Liposuction has been the most implemented cosmetic surgery procedure in America – reportedly about 500,000 people each year subject themselves to this procedure. This is a big number considering that this is after all an elective surgery which has several downsides with pain, discomfort, recovery time, time off from work and costs being the main negative concerns.

That people overcome the fear and suspicion associated with these issues and opt for the surgery speaks volumes of their confidence in the positives that Liposuction may bring in. Where does this confidence come from? Even considering the effects of promotion and advertising, it will not be wrong to conclude that the confidence mainly emanates from the successes of the large number of past procedures.

Liposuction procedures help people look better and fitter, including cases where diet and exercise have failed them to achieve similar results. By removing fat from isolated and localised areas  where dieting and exercise cannot  easily reach, such as in thighs, calves, hips, buttocks, abdomen, arms and improving the body contour, liposuction has been able to give relief to those people who previously were resigned to having unwanted fat bulges on their bodies.

The brief history of the procedure with modern techniques had its beginning in France in 1920s and in Italy in the 1960s,  liposuction was first developed in Europe. In 1980s , the procedure was introduced in the US and in 1985, the Tumescent technique, which involved injecting high volume of  fluid containing anaesthetic Lidocaine (it also restricted blood loss) and a salt solution, was developed.

The fatty tissue in contact with the fluid, swells up (i.e tumescent) and forces the medicines into the cells. The fat is removed by moving a cannula (a hollow tube)put into the fatty layer through an incision. The fatty layer breaks up and is sucked out by vacuum pump or a syringe. This is normally done under local anaesthesia and the duration, which may be as long as four to five hours, depends on the number of body parts under the procedure.

Another technique, the Super Wet technique, is a similar technique with  less fluid and less Lidocaine injected. However, the Tumescent technique is a faster and safer procedure involving one to three hours and normally is done under with mild sedation only, or a general or IV-epidural anaesthesia.

Ultra sound assisted Liposuction (UAL) is another technique in which ultra sound energy is put in the fatty layer by a vibrating cannulaand the fat is liquefiedand is sucked out. The use of UAL is controversial with some physicians as it has been associated with a higher risk of seromas (fluid collections) and more pain after the procedure than the Tumescent technique. These may be due to the UAL technique producing heat and if not handled right, burn injuries may take place. Also the effect of ultra sound energy reaching internal organs is not known.

Power liposuction involves use of a motorised cannula which moves back and forth very rapidly and breaks up more fat at a lesser time and more uniformly. Laser lipolysis is another technique that is helpful for skin tightening, but regular liposuction must also be used with this technique to remove the fat. There are some other techniques also, though not as popular as above.

Post Liposuction, the patient may go home on the same day if the case is performed with just local anaesthesia, but if it was done under general anaesthesia, recovery may be longer. Fluid drainage from the operated area does happen, and some doctors prefer to leave the small incisions un-sutured to allow drainage, some put stitches by inserting drainage tubes and the stitches may dissolve or are removed after a few days.

The patients usually wear tight fitting elastic clothing which compress the operated area and help in reducing swelling and in healing. They may also take antibiotic medications to avoid infections.

Most patients have only mild pain for a few days, but some continue to experience pain, discomfort like soreness, burning for about three weeks or so, after the surgery. All have swelling present and the swelling should disappear after six to eight weeks. The patients should avoid exercise and heavy work for about a month after the surgery.

Like in all other surgical procedures, liposuction has some associated risks such as, infection, formation of fat or blood clots which may turn fatal if they reach the lungs, too much fluid loss leading to shock and possible death, fluid accumulation, injury to organs, nerves or untargeted body parts, reaction to anaesthesia and other drugs, rippling or indentations if too much fat is removed, scarring

The cost of Liposuction depends on the number of body parts worked on, amount of fat removed, the state within USA, the doctor charges and may be $ 2000 to $ 7000 for a body part. If the procedure is extended to another body part, the cost may go up by $1200 to $4000. The cost of anaesthesia, Laboratory tests, post procedure elastic clothing are extra. Cost of Liposuction which normally comes under cosmetic surgery group, is not covered by insurance.

Liposuction may be carried out by any licensed cosmetic surgeon. They are required to have special qualification or training to do so for adequate credentialing. It is important that before selecting a surgeon, one must check out her/his experience in performing the particular procedure to be done and if he/she enjoys good reputation as a successful and dependable professional. The Food and Drug Administration (FDA) encourages people to ask the surgeon or doctor for details about their experience in the specific procedure to be undertaken.

(Information in this article has been partly sourced from Liposuction 101 by Stephanie Watson in Discovery fit & Health and Liposuction by Wikipedia)