Cosmetic Procedures
Liposuction: What to Expect Before, During, and After

Some people inherit a tendency to store fat in a certain area of the body such as the outer thighs or abdomen. When fat remains despite diet and exercise, liposuction may be an option for removing the fat and sculpting the area. The following explains what can be expected if you undergo liposuction.

What to Expect Before Liposuction
A consultation is essential. Your dermatologist will take a complete medical history. Be sure to tell your dermatologist about past surgeries, over-the-counter and prescription medications, allergies, and medical conditions. It also is important that your dermatologist know about all vitamins, herbal supplements, and alternative therapies that you use.

To determine if liposuction is suitable for you, your dermatologist will perform a physical exam. If all looks well, you will need to get some tests. These typically include blood work for everyone and an electrocardiogram for people over 60 years of age. Other tests may be necessary.

Only after your dermatologist has reviewed the results from the lab tests can the doctor tell if liposuction is right for you. If liposuction is appropriate, the dermatologist will make sure you know what will happen during the procedure, the expected results, and the potential side effects. Alternative treatment options will be discussed.

If you agree that liposuction is right for you, photographs will be taken. You also will be provided with instructions to follow before the procedure. These will include not losing or gaining weight as well as avoiding alcohol, vitamin E, and certain medications such as aspirin and ibuprofen for a specified amount of time. An antibiotic may be prescribed so that you can start it the day before.

What to Expect During Liposuction
Liposuction can be safely performed in a medical office. Before being prepped for this procedure, vitals are taken and women are usually given a pregnancy test. If the pregnancy test is negative and the vitals good, the person can be prepped. This typically includes the dermatologist marking the treatment area and confirming what will be treated with you. Next a sedative is given, the area is cleansed, and the anesthesia administered. This is a local anesthesia, so you will remain awake during the entire procedure.

Administering the anesthesia takes about 30 to 90 minutes. As the anesthesia takes effect, the area becomes hard and swollen. Once the area is ready, the dermatologist makes several small incisions so that a small tube called a cannula can be inserted. The cannula suctions out the unwanted fat.

During the procedure, the dermatologist may ask you to reposition yourself. Once the fat has been removed and the area sculpted, the area is dressed — usually with absorbent pads and a compression garment. Stitches are not necessary because the incisions are so small that the skin seals shut in about 1 day. This entire procedure takes fewer than 3 hours.

What to Expect After Liposuction
After liposuction you may feel a bit groggy and have some discomfort. Someone will need to take you home. Before leaving the office, you will be given instructions. These should be carefully followed to ensure the best results and to reduce the risk of side effects. Your instructions will include how to care for the treated area. You will need to change the absorbent pads, wear a compression garment, and take some precautions for a few days.

Many people return to work after 48 hours and resume all normal activities within 1 week of liposuction.

References:
Coleman WP and Flynn TC. “Liposuction.” In: Bolognia JL, Jorizzo JL, Rapini RP et al, editors. Dermatology. 2^nd edition. Spain, Mosby Elsevier; 2008. p. 2345-53.

Johnson DS, Lillis PJ, Kaminer MS. “Liposuction.” In: Kaminer MS, Dover JS, Arndt KA, editors. Atlas of Cosmetic Surgery. United States of America, W. B. Saunders Company; 2002. p. 194-230.

Leonard AL, Hanke CW. “Liposuction.” In: Wolff K, Goldsmith LA, Katz SI et al, editors. Fitzpatrick’s Dermatology in General Medicine. 7^th edition. United States of America, McGraw Hill Medical; 2008. p. 2378-88.