Is Liposuction Right for You?
During the last 10 years, liposuction techniques have changed significantly. The days of patients being left with major skin irregularities and contour deformities are long gone. However, this does not mean that the procedure is a miracle cure-all for anyone with extra weight. Risks, complications, cost and lifestyle changes are all factors weighing in on whether liposuction can be a complete success.
Introduced in the United States in the early 1980s, liposuction – also called liposculpture, lipoplasty or suction lipectomy – is a cosmetic surgery technique developed to remove stubborn fat deposits that don't respond to dieting and exercise.
"The ideal candidate for liposuction is someone who is close to her ideal weight, but experiencing fat bulges or problem areas," says Dr. Nikolas Chugay, a plastic surgeon from Long Beach, Calif. "These fatty bulges are most commonly found in the thighs, hips, abdomen, buttocks, knees, ankles, calves and arms. They are also found in the facial areas such as the chin, cheeks, jowls and neck. A typical procedure will only result in a few pounds lost. However, it almost always leads to a drop in a few clothing sizes."
Effects of Liposuction
Liposuction should not be viewed as a means of weight loss, but rather as a procedure to treat areas of localized excess fat deposits. Often a patient will complain that one part of the body is out of proportion to the rest of her physique, thus the need for liposuction.
"Liposuction can create an improved overall contour and bring a patient's body back into appropriate, symmetrical proportions," says Dr. Douglas L.. Forman, a board-certified plastic surgeon in Bethesda, Md. "When patients undergo liposuction, they should expect to achieve an improved appearance with minimal telltale signs of ever having had liposuction. One of the most common comments patients have following surgery is that their clothes fit better, and they can wear clothes that they never dreamed of prior to surgery."
There are two distinct situations in which liposuction can and does help a person with their body shape and size. According to Dr. Forman, either situation can respond well and with dramatic results. "When a person loses excess weight with exercise and proper diet, they can then use liposuction to further improve their appearance by treating their problem or resistant areas," says Dr. Forman. "On the other hand, some patients have tried all methods to improve their contouring but have reached a plateau, no matter how hard they work out or diet. These patients can often 'jump start' progress with liposuction. Then, following surgery, they continue to improve dramatically, partially inspired by their new appearance."
It's Not a Cure-All
No matter how much people wish it to be, liposuction is not a weight loss technique and is not a cure for overall obesity. There are still limits to what it can accomplish and what one can expect.
"Liposuction will not prevent you from gaining weight in the future," says Dr. Chugay. "It also will not keep you – or get you – fit and in shape. The skin's shape after liposuction will more closely resemble the shape of the stomach muscle, but this surgery will not give you good abdominal tone. This is up to you. In addition, a person who has stretch marks and rippling of the skin before surgery will have it also after surgery. It is not a miracle cure nor a means of cheating Mother Nature."
Understanding the Risks
Nothing comes without a price, and liposuction is no exception. "The risks of liposuction include infection, bruising and swelling, rippling or changes in the skin texture," says Dr. Richard O. Gregory, plastic surgeon and director of the Institute of Aesthetic Surgery in Celebration, Fla. "Additional risks would include the possibility of fluid shifts within the body or of a fat embolism causing severe respiratory distress and even death. These latter risks are generally not seen with reasonably modest liposuction. In fact, the Board of Medicine of the State of Florida has limited outpatient surgery liposuction to 4,000 ml – slightly less than 9 pounds. Numbness as well as exaggerated scars also sometimes occurs."
Life After Liposuction
As with any surgery, the incisions made during liposuction will leave permanent scars. In addition, there are other side effects that often last for days, months, even up to one year after the procedure.
"A scar looks worse initially, but in most instances fades to a fine line after one year," says Dr. Forman. "The treated areas can feel numb for several months to one year. Initially, treated areas may appear quite swollen, and this is a concern for some patients. Furthermore, patients may actually gain weight from fluid retention, which can persist for seven to 14 days. Sometimes, it takes several weeks for patients to see the initial result of the procedure. For all patients, final results are not obtained for at least six to nine months."
Weighing Your Choices
While there are risks and side effects, one must weigh both sides before determining whether a liposuction procedure is the right move. "Once the fat is removed, it is gone forever," says Dr. Chugay. "The result is a permanent recontouring of the body. This can offer a new shape for people who never thought it was possible, giving a psychological boost and the incentive to exercise even more than before to improve the rest of their physique."
An Expensive Upgrade
While fees for a liposuction procedure vary depending upon the area(s) to be done, the general rule is that there is one fee that covers consultation and follow-up care. "Surgeon's fees generally run between $1,000 and $2,000 per area treated," says Dr. Forman. "In addition, patients are responsible for the separate operating room charges and anesthesiologist fees, but many practices have these figures combined in one cost that will be explained at consultation. As with all cosmetic surgery, payment in full is required prior to surgery. However, some practices will assist patients in arranging third-party financing for the procedure, similar to a credit card."
Postoperatively, the patient must continue to work to see the results they are wanting. "Patients should drink plenty of fluids for the first several days post-op," says Dr. Forman. In addition to good nutrition and exercise, it is important to wear a compressive garment – day and night – for several weeks following the liposuction and to massage the areas that have been suctioned. This diminishes swelling and helps the skin to regain shape. Patients are encouraged to walk often, beginning the first post-op day.
The practice of cosmetic surgery has come a long way since first being introduced. "When liposuction is performed, it permanently removes a percentage of the fat cells in the area treated," says Dr. Chugay. "However, in order to prevent weight from distributing to other areas of the body, a sensible diet and exercise regimen must be maintained. It is a great way to get rid of that little bulge, but it is not a means of treating obesity. The goal is for you to be more comfortable with your body and happy with your new shape. Don't go in to your surgeon demanding the impossible."