In liposuction the extra fat in the body, generally in hips, thighs, buttocks, abdomen, knees, chin, cheeks, neck and upper arm, are removed using a cannula and a suction device called aspirator. This method is used to remove the fat that would not respond to usual weight loss methods.

The ideal candidates for this surgery are people who have excess fat in some areas, but are in their ideal weight and have firm, elastic skin. The patient must be in good health condition. Some certain medical conditions would prevent such a surgery. The patient should know that liposuction would not replace dieting and exercise and be realistic about the outcome of the surgery.

Smoking has bad effects on blood circulation and can cause blood clots. It should be avoided for at least a month before surgery. Also, any anticoagulant medication should be stopped two weeks before the surgery because of its effect on blood clotting.

Depending on the amount of fat and the number of the areas for the surgery, the surgeon will use the proper method of anesthesia. If the amount of fat is low and there are only a couple of areas, a local or twilight anesthesia will be used and only those areas will only be numbed. In more extensive surgeries, general anesthesia will be used and the patient will be kept asleep during the surgery, supervised by an anesthesiologist.

There are several techniques used for liposuction. Usually a mixture of epinephrine, lidocaine and intravenous salt solutions is injected into the areas before the fat is removed. This solution is injected to remove the fat easily, reduce blood loss and provide anesthesia for surgery and after that. Epinephrine is for contracting blood vessels and lidocaine is a local anesthetic.

Here are some of the methods used in a liposuction cosmetic surgery:

1- In this one, the amount of fluid injected is three times the amount of the fat to be removed. Although the procedure takes about four to five hours, local anesthesia will be used.

2- In this technique, general anesthesia will be used and the surgery would take only one to two hours. The amount of injected fluid is as much as the fat to be removed.

3- In this technique a special cannula that produces ultrasound will be used. The energy of the ultrasound breaks the fat cell walls and causes the fat to liquefy. The fat will then be removed by a suction pump. Enlarged male breasts, upper back and other fibrous areas of the body are usually treated with this technique.

Usually a compression garment should be worn for a few weeks to prevent swelling. In the beginning some swelling, numbness and discomfort happen but will gradually subside. Antibiotics are used to prevent infection.

As with any surgery, there are complications. In liposuction these complications rarely happen. Sometimes infection at the punctured sites will happen and might delay healing. Numbness for the first few weeks is normal but it might get longer and occur with pigmentation. The skin at the site of the surgery might get hurt, and sometimes skin necrosis occurs. In that case the skin of the hurt area will fall and body would lose its immunity against infections at that area. Sometimes the skin looks irregular after the surgery, and in older patients it might become baggy. Excessive fluid loss will cause shock, and on the other hand if too much solution is injected into the body, especially in super wet technique, the amount of lidocaine might be too much for the patients system and lidocaine toxicity occurs. If fluid accumulates, it should be drained by the surgeon. Damage to the skin and nerves or friction burns might hurt some nerves. Some patients show poor reaction to anesthetics. If fat or blood clots form and migrate to lungs, death will occur.