Cosmetic Surgery

Body Fat Removal (Liposuction) at Mayo Clinic

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(Synonyms: body contouring, lipoplasty, body lift)

The passage of time and the effects of gravity, coupled with weight fluctuations and pregnancy, take their toll on the body. The abdomen often becomes slack and buttocks and thighs saggy. Even with exercise and a healthy diet, some fat resists attack. Unsightly bulges and poorly fitting clothing can become frustrating.

Improvements in technology and techniques now enable surgeons to remove excess fat through liposuction.

Liposuction — removal of unwanted, localized fat by suction technique — is a surgical procedure that offers an improved body contour with minimal scarring. Liposuction is the most common cosmetic procedure in the United States. It is not a weight-loss alternative, but rather a way to treat isolated areas of fat that are resistant to exercise and diet.

Liposuction is used to remove the superficial layer of fat rather than the deep one. Some areas of the body respond better to liposuction. It is most commonly performed on the abdomen, hips, thighs and flanks.

Fat cells increase in size and volume with weight gain. Liposuction reduces the number of fat cells in a specific area. The resulting contour changes are long lasting, if weight remains stable.

If a person gains weight after a liposuction procedure, fat distribution may change. For example, if the abdomen and hips were the areas suctioned, the thighs or buttocks may become problem areas, if weight is gained after surgery.

Because the skin must mold itself to new contours following surgery, candidates for liposuction are generally physically active, near their ideal weight and have good skin tone and elasticity. If the skin is thin and loose with poor elasticity, the skin in the areas treated with liposuction will often appear loose.

For people who are moderately overweight, liposuction can provide the motivation to lose weight. The best time to have liposuction is when weight has been stable for as long as six months. A person who has liposuction during a period of weight gain would likely develop fat deposits in untreated areas.

Areas most effectively treated with liposuction are the abdomen, hips, chest, flanks, thighs, neck, upper arms and knees. One way to tell if a person could benefit from liposuction is to stand in front of a full-length mirror and note the contours of the body's silhouette. If hips and thighs bulge outward, liposuction may be beneficial. Points to be discussed with the surgeon prior to having the procedure are goals and expectations, the number of sites to be treated, and the techniques that will yield the best result and least scarring.

Body fat removal also can be a complementary treatment to surgical procedures to improve body contour, such as an abdominoplasty (tummy tuck) or body lifts to the arms or thigh. Patients typically report that they do not lose much weight with liposuction, but rather lose inches, which results in their clothing fitting better.

What to expect

Before surgery, the surgeon will mark the areas of body to be treated with liposuction. These will be used as a guide during surgery. Patients may be asked to stand partially naked during preparation for the surgery. The skin will be washed with a surgical soap to thoroughly clean all surgical sites.

During surgery, a sterile solution may be injected along with a local anesthetic (to control pain) and epinephrine (to minimize bleeding). The result is often less bleeding, bruising and pain following the procedure. The injections lessen recovery time.

After anesthesia is administered, one-half inch or smaller incisions are made near the area where the fat is to be removed. The incisions may be hidden in the pubic hair, the belly button or in natural skin creases. A thin, hollow rod (cannula) is inserted through the incision to create tunnels through the fat; the suction forces the fat into the cannula and out a high-vacuum hose.

Ultrasonic-assisted liposuction (UAL) is another technique for removing fat. The device uses high-frequency sound waves to liquefy fat cells before suctioning. Patients report increased discomfort with this technique and the incidence of seroma (fluid collection under the skin) is higher. For these reasons, UAL is used only when other techniques are not an option.

How much fat is removed is based on the appearance of the area and the volume of fatty fluid that can be safely suctioned. When the desired amount of fat is removed, dressings are applied. Patients will wear a compression garment, which will be provided, for six weeks after surgery. The garment helps minimize swelling and discoloration, and enhances the final contour.

Liposuction will not improve cellulite dimpling or other surface irregularities present before the procedure. It also will not get rid of stretch marks. An abdominoplasty (tummy tuck) can sometimes be performed in combination with liposuction.

Risks

Risks associated with body contouring include, but are not limited to:

• Infection
• Uneven body contours
• Sagging skin, which occurs when the skin does not shrink (contract) to the newly contoured area
• Depressions/dimpling
• Blood or fluid collection under the skin. This usually dissipates over time.
• Rarely, blood clots to the lung (pulmonary embolism) or the legs (deep vein thrombosis)
• In rare cases, a fluid and electrolyte imbalance may result in shock

The procedure is performed by specialists in Plastic and Reconstructive Surgery.