In many patients, the primary problem is an overabundance of fatty tissue underneath the skin, which can be addressed with weight loss either from dieting, exercising, or in more severe cases weight loss surgery. But when it comes to a substantial weight loss journey, the unsightly presence of the excess skin seems to be quite…
I get asked this question, or a variation of it, on almost a daily basis and it is a good question. Many of my patients have an area or areas of their body that they would like to have reduced or, at least, better contoured. I have been performing liposuction for 26 years, and the answer is, “It depends.”
Liposuction does just what it says, it sucks out the fat. It works best for patients that have isolated fat deposits, like the abdomen, flanks, or thighs; and fairly good skin tone. Liposuction as an outpatient procedure is not for the removal of very large amounts of fat (greater than 5-6 liters or quarts) or for weight loss. It is used to correct contours and curves, like making the belly flatter or the waist thinner.
It is also important to remember that only external fat (fat outside of the muscles and just under the skin) can be treated. Internal fat (fat inside the abdominal wall and wrapped around the bowels) cannot be treated with liposuction. Only weight loss can remove internal fat.
Although liposuction does cause some skin tightening or retraction, it does not significantly tighten very loose skin. There are some liposuction systems that incorporate lasers to try to tighten the skin. I have extensive experience with these systems and the results were only “O.K.”, even in patients who were good candidates.
Liposuction is usually performed in the outpatient surgical setting. Larger or multiple areas require general anesthesia, but smaller areas can be treated under local anesthesia or with mild (oral) sedation.
The area(s) to be treated are prepared and draped in a sterile manner. Very small incisions, less than ¼ of an inch, are made and the area(s) to be treated are filled with a tumescent fluid, which is basically salt water and numbing medicine. Hallow metal tubes (cannulas) are then used to remove fat, but it is not like a vacuum cleaner sucking out fat. What we are really doing is making a lot of “Swiss cheese” holes in the fat. Once the proper amount of fat is removed, dissolving stitches are placed at the incision sites and band-aids are placed. If you think about it, we need all of those Swiss cheese holes to be “squished” together, so we place a compression garment.
The procedure takes about 1-4 hours depending on how many areas are treated. Postoperative discomfort is usually well tolerated, often with little downtime. Return to normal activities is usually within 1-2 weeks. Showering is allowed the next day. Driving is permitted once you feel safe to drive and you are not taking pain medications. Results are noticeable immediately but there is some swelling initially, which improves weekly. Final results are seen after about four months. Most patients wear some sort of compression garment for about a month. Complications are rare in properly chosen candidates and can include over-resection (taking too much fat) and under-resection (not taking enough fat). I have not had a patient develop an infection with liposuction.
So, if you have isolated areas of excess fat and fairly tight/toned skin, then you are probably a good candidate for liposuction. But if you have loose skin, bulging abdominal muscles, or a lot of internal fat, procedures other than liposuction should be considered.
If you or someone you know is interested in liposuction or plastic surgery in general, do not hesitate to reach out to us. We can answer any and all of your questions or concerns. Contact us today to learn more about our liposuction procedure, or our non-surgical as well as surgical procedures in Wilmington, NC.