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The amount of time needed to perform liposuction can vary substantially, depending on the volume of fat being removed, the number of body sites being treated, and the technique used. In general, liposuction takes from 1 to 4 hours.

After Surgery

To prevent fluid buildup, the surgical team will probably insert small drainage tubes under your skin. You may have to wear a tight-fitting elastic garment over the treated area for a few weeks to help minimize swelling. Pain, burning, bleeding, bruising, and temporary numbness are common. Your doctor will probably prescribe medication to help relieve any discomfort, along with antibiotics to prevent infection. Most people who have liposuction can go back to work a few days after the procedure. The stitches are removed or will dissolve on their own in 7 to 10 days.

How liposuction is performed

During a liposuction procedure, the surgeon makes a small incision and inserts a narrow tube called a cannula under the skin. He or she pushes and pulls the cannula back and forth through the underlying layer of fat and suctions the fat away with a vacuum pump or syringe. When one area is finished, the surgeon moves on to the next until all the specified areas are treated.

The risks of liposuction increase with the size and number of areas to be treated. Although complications are rare, they can include infection or the formation of clots of fat or blood that can travel to the lungs and cause sudden death. Other risks include excessive fluid loss that can lead to shock (see page 579), fluid accumulation in the lungs, burns or other damage to the skin or nerves, and injury to a vital organ. As with all cosmetic surgery, there may be imperfections in your final appearance, including baggy skin or an asymmetrical body contour. After the swelling goes down, you will begin to see the improvement in your body shape in 4 to 6 weeks.

Abdominoplasty

Abdominoplasty (also known as a tummy tuck) is a cosmetic procedure that removes excess skin and fat from the abdominal area and tightens the muscles in the abdominal wall to flatten a protruding abdomen. The procedure can also remove existing scars and stretch marks. Abdominoplasty is considered major surgery and leaves a permanent scar that can extend from hip to hip.

Cosmetic surgeons perform more than 50,000 abdominoplasties in the United States each year. The best candidates for the procedure are people who are generally healthy but who have a large amount of abdominal fat or loose abdominal skin that they cannot eliminate with dieting or exercise. The surgery may be especially beneficial to women whose abdominal muscles and skin have become stretched from multiple pregnancies. Older people whose skin has lost some elasticity may choose to have abdominoplasty to improve the contour of their abdomen.

People who have only a small amount of excess fat mainly below the navel may qualify for a partial abdominoplasty, in which a wedge of skin and fat is removed from the lower abdomen, leaving a smaller horizontal scar above the pubic hair. The abdominal muscles still can be tightened and liposuction (see page 1093) can be performed above the navel or around the waist to treat problem areas.

If you intend to lose a substantial amount of weight or if you plan to become pregnant, you should delay having abdominoplasty. Your abdominal muscles will stretch during pregnancy and undo the muscle tightening that is part of the procedure.

The Procedure

Many surgeons perform both types of abdominoplasty in outpatient facilities, but some prefer to do them in a hospital. Some surgeons prefer to use general anesthesia; others choose a local anesthetic combined with sedation. A full abdominoplasty takes 2 to 5 hours; a partial procedure can be done in 1 to 2 hours.

To begin the procedure, the surgeon makes a long, semicircular incision across the pubic area from one hip to the other. In a full abdominoplasty, he or she makes a second incision around the navel to free it from the adjoining tissue.