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Liposuction/Tumescent Liposuction

Liposuction is used for the removal of fat from areas of the body that have not responded to exercise and diet. It is minimally invasive, meaning that the patient does not need to have large incisions made in the skin; it is minimally intrusive to the body. The fat is taken out of the skin by means of a thin tube, or cannula, which is attached to a suction machine that vacuums the fat particles out of the area. One of the most popular cosmetic procedures, liposuction can remove fat from any area of the body where undesired fat is present. This can include the limbs, abdomen, hips and waist, back, buttocks and thighs as well as the chin.

Though this form of traditional liposuction was a revolutionary method for localized fat removal when it first came out, today’s technology allows plastic surgeons to use tumescent and laser technology during liposuction. The term “tumescent” refers to the use of a solution that is injected into the under layer of the skin prior to suctioning the fat out with the cannula. The solution numbs the area to be treated and constricts the blood vessels in the tissue which helps to reduce blood loss.

The laser technology we use is called SmartLipo (or SmartLipo-MPX). It is so far ahead of conventional liposuction, in fact, that we exclusively use either the tumescent or SmartLipo laser technique in all of our body sculpting procedures. The laser liposuction is unique in that the laser beam produces gentle heat in the fatty layer of the skin. The areas where the laser touches are instantly melted away and destroyed so that the fat can be suctioned away by vacuum.

Take a look at our benefits of SmartLipo page to read more about how SmartLipo involves very little down time (only 1-2 days), costs less than traditional liposuction, and uses local anesthesia which reduces the risks associated with using general anesthesia. Additionally, the skin is tightened after the procedure due to the laser’s unique ability to cause the collagen under the skin to contract as it removes the fat. This produces a smooth, shapely contour that only our expert surgeons can achieve when body sculpting using the SmartLipo laser.

Candidates for Liposuction

Patients who are ideal for the liposuction procedure have several things in common:

  • They maintain a routine of regular exercise and a good diet.
  • They are within 25 pounds of their ideal body weight (though we do make exceptions).
  • They have one or more problem areas of stubborn fat that have not responded to diet and exercise.
  • They wish to have those areas ly re-shaped into a better contour.
  • They are not looking to use liposuction as a weight loss tool.

Areas That Can Be Treated

Nearly any area of the body can be treated for removal of unwanted fat. This includes the arms, legs, thighs, knees, hips, buttocks, waist, back, abdomen, and under the chin. Often times, liposuction can be used as a means of enhancing a different procedure that a patient is having. For example, liposuction can aid in a facelift (tightening of the neck skin and removal of extra fat under the chin). It can also help reduce localized fat during an arm lift, body lift, butt lift, tummy tuck, or mommy makeover.

The Day of the Procedure

Liposuction procedures (whether tumescent or tumescent laser) are performed at one of our two AAAHC accredited surgical centers. You will arrive about 30 minutes prior to your procedure being performed so that you can change into a surgical gown. We ask that patients arrive with no body lotion, hair styling products, perfume/cologne, makeup, or jewelry. These items can contaminate the areas being treated (or impede access) and compromise the sterility of the procedure. Our staff will speak with you for a few minutes, asking you how you are feeling and helping you with any “game day jitters”. We find that once patients are able to express how they are feeling, they immediately become more relaxed. We will be sure to answer any remaining questions you may have and be sure that you are comfortable. You will be given a sedative in a tablet form and an injection of a strong pain medication under the skin to help relax you and reduce discomfort during the numbing period. Photographs will be taken and the area of the body that will undergo liposuction will be marked down. After using the bathroom one last time, we will escort you to the procedure room and begin numbing the area that will undergo liposuction.

