The History of Liposuction

This truly revolutionary technique was developed in France and Italy in the late 1970s by Doctors Jean Yves Illouz, Pierre Fournier and Georgio Fischer. It was introduced in the United States in the summer of 1982 and has added new dimensions to body contour surgery ever since. Since the late 80's, the tumescent technique developed by dermatologic surgeon Dr. Jeffry Klein (as featured on ABC's 20/20), has rendered liposuction surgery easier and safer. It also allows for a much greater portion of patients to have liposuction with only local anesthesia.

What Liposuction can do

Liposuction is used to remove unwanted fat from various areas of the body. It is not a weight loss technique. It is a volume reduction technique that can remove inches and give a cosmetically desired contour appearance to the abdomen, flanks, buttocks, thighs, knees, neck and other areas. Such commonly known contour irregularities as "fat tummies," "love handles," "saddle bags," "double chins" and "fat knees" can literally be sucked away with this technique.

The Procedure

The procedure consists of making one or more incisions one-eighth to one-quarter inch long, generally hidden in the natural skinfolds, through which a long, hollow tube is introduced into the fat. Using a powerful vacuum, the fat is sucked out. Not all of the fat is taken out; instead, many tunnels are made creating a Swiss-cheese like effect. The smooth, blunt tip of the tube literally brushes aside most of the few small and relatively unimportant nerve or blood vessels located in the fat layer, thus minimizing tissue damage. The remaining fat then collapses on itself like an accordian, shrinking down considerably. A thin, superficial layer of fat just under the skin surface is left intact. Along with the natural elasticity of the skin, this allows for an even, smooth result. A tight elastic support is worn for five to seven days, or longer in patients with poor skin tone. This futher enhances the final contour.

Once the fat is removed from an area, it tends to stay off. In adults, fat cells do not multiply, they only grow bigger as they store more and more fat when weight is gained. Once the fat has been removed via liposuction, on the abdomen and hips, for example, only 10 to 20 percent of future weight gain will localize back into these areas. The rest will be distributed over other areas of the body.

Anesthesia

Depending upon the amount and the locations of the fat to be removed, liposuction can be performed under local anesthesia, under local with sedation (twilight sleep), or under general anesthesia. For some larger cases with multiple sites, and for anxious patients, general anesthesia is preferred.

Regardless of the type of anesthesia selected, almost all patients can be released home the same day. An outpatient surgery center is selected for I.V. and general anesthesia cases. These centers are fully certified and accredited, modern facilities providing a high standard of care and safety. Currently, we use Corona Regional Medical Center Outpatient Surgery; the Glenwood Surgery Center on Magnolia nex to the Parkview Hospital campus; and the Riverside Community Surgery Center at the Community Hospital campus. For patients from the L.A. area and for teaching cases, the liposuction surgery can be done at UCLA. The tumescent liposuction technique is performed on all patients, regardless of type of anesthesia used.

Recovery

Recovery is remarkable quick. Most patients are able to return to work and non-strenuous activities after three to seven days, depending on the amount and number of sites involved, along with the overall condition of the patient. Light to moderate exercise is generally okay after two weeks and normal exercise may be resumed after three weeks.

Complications

Liposuction has an excellent safety record and low rate of complications. Nonetheless, patients must remember this is an operation and serious complications, even death, can occur on rare occasions. This is true not just from an operation but from anesthesia or reactions to medications administered in the course of the surgical procedure.

Answers to Frequently Asked Questions

Question: What happens to excess skin after fat is removed?
Answer: Skin has natural elasticity and will shrink back when liposuction is performed properly. It should be noted that existing skin irregularities, stretch marks, dimpling from pre-existing cellulitis, are generally left unchanged. Only rarely will skin excision be required in addition to fat suction.

Question: Will there be visible incision scars?
Answer: Most scars are hidden away by natural body folds. The incisions are very small and with time they become barely noticeable.

Question: Are "waves" and other skin irregularities a common problem with liposuction?
Answer: Not anymore. When American surgeons first started performing liposuction they often usede larger tubes and removed too much fat too close to the surface. By using smaller suction tubes and leaving a layer of fat in place just underneath the skin, such problems are largely avoided.

Question: What are the possible complications?
Answer: Infection, bleeding, scarring, post-operative pain, increased or decreased skin sensation, along with reactions to anesthetic and medications are all examples of possible complications. Fortunately, these complications are rare and can be decreased by the use of proper technique, anesthesia and post-operative care. Alerting the doctor to any existing health problems will also reduce the risk of complications.

Question: What is the cost and is it covered by my insurance?
Answer: Liposuction is generally considered a cosmetic procedure and is not covered by insurance. The cost for the procedure will vary, with costs ranging between $2000 and $4500, depending upon the complexity of the case and type of anesthesia used. General anesthesia surgery is only performed in a fully-certified facility. Most cases fall in the $3000 to $3500 range.

Question: Is there a charge for the initial consultation?
Answer: No. The initial evaluation is always performed by the surgeon and takes from 30 to 45 minutes. Preliminary information may be obtained in advance from the nursing staff if desired. During the initial evaluation, the cost will be carefully discussed, based upon the patient's individual needs and desires.