According to the American Society for Aesthetic Plastic Surgery, liposuction is now the most popular form of cosmetic surgery in the U.S. Almost 4000,000 people undergo the procedure every year, with the percentage of men increasing considerably.

How Does it Work?

The doctor removes fat from under the skin using one of two available techniques.

1. Tumescent Technique – A saline solution is injected through slit incision in the skin, and then allowed to diffuse (percolate) through the fatty tissue. Best for in-office surgery, since agents in the solution reduce bleeding. This technique is the safest and it allows for a faster recovery, but it’s also the most expensive. Percolating can take up to 60 minutes, which means an extra hour of operating-room costs.

2. Ultrasound-assisted Lipoplasty (UAL): An ultrasonic vibrating probe “liquefies” the fat before it is suctioned. It can be done externally, through a hand-held device applied to the skin, or internally, through a vibrating canule. UAL is the preferred method in clinics.

Where?

Liposuction can be performed on almost any part of the body where an accumulation of fat is present: the hips, thighs, calves, buttocks, abdomen, back, neck, or face. Extensive procedures can deal with more than one site at once.

What to Expect

A procedure using the Tumescent Technique averages two hours, although longer is possible. UAL procedures can take about 30 percent longer.

Usually only local anesthesia is used; general may be necessary in some cases.

Ninety percent of cases are performed as outpatient surgery.

Recovery time can be up to two weeks, depending on the area and how extensive the procedure was. Expect a rather high discomfort level, bloating, and bruising.

Costs

$3,000 to $10,000 depending on size of area.

Liposuction is considered cosmetic surgery and is not covered by insurance.

Who’s a Good Candidate?

Somebody who can afford it. Obviously, you should be able to pay for the surgery itself, but also have the resources should anything go wrong or should you need touch-ups.

Somebody who wants to get rid of stubborn fat deposits that have not responded well to diet and exercise. Good examples are upper thighs in women and "love handles" in men.  

Who Isn’t?

People more than 20 percent over their ideal body weight. Liposuction should not be considered a weight-loss technique.

Patients with any type of disease that affects wound healing, with a history of bleeding, or taking any medication that interferes with blood clotting.

Patients over 40, unless their skin elasticity is excellent.

What Happens After?

Normal: Bruising, swelling, soreness, pain and discomfort. The level depends on the area and the extent of the procedure. Note that the swelling may last up to six months and make results less apparent.

Abnormal (but possible): Asymmetry. Baggy or rippling skin. Excessive fluid loss. Scars at the site of the incisions. Infection. In some cases, touch-ups may be necessary.

Most patients need to wear a tight, restrictive outer garment (similar to a girdle) to help with skin reshaping, and to lessen swelling.

After one or two days of bed rest, most people are able to start moving and doing light activities. Strenuous activities should be restricted for at least two weeks, after which they can be introduced back one at a time. Complete recovery can take up to six months.

Where to Go?

There is no standardized training required to perform liposuction, which means any licensed physician can do it. It is recommended, however, that you choose a plastic surgeon or a dermatologist, or consult with a clinic that specializes in different types of plastic surgery.