Suction lipectomy is a procedure which removes fat cells through small incisions utilizing surgical suction catheters. The goal of surgery is to improve body contour by removing localized accumulations of fat. This will establish more normal proportions between various areas of the body and improve the appearance both in and out of clothing. Suction lipectomy is not a treatment for generalized obesity, but rather is indicated for well defined localized accumulations of fat. In any given patient, these goals may be only partially met.
Limitations of the Procedure
This procedure will not improve body contour where diffuse obesity is the underlying problem. In addition, excess or loose skin will not be improved. Body contour irregularities which are due to structures and tissues other than fat are not improved by suction lipectomy (for example, muscle weaknesses or bony asymmetry). Skin dimpling (“cellulite”) which is present before surgery will remain after surgery. Skin elasticity is not improved by this procedure. The ability of the skin to shrink over new contours following suction lipectomy is generally better in younger patients than older patients. The more fat removed from an area the more difficult for the skin to shrink smoothly over the new contour regardless of age. This can result in skin laxity, rippling, dimpling or other skin irregularities.
Alternatives to the Procedure
Suction lipectomy is a purely elective procedure designed to alter body shape. Without surgery, the disproportions between various body parts will generally persist or increase. Diet and exercise may change body size, but the body shape itself is generally determined by familial traits and sexual (male v. female) characteristics. In some instances direct surgical removal through incisions can also alter body shape. In some patients this may be a better choice than suction lipectomy.
Surgical Techniques / Anesthesia / Recovery
This procedure can be performed under either a general anesthetic or, if only lower body suctioning is performed, under a regional anesthetic (spinal/epidural). This is a decision which should be made after consultation with both the surgeon and the anesthesiologist. Depending upon the amount of suction to be performed, the procedure may be done as an outpatient or with an overnight stay. In certain patients a “tumescent technique” with preinjection of fluids designed to decrease blood loss and bruising may be used. Multiple, short incisions (1/4-1/2") are placed in normal skin creases to allow access to the area to be suctioned. Through these incisions, suction catheters are passed and the fat accumulations noted preoperatively are reduced. The skin is generally closed with absorbable sutures and supportive steri-strips. A compression garment is placed at the end of the procedure to help control postoperative swelling. It is generally recommended that such a garment be worn day and night for a minimum of two weeks following surgery and during the day for at least an additional two weeks. Some patients find it beneficial to wear the garment for up to six weeks.
Most patients return to work within seven to ten days following surgery. You can expect to resume athletic activity such as treadmill walking or stationary cycling after 3 weeks. It is normal for body tissue fluid and blood to accumulate in the areas from which the fat is removed. This will result in swelling in the areas of suction for weeks to months following the procedure. Consequently, the final result of suction lipectomy may not be totally apparent for three to six months following surgery.
Risks / Complications
Due to the extensive tunneling necessary to remove the fat cells, significant bruising always accompanies this procedure. It may even extend beyond the areas of fat removal. Temporary, or in rare instances, permanent numbness may occur in the skin overlying the areas of suction. Serious infection is rare, but if it should occur, hospitalization may be required for antibiotic treatment. In rare instances severe infection has led to skin loss in the areas of suction. As noted above, skin dimpling, rippling or other irregularities may result due to poor skin elasticity. Depending on the degree of skin shrinkage and swelling there may be asymmetry between areas of suction. The incisions utilized to insert the suction cannula usually heal well, but will leave small scars. In very rare instances pigmentation changes in the overlying skin may occur.
Depending upon the amount of fat to be removed, blood loss may approach the point where transfusion is required. If this is anticipated, arrangements will be discussed with you prior to surgery to assist you in donating your own blood or in providing banked blood for the time of surgery. In rare patients, respiratory difficulties have occurred due to small amounts of suctioned fat leaking into the blood stream and causing blockages within the pulmonary vessels (pulmonary embolus, fat embolus).