page of this website listed under Dr. Fisher’s information.

Liposuction is a procedure that can help sculpt the body by removing unwanted fat from specific areas, including the abdomen, hips, buttocks, thighs, knees, upper arms, chin, cheeks and neck. During the past decade, liposuction, which is also known as “lipoplasty” or “suction lipectomy” has benefited from several new refinements. Today, a number of new techniques, including ultrasound-assisted lipoplasty (UAL), the tumescent technique and the super-wet technique are helping many selected patients with more precise results and quicker recovery times. Although no type of liposuction is a substitute for dieting and exercise, liposuction can remove stubborn areas of fat that do not respond to traditional weightloss methods.

The best candidates for liposuction are normal-weight people with firm, elastic skin who have pockets of excess fat in certain areas. You should be physically healthy, psychologically stable and realistic in your expectations.

The time required to perform liposuction may vary considerably, depending on the size of the area, the amount of fat being removed, the type of anesthesia and the technique used. There are several liposuction techniques that can be used to improve the ease of the procedure and to enhance outcome.

The basic technique of liposuction, as described above, is used in all patients undergoing this procedure. However, as the procedure has been developed and refined, several variations have been introduced.

Fluid Injection is a technique in which a medicated solution is injected into fatty areas before the fat is removed. The fluid which is a mixture of intravenous salt solution, lidocaine (a local anesthetic) and epinephrine (a drug that contracts blood vessels) helps the fat be removed more easily, reduces blood loss and provides anesthesia during and after surgery. Fluid injection also helps to reduce the amount of bruising after surgery. The amount of fluid that is injected varies depending on the preference of the surgeon.

Large volumes of fluid, sometimes as much as three times the amount of fat to be removed are injected in the tumescent technique. Tumescent liposuction, typically performed on patients who need only a local anesthetic, usually takes significantly longer than traditional liposuction (sometimes as long as 4 to 5 hours). However, because the injected fluid contains an adequate amount of anesthetic, additional anesthesia may not be necessary. The name of this technique refers to the swollen and firm or “tumesced” state of the fatty tissues when they are filled with solution.

The super-wet technique is similar to the tumescent technique, except that lesser amounts of fluid are used. Usually the amount of fluid injected is equal to the amount of fat to be removed. This technique often requires IV sedation or general anesthesia and typically takes one to two hours of surgery time.

Ultrasound-Assisted Lipoplasty (UAL). This technique requires the use of a special cannula that produces ultrasonic energy. As it passes through the areas of fat, the energy explodes the walls of the fat cells, liquifying the fat. The fat is then removed with the traditional liposuction technique. UAL has been shown to improve the ease and effectiveness of liposuction in fibrous areas of the body, such as the upper back or the enlarged male breast. It is also commonly used in secondary procedures, when enhanced precision is needed. In general, UAL takes longer to perform than traditional liposuction.

After surgery, you will likely experience some fluid drainage from the incisions. Occasionally, a small drainage tube may be inserted beneath the skin for a couple of days to prevent fluid build up. To control swelling and to help your skin better fit its new contours, you may be fitted with a snug elastic garment to wear over the treated area for a few weeks. Dr. Fisher may also prescribe antibiotics to prevent infection.

Healing is a gradual process. You will begin to feel better after about a week or two and you should be back at work within a few days following your surgery. The stitches are removed or dissolve on their own within the first week to 10 days.

Strenuous activity should be avoided for about a month as your body continues to heal. Although most of the bruising and swelling usually disappears within three weeks, some swelling may remain for six months or more.