How Tumescent Liposuction is Done

At Advanced Cosmetic Surgery of New York, liposuction is performed using the tumescent liposuction technique, either with or without the use of laser. With the tumescent method, the area is prepared for liposuction by injecting tumescent fluid, or a sterile water based solution mixed with local anesthetic, into the area to be treated. This helps to expand the fat cells and localized tissues to prepare it for optimal fat removal. When the fatty tissue is expanded, it becomes easier for the fat to be removed using the suction tube. This procedure is minimally invasive, with only a few tiny incisions being made to the area in which the fat is being removed. Once the area is fully prepared and numbed, the surgeon inserts the liposuction tool with breaks up the fat in solid particles as it also sucks the particles away using suction. The tumescent method is safer than conventional liposuction (which we do not perform) because it does not require the use of general anesthesia. This reduces the risk to the patient as well as eliminating the high costs associated with being under general anesthesia. The tumescent solution helps to constrict the blood vessels in the fatty layer, minimizing blood loss. Each area takes approximately 60 to 90 minutes to sculpt and can take from 2-3 hours depending upon how many areas are to be treated. The incisions do not require any stitches to close because they are so small.

How Laser Liposuction Using SmartLipo is Performed

We much prefer the laser method of liposuction (and so do our patients, it seems!) because of the many advantages it has over standard tumescent liposuction. The preparation part of the laser procedure is the same as with the tumescent method; the sterile water based solution and local anesthetic are injected into the treatment area to expand the fat cells and completely numb the area. However, this is where the procedure differs greatly. With laser liposuction, the laser is the actual tool used to sculpt the body. The laser fiber is inserted into the treatment area via a tiny incision in the skin. Once the laser is activated, its high energy light beam targets only the fat cells – completely destroying them on contact and liquefying them. The laser accomplishes this through the gentle heat that it creates when the beam is activated. Further, the laser beam is able to target only the fat because the heat melts it away and does not require the surgeon to come in physical contact with blood vessels and nerves in the area. This means that patients experience less blood loss during the procedure and benefit from minimal bruising and discomfort afterward. Healing times with laser liposuction are also greatly reduced because of these benefits. Click here to read complete information about SmartLipo in the Smartlipo section of our website.

Healing and Post-Operative Recovery Times

Though both tumescent liposuction methods have very short healing times and use tiny incisions that do not require stitches, there are several differences in their post-operative profiles. With tumescent liposuction, patients will experience some discomfort and moderate bruising afterwards due to the method by which the fat was removed (manually using a tube and suction). Because the fat was manually removed, the blood vessels and nerves in the fatty layer of skin were also disrupted. This results in more bruising and post-operative discomfort than with laser liposuction. Recovery can take up to 4 days until a patient feels that their normal routine can be resumed.

With tumescent liposuction using the SmartLipo laser, discomfort and post-operative bruising are greatly reduced. The SmartLipo laser technology targets only the fat cells and leaves the blood vessels and nerves largely undisturbed. Therefore, the post-operative profile is greatly improved for the patient. Down time is reduced to only 1-2 days and patients have far less discomfort and post-operative bruising following the procedure.

With either liposuction method, discomfort following the procedure will occur to some degree after the local anesthetic wears off (this takes anywhere from 8 to 36 hours). For this reason, we encourage patients to take some extra strength Tylenol (or we can prescribe some Tylenol with codeine) to help make them comfortable. One of the great advantages to the tumescent liposuction is the use of local anesthesia alone. Patients don’t have to deal with the “hangover” feeling or nausea that occurs with general anesthesia. They can eat regularly right away and may shower the evening after the procedure. We also encourage patients to get up and walk around 24 hours after the procedure to encourage blood flow and healing to the treated areas. Exercise can be resumed (non-strenuous) about a week after the procedure.

How Long Will It Take to See Results?

Results with either method of tumescent liposuction are immediate; some results are seen right away due to the removal of fat cells with final results being observed between 12 and 24 weeks afterward. Because tumescent solution is injected into the areas as well as from the body’s natural healing process which involves some swelling in the treated areas, full results will not be seen until several months after the procedure is done. With standard tumescent liposuction, patients may notice firmness and lumpiness which goes away as the healing phase progresses. For patients who have had laser liposuction, they will have a smoother profile with tightened skin immediately but will also have post-operative swelling which will go away over the following few months. Click here to view what a patient’s final results look like and see the amazing before and after difference.

