Liposuction is primarily a cosmetic procedure intended to remove fat from strategic locations in the body. It is not a weight loss procedure. Historically the application of a suction tube to areas of human fat goes back to at least the early 80s, and maybe earlier. The technique has evolved over the years to become in some surveys, the most common cosmetic procedure. I also perform liposuction in conjunction with other body contouring procedures. It’s a tool that can help improve appearance.
Like all cosmetic procedures, it must be performed by a trained board-certified plastic surgeon. In Florida to perform liposuction in an office setting the surgeon is supposed to have hospital privileges for that procedure. Unfortunately, especially in South Florida violation of this rule is common.
The worst complication with liposuction is death. Blood can become contaminated with fat globules and as the blood returns to the heart and lungs, it can stop the flow of blood in the body. This is referred to as a fat embolus. This can cause death.
Liposuction can be performed under local anesthesia which I do not support. It can be done under heavy sedation, which can be very risky, or what I prefer, which is general anesthesia. I can do my best work when the patient is asleep and comfortable.
Liposuction
Tumescence is a term used to describe the first step in this procedure which is to infiltrate the desired area of reduction with a special combination of fluid. This provides less bleeding, less bruising, and some painlessness postoperatively. Once the fluid is infiltrated and a reasonable amount of time is allowed to lapse, small incisions about 1/4 of an inch are made to introduce the cannula or tube. Through this tube, suction is applied and the fat flows out. I personally use different types of tubes to achieve the best contour reduction and result.
Under local lidocaine overdose is a possibility and this is reduced by doing this procedure under general anesthesia. It’s important to be aware of the depth in the position of the cannula to avoid contour irregularities – which are very difficult to correct. Therefore, avoidance is essential. Again, awake procedures in my opinion preclude the best possible result because the patient’s comfort is not maximized.
The biggest non-candidate is an overweight patient who believes this to be a weight loss procedure – which it is not. Proceeding in life looking our best is very fulfilling. Also, believing we present to the world our best self is a highly sought-after state of being. It’s very satisfying for us to be able to help people achieve their goals and look their best.
THOMAS TREVISANI, MD
BOARD-CERTIFIED PLASTIC SURGEON
MEMBER OF THE AMERICAN SOCIETY OF AESTHETIC PLASTIC SURGERY
