Although the procedure was originally developed for the torso and thighs, it is now used on all areas of the body and has proved particularly helpful in contouring the area under the chin and as an adjunct to face lifting.

Fat distribution is determined by two factors, heredity and diet. Heredity determines the location and number of individual fat cells, which are fixed and unchanging after puberty. Diet can increase or decrease the amount of fat in each cell but will not affect the total number of cells or their distribution. For example, if you have inherited large numbers of fat cells on your thighs and small numbers of fat cells on your chest, you will always have more fat on the thighs than on the chest, and strenuous attempts at weight loss can leave you with a thin upper body and persistently bulky thighs.

Your appearance after liposuction will be influenced by your general state of health, the overall condition of your skin, age, weight, hormonal influences, and other factors. Each patient is unique, and during your consultation I will discuss with you in detail how these general factors apply to you in particular. Liposuction is not a substitute for a healthy diet nor is it useful for generalized weight reduction. While the foregoing may seem obvious, I mention it because some patients may expect localized fat removal to effect a dramatic weight loss. This is not possible.

Liposuction selectively removes fat only from those areas in which the patient desires reduction. Since the actual fat cells are removed, the procedure is permanent, and following liposuction the body will always have less fat in the treated areas.

Skin elasticity Good skin elasticity is a desirable attribute in all patients since it makes for a smooth surface contour. Tight skin is universally seen in the very young and is gradual lost as we age. Even through middle age, however, we retain some elasticity. The skin envelope always shrinks to adjust to the reduced contour following appropriate liposuction..

Cellulite The word “cellulite” has no precise medical meaning. Most people use the word to refer to dimpling and irregularities that occur on the surface of the skin. It is seen most frequently over the lower torso and thighs, worsens with age, and is frequently associated with loose skin (see below). Cellulite is tied to protein degeneration in the skin and it’s supporting structures.

While liposuction will not cure cellulite, it will remove fat and reduce contour. In mild cases liposuction may lessen the intensity of cellulite. Severe cases, however, require abdominoplasty ("tummy tuck") or thigh lift for permanent improvement.

Loose Skin and Musculature Some individuals have lax musculature and loose skin with or without excess fat. These patients require additional procedures such as abdominoplasty (tummy tuck) or thigh lifts. During your consultation I will evaluate your skin and musculature as well as localized fat deposition. If you require thigh lift or abdominoplasty for optimal results, I will so inform you.

Permanency of Results The number of fat cell is fixed after puberty. Adults become thinner or fatter by reducing or increasing the amount of fat in each cell. Since liposuction reduces contour by removing fat cells, the procedure is permanent. Should you gain weight following liposuction, you will tend to deposit the fat in areas other than those treated.

Duration of the Operation The operation lasts 30 minutes to 2 hours, depending on how many areas are treated.

After Surgery There are usually bandages over incision sites. You will be placed in a support garment immediately after surgery, and you will wear the garment continuously for 2 to 3 weeks. You may remove the garment to shower starting 24 hours after surgery. If your calves and/or ankles are treated, you will wear support hose for up to 6 weeks.

You will experience very little pain after surgery, for which you can take Extra Strength Tylenol. There is usually only mild discomfort thereafter. I will see you 1 month, three months, and 6 months after surgery. All patients may return to work in three days.

For the first week following surgery the treated areas will be swollen and will show no reduction in contour. In fact you may appear larger than you did before surgery. You clothes may fit more tightly, and you may weigh more. By the end of the first week, however, the swelling associated with surgery begins to subside, and sometime during the second week you will notice a diminution in contour and the treated areas will be smaller than they were before surgery. Resolution of swelling occurs rapidly after the first week, but your final improvement may not be apparent until as long as 6 months after surgery. If the calves and ankles have been treated, subtle additional improvements may take place even beyond 3 months.

Photographs Preoperative photographs will be taken. The body photographs do not show your face. They are important aids in planning and performing surgery and become a permanent part of your patient record. Postoperative photographs are taken 6 months after surgery.

Scars In the past, scars from body contouring were long and conspicuous. Liposuction scars are usually less than 1 inch long and can be placed in natural body creases or in other areas where they are inconspicuous or easily hidden by clothing or bathing suits. In most patients the scars will be red or pigmented for 6 months and gradually fade there after until they are not noticeable by 12 months after surgery. The scars are rarely troublesome. Nevertheless, you should know that all scars are permanent and their height and width are not totally predictable.

Complications and Untoward Results Serious complications are uncommon with this kind of surgery. All patients have bruising, which lasts 3 to 6 weeks, occasionally longer. A certain amount of numbness or reduced sensation in the treated area is also to be expected. As with any surgery, bleeding, infection, and other complications are possible.

Patients may experience contour irregularities in the treated areas following surgery. Usually this is temporary, but, in occasional patients, may be permanent.
Symmetry is the goal, although small side-to side differences can occur. I will make every effort to give you as smooth and symmetric a result as possible. Five percent of patients have secondary surgery or a “touch-up” after 6 months, most frequently for removal of additional fat.

Articles have appeared in the lay press publicizing and even sensationalizing disastrous consequences following liposuction. Fat embolization (small particles of fat travelling to the lungs or other parts of the body) have received particularly lurid coverage. I have investigated all serious complications and/or deaths associates with liposuction that have come to my attention either through reports in the medical literature or informally through my professional associations. I have found that almost all patients who had a disastrous consequence following liposuction had either been operated by unqualified practitioners or had had additional simultaneous surgical procedures performed that were more likely to have caused the complication. I believe that fat embolization is a universal accompaniment of all surgery and is of no clinical significance in healthy patients. While no surgery can be totally safe, liposuction compares favorably with any cosmetic procedure.

I mention these problems because I want to give full disclosure. I hasten to add, however, that the vast majority of patients are immensely satisfied with their results, and in my personal practice I have never seen a serious complication from this procedure.