How Long Will Results Last?

Results will last for many years if a patient maintains a consistent exercise program and watches caloric intake. Though the fat cells have been destroyed and removed through the liposuction procedure, the fat cells that remain in the body are all prone to becoming filled with more fat if weight is gained. Fat cells that were removed will not grow back, but again, the fat cells that remain can become larger if a patient gains weight. For patients to truly keep their results looking like they did at first, maintenance and care of the body is essential to success. When weight is gained, it will be proportionally distributed throughout the body and not focused in the areas where liposuction was done. Patients who gain weight or experience age-related weight gain will find that their overall profile will still be more desirable than if they had never had liposuction.

Liposuction and Cellulite

Liposuction is a wonderful solution for treating areas of stubborn fat that have accumulated in specific areas of the body. Cellulite, however, is not the same as excess fatty tissue and can be present in either thin or obese patients. The bumpy, puckering of the skin that cellulite causes is actually due to fibrous tissue in the skin that connects the skin to the muscles. Tumescent liposuction can certainly lessen the appearance of cellulite (especially with the laser liposuction method) but is not the solution to eliminating cellulite completely. Studies that have been done on laser liposuction patients have shown definitively that cellulite is improved long term after their procedure.

Liposuction as a Weight Loss Method

We always remind our patients that liposuction is not a method for losing weight. It is for patients who are already close to their ideal body weight (within about 25 pounds), exercise regularly and eat well. Liposuction helps patients lose those last few inches in areas where diet and exercise have failed to produce the results they are looking for. Patients can lose up to a couple of pounds after liposuction, depending upon how many areas have been treated and the size of those areas. However, the goal with liposuction is to lose inches and to sculpt the body areas into more desirable contours. Patients will experience a loss of several clothing sizes and will be thinner in terms of inches lost.

Liposuction for Obese Patients

The reason why we label our ideal liposuction candidates as those patients who are within 25 pounds of their ideal body weight is because the best result will be achieved. However, for obese patients who are looking to target specific trouble areas of the body such as especially large tummy pouches, love handles or bra strap bulges, liposuction is a viable solution. It is not to be thought of as a means for weight loss, but instead can be a way for obese patients to create for themselves a more desirable contour as they area on their journey of weight loss.

Risks of Liposuction

As with any cosmetic procedure, liposuction carries its own risks. At Advanced Cosmetic Surgery of New York, however, our unique methods use only local anesthesia which greatly reduces the risks to the patient. Since general anesthesia is the element that causes the greatest risk to the patients, we have found a way to eliminate those risks by using only local anesthesia. In fact, a recent study has proven that our method of tumescent liposuction is the safest; out of over 20,000 patients observed after having tumescent liposuction, none experienced serious infections or complications, none were hospitalized afterward and there were no deaths caused by the procedure. We ask patients to provide a list of medications (prescription and over-the-counter) they are currently taking, including herbal supplements, so that we can reduce the risks of complications that can be brought on by these factors. Some medications and herbs can cause the blood to thin, thus increasing the risk of excessive blood loss and compromising healing. That is why it is imperative that we know everything that a patient is taking.

Though only one treatment is needed in most cases, one of the risks of liposuction is rippling of the skin or a break-through of the skin caused by either the cannula or the laser. If this occurs, patients may require a follow-up treatment to resolve rippling or may need to undergo repairs to the skin if the cannula or laser breaks through the skin. To reduce the risks significantly, we use the smallest sized cannulas possible. This is also why we use the tumescent fluid method; it enlarges the fatty cells and allows for more accurate removal of fat. The SmartLipo laser helps to further reduce the risks of rippling under the skin because it melts away fat evenly and therefore does not leave behind lumps of uneven fat.

Click here to see our before and after gallery.

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