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The Skinny on Liposuction

Photo Researchers, Inc.

Liposuction involves inserting a needle through the skin and drawing out some of the underlying fat. It is being done here to add definition to the abdomen. The area which will be affected has been marked in purple.

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On this page:

• Regulation
• Who Can Perform Liposuction Surgery?
• What are the Risks?
• More Factors to Consider

Liposuction is the most popular form of cosmetic surgery in the United States, according to the American Society for Aesthetic Plastic Surgery (ASAPS).

The 403,684 liposuction procedures performed on Americans in 2006 represent a 128% increase over the number performed in 1997. Interestingly, this same procedure—during the same year—was the top cosmetic surgery performed on men in the United States. In addition, the 383,885 liposuction procedures performed on U.S. women ranked second only to breast augmentation.

If you are considering joining the millions of people worldwide who have had liposuction, FDA's Center for Devices and Radiological Health, which regulates the medical products used in liposuction, suggests you consider the following before having the surgery:

• Liposuction is intended only for body contouring. It is not intended as a means of weight loss.
  
• During liposuction, body fat is removed from under the skin with the use of vacuum suction—either with a hollow pen-like instrument called a "canula," or an ultrasonic probe that breaks fat up into small pieces and then removes it.
  
• While physicians may perform liposuction on the abdomen, hips, thighs, calves, arms, buttocks, back, neck, or face, it has never been cleared for use on the neck or face.
  
• Liposuction is also used in medical procedures such as reduction of mens' breast size and removing fat tumors (lipomas).

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Regulation

In the United States, FDA regulates the sale of medical devices and drugs that physicians use to perform liposuction. This includes equipment such as canulas, pumps, collecting containers, and ultrasound probes, as well as anesthetics used during the procedure.

FDA does not have authority to

• regulate a doctor's practice.
• tell a doctor how to run his or her business.
• tell a doctor what he or she can or cannot tell patients.
• set the amount a doctor can charge for liposuction surgery.
• insist that patient information be provided to potential patients.

FDA also cannot

• recommend individual doctors, clinics, or liposuction centers. (The agency does not maintain or have access to lists of doctors performing liposuction.)
• conduct or provide a rating system on medical devices it regulates.

Source: American Society of Aesthetic Plastic Surgery

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Who Can Perform Liposuction Surgery?

Plastic surgeons and dermatologists often perform liposuction, but any licensed physician may perform the procedure.

While some physicians' professional societies recommend it, no standardized training is required for conducting liposuction. You may want to base your decision to have liposuction on whether or not a doctor has had specialized training in the procedure, and has successfully performed it before.

Liposuction may be performed in a doctor's office, surgical center or hospital. Because it is a surgical procedure, it is important that

• it be performed in a clean environment
• there be access to emergency medical equipment or a nearby hospital emergency room.

Remember, even the best-screened patients under the care of the best-trained and experienced physicians may experience complications as a result of liposuction.

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What are the Risks?

• Infections can become serious issues. Keep the wounds clean.
• Embolisms may occur when loosened fat enters the blood through blood vessels ruptured during liposuction. Pieces of fat can wind up in the lungs, or even the brain. Fat emboli may cause permanent disability or, in some cases, be fatal.
• Puncture wounds in the organs (visceral perforations) may require surgery for repair. They can also prove fatal.
• Seroma is a pooling of serum, the straw-colored liquid from your blood, in areas where tissue has been removed.
• Paresthesias (changes in sensation that my be caused by nerve compression) is an altered sensation at the site of the liposuction. This may either be in the form of an increased sensitivity (pain), or numbness in the area. In some cases, these changes in sensation may be permanent.
• Swelling, in some cases, may persist for weeks or months after liposuction.
• Skin necrosis occurs when the skin above the liposuction site changes color and falls off. Large areas of skin necrosis may become infected with bacteria or microorganisms.
• Burns can occur during ultrasound-assisted liposuction if the ultrasound probe becomes hot.
• Fluid imbalance may impact you after you go home. The condition can result in serious ailments such as heart problems, excess fluid collecting in the lungs, or kidney problems.
• Toxicity from anesthesia due to the use of lidocaine, a skin-numbing drug, can cause lightheadedness, restlessness, drowsiness, a ringing in the ears, slurred speech, a metallic taste in the mouth, numbness of the lips and tongue, shivering, muscle twitching and convulsions. Lidocaine toxicity may cause the heart to stop.
• Scars at the site of the incision are usually small and fade with time, although some may be larger or more prominent.
• Bumpy or wavy appearances can occur at the liposuction site after the procedure.

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More Factors to Consider

Will you like your looks after liposuction?
The cosmetic effect after liposuction may be very good and many patients report being satisfied. However, your appearance afterward may not be what you expected or wanted. Some physicians counsel their patients that reasonable expectations are important.

The results may not be permanent.
If you gain weight after liposuction surgery, the fat may return to sites where you had liposuction or to other sites.

Liposuction is not for everyone.
You are probably not a good candidate for liposuction surgery if cost is an issue. Most medical insurance will not pay for cosmetic liposuction, and the cost may be significant. You are also probably not a good candidate if you are overweight or obese and trying to lose weight, if you have a disease or are on medication that affects wound healing, or if your skin elasticity is inadequate. Lack of skin elasticity can cause the area the fat was removed from to be baggy after liposuction.

There are alternatives.
These include changing your diet to lose excess body fat, exercising, accepting your body and appearance as it is, or using clothing or makeup to downplay or emphasize body or facial features.

Make sure you understand the procedure and what you can expect.
It is important for you to read the patient information that your doctor provides so that you understand the risks involved. Ask about potential problems that could occur, and ask about the physician's experience in performing liposuction.

How accurate is the advertising?
Be wary of advertisements that say or imply you will have a perfect appearance after liposuction. Remember that advertisements are meant to sell you a product or service. Also, don't base your decision simply on cost.

Don't be pressured.
Take your time to decide whether liposuction is right for you and whether you are willing to take the risks of the surgery for its benefits.

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Date Posted: August 20, 2007

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