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Liposuction is the reduction of fat below the skin. It involves a tube that reduces tunnels of fat without damaging blood vessels or needing skin removed. It can be combined with skin removal procedures such as abdominoplasty or other lifts or is done alone. To be done alone, the skin must be of good quality and not have much laxity.
There are several methods of liposuction. Tumescent involves infiltrating fluid with lidocaine and epinephrine which reduces blood loss. It is the standard at this time. Laser liposuction and ultrasonic liposuction are also promoted but have not been shown in studies to be safer or better results. First generation machines that either freeze or melt the fat are now available but the average reduction is small and still costly. Liposuction still remains the best alternative for most patients.
Liposuction, except in rare cases, is limited to about 5 liters of fat at one operation. It is not a weight loss operation, and can only be used for external fat beneath the skin. It cannot be used for deep belly fat.
Liposuction best treats stubborn bulges such as the outer thighs. Other common areas include love handles or flanks, abdomen, inner thighs, and knees. Other areas include the neck in younger patients, arms, and the upper back. Any area treated has to have good skin elasticity, otherwise the skin will not contract and hang as loose skin. When loose skin exists, other procedures are necessary such as a tummy tuck, or neck lift.
The risks include dimpling, dents, and loose skin. The procedure does not buff or smooth the skin.