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What Happens During Liposuction? 

August 28, 2023

A Closer Look At The Surgical Body Contouring Process 

Liposuction techniques have improved dramatically since their inception in 1975. Better instrument designs, stronger suction, more targeted medication infiltration, and applied ultrasonic and laser technologies allow larger amounts of fat to be removed safely with less pain, bruising and recovery time.

This minimally invasive surgical procedure can target and isolate particular areas, making it the most requested body contouring solution. We wanted to pull back the curtain for a minute and show you what happens during liposuction — depending on the patient’s needs and our surgeons’ best recommendations. 

Note: This article showcases what happens in the operating room when liposuction is performed on its own, not when combined with another procedure like a Tummy Tuck or Breast Augmentation.

What Happens During Liposuction

Liposuction Is Performed On An Outpatient Basis

General anesthesia is used during large-volume liposuction or when multiple areas are being treated at once; local anesthesia with oral pain medication may be used when the area is small or isolated. Custom compression garments are fitted to your body before the patient leaves the operating room. This supportive clothing reduces swelling and helps the skin conform to the thinner underlying contour.

Choosing The Best Entry Point To Minimize Scarring 

Once the patient is properly sedated, several small (5mm or 1/4 inch), well-hidden incisions are used to access the underlying fat through the skin. Often a freckle or small skin fold is chosen to camouflage the scar. A thin tube or cannula is used to introduce the tumescent solution.

What Is Tumescent Fluid?

Tumescent fluid is a solution used during surgery to provide pain relief while also minimizing bleeding and bruising. The formula is most often comprised of lidocaine (numbing medication), IV fluid and adrenaline (epinephrine). 

Dr. Donaldson and Dr. Sieffert recommend tumescent for the most common fatty areas. This technique — sometimes referred to as super wet or suction-assisted liposuction (SAL) — is often considered the safest and most predictable because it does not entail destructive energy sources.

Dr. Donaldson performing a liposuction procedure

The Extraction Process Begins

Next, a series of Mercedes-tip lipo cannulas of varying caliber are used to dislodge fat and carry it away through a suction apparatus. Our expert surgeons use a controlled back-and-forth motion to steadily and evenly remove the unwanted fat from the target area. This technique is smooth and reliable, with no risk of burns or damage to the overlying skin. The entry incisions are closed with dissolvable sutures and surgical glue. 

This surgical method works especially well under the chin (wattle), behind the upper arms (bat wings), on the low abdomen and flanks (love handles), on the outer thighs (saddle bags), inner thighs and knees, and beneath the buttock creases (banana rolls).

VaserLipo: Ultrasound-Assisted Liposuction For More Strenuous Circumstances

With ultrasound-assisted liposuction (UAL), the surgeon uses high-frequency sound waves at the tip of the small cannulas to cavitate and emulsify the fat before removing it. This method generally makes it easier to release stubborn fat that would not respond to SAL alone; however, it carries a slightly higher risk that is unnecessary for the majority of cases.

Vaser UAL Is Usually Reserved For Tougher, More Fibrous Areas, Including:

Determining if ultrasound-assisted liposuction is right for a patient
  • Behind the neck
  • The back
  • Under the armpits
  • Upper abdomen and lower ribcage
  • Any areas where liposuction has been performed previously (creating underlying scar tissue)
  • Virtually anywhere on men including the chest (gynecomastia)

Liposculpture: Reshaping Body Contours With Existing Fat 

“Liposculpture” has taken the discipline of liposuction to another level with consideration of deeper and more superficial layers of fat and their removal and manipulation. Fat that is removed from one area may be injected or grafted into another area. Patients with a greater volume of fat can now undergo body contouring with greater precision and predictability as well.

“Focal” or “micro-liposuction” can help with even the most subtle and nuanced locations by using extremely small instruments and fine-motor surgical movements.

About The Author 

Jeffrey Donaldson, MD Author Bio

Jeffrey Donaldson, MD, is an esteemed plastic surgeon in Columbus, Ohio. Throughout his 18+ year tenure, he has performed countless successful liposuction procedures for satisfied patients.

Dr. Donaldson is constantly researching the newest techniques and variations of liposuction to best serve his patients along their self-confidence journeys and further educate individuals everywhere about the art of plastic surgery.