Liposuction

Liposuction is one of the commonly performed cosmetic surgical procedures.  Through small incisions we’re able to remove excess fat that accumulates disproportionately in the body, especially in the hips, thighs, and abdomen.  The incisions are small, the recovery rapid, and the results can be very impressive.

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Best candidates

The best candidates for liposuction are those that are at a stable weight and have areas of excess fat deposits that are out of proportion to the rest of their body.  The overlying skin should be of good quality, as we will need this to shrink up after the procedure to provide a good result.  Our best results are in those with good quality skin who are at or near their ideal weight and exercise regularly.

We have discouraged patients from using this as a weight loss technique as there are really better, safer, and cheaper ways of losing weight if you are simply too heavy.  We also are reluctant to perform this in areas where the skin is stretched and has lost it’s elasticity as there may be a “deflated” look to the suctioned area after the surgery which may be unattractive.

Of course, you should be in overall good health to undergo liposuction to minimize your risks of complications.

Types of liposuction

We utilize the “tumescent technique” to perform our cases.  We begin by infiltrating a very dilute anesthetic solution into the fatty tissue where we will be performing our procedure.  Infusing this solution prior to suctioning:

  • Reduces pain during and after the procedure
  • Loosens the fatty tissue so that smaller cannulas can be used
  • Helps minimize blood loss

The tumescent technique is not new, having been first described around 20 years ago.  At that time it represented a significant improvement over the standard liposuction techniques of that time and allowed liposuction to be performed much more safely on a wide variety of patients.  We were some of the earliest to utilize this technique, as we recognized its potential.

Over the years, other techniques have been utilized for liposuction and we have carefully evaluated (and sometimes used) these techniques.  Ultrasonic liposuction, power assisted liposuction, laser assisted liposuction, water jet liposuction, external ultrasonic liposuction, lipodissolve and other techniques have all been greeted with great fanfare (and marketing) only to fall short of delivering any significant improvement over the more traditional liposuction done by an experienced surgeon.  External techniques such as CoolSculpting and others offer a reasonable alternative for patients although the cost and time involved may be even greater than with liposuction.  While we continue to look for new and better tools to help us achieve your goals, we are so far unimpressed with many of these newer techniques.  We urge you to beware of the inexperienced practitioner marketing a “new” technique.  It is ultimately the surgeon, not the tools used, which determine your result.

The consultation

At your initial consultation we will evaluate and carefully discuss your problem areas.  We will be looking at your underlying muscle and bone structure, assessing the amount of fat present, looking at the elasticity and quality of your skin, and evaluating scars from previous surgery that might affect our approach.  If we feel that the skin is too loose or stretched to allow correction by liposuction we may suggest an excisional procedure.  For example, loose skin and excess fat on your abdomen may be better treated with an abdominoplasty rather than liposuction.  We will then discuss how we might best approach these areas to achieve your goal.

The areas we most commonly treat are the abdomen, outer thighs (“saddlebags”), inner thighs, hips, flanks (“muffin top”), back folds, and arms.

Many times we combine liposuction with other procedures. In some cases, we may suggest adding liposuction to your primary procedure (such as an abdominoplasty) if we feel it will improve your overall result.  Other procedures we have combined with liposuction at the patients request include:

We will discuss the possibility of these and other combined procedures with you at the time of your consultation.

The operation

We typically perform our liposuction procedures in the operating at the Lawrence Surgery Center.   In addition, we also perform more limited liposuction procedures in our office under local anesthesia.  Prior to surgery we mark the areas to be treated and confirm this with you.  In the operating room or procedure room, small incisions are made in the skin in discreet areas to allow us to infiltrate our tumescent solution and perform the removal of fat.  The suctioning is then performed using thin metal cannulas, usually 3-4 mm in diameter.  The total amount of fat removed varies greatly from patient to patient.

The procedure varies in length depending on the extent and number of areas to be treated but typically lasts 1-2 hours.  After the procedure we will place you in a compressive garment to provide pressure to the areas treated which helps minimize pain, swelling, and bruising.  It also helps shape and contour the newly suctioned areas.  Pain is typically mild to moderate and controlled with oral pain medication.

Recovery

Most patients are on their stronger pain medications for 1-2 days after the procedure, and then transition to over the counter medications.  We will keep you in a compressive garment for at least a week and sometimes longer, especially if extensive liposuction is performed. The time before you can return to work and everyday activities varies from patient to patient, but ranges from a few days to about 1 week.  We have patients refrain from strenuous work and exercise, especially those involving the treated areas, for 1 week and then gradually return to their exercise routine.  Swelling and bruising are typically present, especially in the first week.  Significant improvement is typical right after surgery but the final result may not be apparent until up to 2 months after surgery when all the swelling has subsided.

Touch up procedures

We work carefully to avoid oversuctioning an area, as this can create defects which are difficult to correct.  If too much fat remains in a suctioned area, however, this can usually be corrected in the office under local anesthesia.  We occasionally need to perform these “touch-up” procedures to perfect your final result.  Fortunately, these are minor procedures with much less pain, swelling and recovery time.

Fast fact

There were over 250,000 liposuction procedures performed in the U.S. in 2018, making it the 2nd most common cosmetic surgical procedure.  Almost 90% of the patients were between 20 and 55 years old.

5 Reasons why you should have your liposuction performed at Lawrence Plastic Surgery:

  • Experience– We have been performing this procedure for over 18 years using the tumescent technique with excellent results.  We have evaluated and tried other techniques and found they provide little, if any, improvement over the tumescent technique.
  • Accredited facilities–  When a general anesthetic is required we perform this operation at the Lawrence Surgery Center, both licensed and accredited facilities.
  • Choices– Liposuction alone may be the best solution to your problem, but other procedures may be required to achieve your desired result.  We can offer a broad range of solutions, not just one.
  • Surgeon certified by the American Board of Plastic Surgery.  In addition, Dr. Thellman achieved board certification in General Surgery prior to his Plastic Surgery certification.
  • Personal attention– While we’re a busy practice our staff will give you the personal attention you deserve.

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