84 - Liposuction

Summary

Liposuction or suction assisted lipectomy (SAL) is used to recontour specific areas of the face and body by removing unwanted deposits of fat, though it is not considered an alternative to weight loss. It is best performed on localized areas that do not respond well to diet and exercise. The ideal liposuction patient is healthy, exercises, eats a well-balanced diet, has good skin elasticity, desires treatment of minimal-to-moderate localized fat deposits, and is within 20%–30% of ideal body weight. A preoperative CBC is important when performing “mega” liposuctions in which a large blood volume may be lost. Clotting studies, electrolytes, urinalysis, EKG, and radiographs may also be indicated by patient age and medical history. A set of standard photographs should be taken prior to the procedure which can serve as an intraoperative guide and enable comparison of preoperative and postoperative results.

The procedure involves making small stab incisions with insertion of a cannula into the deep fat layer. Using the tumescent technique, the targeted area is first infused with a saline solution containing lidocaine and epinephrine. The cannula is then attached to a vacuum device that suctions out the targeted fat. This suctioning is repeated in a “to and fro pattern” through the layer, creating a radial pattern. Ultrasound-assisted liposuction (UAL) is similar in technique to SAL, except that it uses ultrasonic energy to fractionate or burst the fat cells.