Bulges, lumps, fat areas, and saddlebags are all accumulations of fatty tissue that are often impossible to reduce with dieting and exercise. Many times these problems are hereditary. These areas can be flattened out and removed by a safe surgical procedure called tumescent liposuction. Liposuction is the most popular cosmetic surgical procedure.

The surgery:
Liposuction is a surgical procedure in which a small tube is used to remove fat cells from the body using a suction machine. The tube is inserted through a very small ¼ inch opening in the skin. There is no discomfort because the area is completely anesthetized. The small tube is moved back and forth through the fat to loosen and remove the excess fat cells from the fatty bulges and deposits. The tube is a blunt instrument, and there is no cutting. Areas that are commonly treated are the outer thighs in women (“saddlebags”), the inner thighs where the excess fat causes the skin to rub together, the bulges around the knees, stomach bulge, waistline bulges (“love handles”), heavy neck and jaw areas, heavy thick ankles, and enlarged breasts in men. After the excess fat is removed, the skin tightens up. Cellulite is not improved by liposuction. The procedure is not designed to correct general obesity, and actual weight loss is not a benefit of the procedure. However the areas of fat that are removed do not reoccur. If people gain weight, the fat increase is localized to other untreated areas.

The details:
The surgery is done in the office where the patient spends about ½ a day. The surgery actually takes 1 – 2 hours. Medication is used to relax the patient, and tumescent local anesthesia is painlessly put into the areas of the skin so that there is no discomfort. The areas of the skin are carefully marked in consultation with the patient to determine what areas of fat are to be removed and the precise location of the small openings. The procedure is done under strict sterile conditions with full safety equipment. Patients feel no discomfort and are quire relaxed but are not asleep and are able to turn and move as necessary. Patients are most gratified when one side has been completed, and they can look down and see the difference in the treated side compared to the untreated side. The small opening is closed with precise stitches to minimize the small scar. A compression garment (which the patient has obtained prior to surgery) is then put on the area. To maximize safety, Dr. Webb limits the total area to be treated at one session and the total amount of fat to be removed. Additionally, patients take antibiotics after surgery as a precaution to prevent infection. After a brief period of rest in the office, patients are driven home by a friend or family member.

After surgery:
There is very little discomfort after surgery. Patients compare the sensation to muscular soreness after a hard physical workout. Usually there is no need for any pain medication. Patients relax at home for the first two days and can resume light activity and return to work on the 3rd day. Full activity can be resumed after 2 weeks. The compression garment is worn 24 hours a day for the first two weeks and then during the day for several months after surgery. Immediately after surgery, swelling and bruising appear and gradually subside over several weeks. The treated areas look quite good after several weeks but the full benefit is often not seen for several months as the skin contraction and healing process continues.

Cost:
The cost the surgery, depending on the extent and complexity, ranges up to several thousand dollars and should be discussed with Dr. Webb. The fee includes follow-up visits, all surgical materials, equipment, and anesthesia. A later “touch-up” procedure is occasionally needed with an additional minor charge.

Risks:
Liposuction is very safe. Precautions are taken to minimize the chance of bleeding or infection and include preoperative testing, preoperative instructions, and the use of medications. Aspirin-type products are to be avoided for two weeks prior to surgery, and antibiotics are to be taken as directed after surgery. Surface skin irregularities can occasionally occur, but are avoided by only removing fat deeper below the skin. Cellulite or dimpling is not improved by liposuction. Vital structures, organs, nerves, and large blood vessels are not touched with the procedure. The surface skin is often somewhat numb for several months after surgery. Bruising takes a while to fade, and excessive sun exposure or vigorous physical activities are to be avoided during the early healing phase. The specific risks and benefits of liposuction for your particular problem should be discussed in detail with Dr. Webb.

C.B. says “My liposuction was comfortable, and I look great after healing.”