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Liposuction

Suction-assisted lipectomy or liposuction is one of the most frequently performed plastic surgery procedures in the United States.  Liposuction is used to remove unwanted fat deposits from specific areas of the body.  Most commonly treated areas are the neck, flanks (“love handles”) and lateral thighs (“saddle bags”).  Other areas treated include cheeks, upper arms, abdomen, buttocks, hips, thighs, knees, calves and ankles.  Liposuction is not a substitute for weight reduction, but a method of removing localized fat that doesn’t respond to diet and exercise. For small, localized bulges on the abdomen and back, Coolsculpting by Zeltiq is a non-surgical alternative.  Coolsculpting was the first, but new options have developed and obtained FDA approval.  Kybella is an injectable treatment which was approved in 2015 for reduction of submental fullness and fat.  This is designed for the submental (under the chin or jawline) area and not for large body areas.  SculpSure is a laser from Cynosure which has FDA approval for non-invasive reduction of fat in the abdomen and flanks.  Dr. Bass has been at the forefront of non-invasive body contouring research, having been an investigator in the FDA clinical research studies for both of these products.

The best candidates for liposuction are of relatively normal weight but have pockets of excess fat in particular areas.  Firm elastic skin will tend to adjust after removal of the fat, restoring a normal skin contour.  Loose, drooping skin will not redrape adequately.  This skin must be removed by “lifting” procedures which leaves a visible external scar.  To provide maximum improvement, procedures that may be required in addition to or instead of liposuction include facialplasty abdominoplasty and thigh, buttock or arm lift.  The character of your skin and suitability for liposuction will be assessed during your consultation.

About the Procedure
Liposuction can be performed under local anesthesia with sedation or in some cases under local anesthesia alone depending on your preference and the number of areas being treated.  Liposuction can be performed in the accredited office operating room.  med in the ambulatory hospital setting.  Small inconspicuous incisions (usually ¼ inch) are used to allow introduction of the liposuction cannula.  Suction is applied to the cannula to aspirate fat as the cannula is moved back and forth over the area to be treated.  Dr. Bass uses the SlimLipo system for laser lipolysis in conjunction with the tumescent technique for liposuction, where greater amounts of fluid are injected into the fat than in traditional liposuction.  These combined techniques facilitate improved fat removal as well as reduced blood loss, fluid requirements, bruising and postoperative discomfort. Dr. Bass also believes they help maximize the amount and evenness of fat removal and post-operative skin tightening, which is particularly useful in the neck, arms, chest, and knees.  Calves and ankles can also be treated.   Laser light can get into areas that are fibrous like the chest or areas which have scar from previous liposuction, greatly easing the removal of fat.

After the Procedure
You will need someone to accompany you home and provide care for you at home during the first 24 hours.    Swelling and bruising will be present for several weeks.  Return to office work is usually possible after 3-5 days.  This may be longer or shorter depending on the areas treated.  Instead of compression garments, Dr. Bass uses in-office ultrasound treatments after the procedure to hasten the resolution of swelling.

Extent of Improvement
Liposuction will soften or flatten areas of focal fat deposit.  “Cellulite” or skin texture changes will not be improved by liposuction.  Small amounts of residual swelling and ongoing healing means that the final improvement may not be fully visible for several months.  The improvement in your contour should be permanent.  You will not automatically regain fat in the suctioned areas.  Rather, if you do gain weight, you are likely to add the weight uniformly over the body.  Fat is removed from the deep layers.  Superficial fat removal has been associated with increased risk of skin injury and scarring.  The goal of liposuction is to provide a pleasing, natural body contour.  For these reasons, some fat will remain under the skin after liposuction.

Before and After Images