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Liposuction/Fat Injection /Buttock Enlargement (Lipoplasty)

What Is It?

Liposuction is a procedure that uses small cannulas (thin tubes) to suction and remove fat cells from the layer of fat beneath the skin. Liposuction is ideally done in patients who are of normal weight, but have excesses of fat in certain parts of the body. The most common areas for liposuctioning are the thighs, the abdomen, the flank areas ("love-handles"), the buttocks, the knees, the arms, the breasts, and the neck and jowl regions. It must be emphasized that liposuction is not a means for weight loss. It does not remove cellulite (the dimpling pattern sometimes seen within skin) or stretch marks.

Liposuction has a limited effect in tightening the skin regardless of whether it is ultrasonic, tumescent, or laser ("smart") liposuction. Since fat is actually a filler, the procedure is not typically recommended for patients who have loose skin, unless it is done in conjunction with a skin-tightening procedure.

Liposuction is a very popular procedure because of the significant changes in body contour that can be achieved. These contour changes are essentially permanent if the patient's weight remains stable.

Patient Examples

Click on any photo for larger version and more views of that patient.

Before Surgery Consultation

Dr. Neu will do a detailed review of the patient’s past health. He will need to determine whether there have been fluctuations in weight, and if the weight is now stable. Multiple areas can often be liposuctioned during one surgery.

Skin laxity requires a careful evaluation. For example, it is not uncommon for women after pregnancy to think that they would benefit from liposuctioning of the lower tummy region, when in fact they would be better cared for with a tummy tuck. A tummy tuck not only removes excess fat but also excess skin. Liposuctioning in this type of patient might still be advisable in the flank regions.

It is also helpful to realize how much fat can be removed. The only fat that is amenable to liposuctioning is the layer between the skin and muscle. This layer of fat is readily appreciated by pinching a roll of skin and fat, for example, in the tummy region. This “roll” consists of two layers of skin and fat. The skin is very thin. Most of what is felt is the two layers of fat. Therefore, if the "roll" is 6 cm thick, then one fat layer by itself will be approximately 3 cm. All layers of skin in the body require a couple of millimeters of underlying fat to look and feel normal. In the tummy region this should be at least 5 mm, so the most that can be thinned out in this example is 20 to 25 mm of fat. This is substantial and typically very gratifying to patients. It is, however, important to realize that heavy bone and muscle structures can contribute to a "heavy" look, and obviously cannot be reduced by liposuctioning.

The Surgery

Liposuction is typically a day surgery procedure. Depending on the amount of fat to be removed, it can be done under local or general anesthesia. While not a technically complex operation, the finesse comes in knowing how much to remove, and how to blend it into the surrounding tissues so that the effect of liposuction is imperceptible. Dr. Neu spares no effort in trying to achieve the most natural looking result.

The tissue that is being liposuctioned is first infiltrated with a tumescent solution that reduces bleeding and also postoperative discomfort. Small 3-4 mm cuts are made into the skin at discrete points to allow insertion of the thin cannulas. The volume of fat removed from each area is carefully measured to achieve the greatest symmetry.

Resumption of Activity

Depending on the amount of liposuction being done, most patients can return to sedentary activities in two to seven days, and can resume sports three weeks after surgery.