About the procedure

Suction lipectomy (liposuction) surgery may be done using general anesthesia, local anesthesia (while you're awake), or a local anesthetic with sedation.

The operation involves removing excess fat tissue by inserting a narrow metal tube called a cannula through a small incision in the skin and applying suction. The tube has one or several openings close to the tip. By passing the instrument forward and backward as suction is applied, fat tissue is sheared off, and fat globules pass into the tube. During the procedure, intravenous fluids are given to replace body fluids that are lost.

The fat globules are removed similarly to a "tunneling" procedure, creating a "sponge-like" effect within the tissues. By forming numerous such interconnecting and closely related spaces within the tissue, this reduces the fullness, firmness and size of the area. Eventually, the treated area collapses or shrinks, with an accompanying change in the surface contour.

New modifications

  • The "syringe method": When the operation was first introduced, suction was obtained from a powerful vacuum machine. However, for the past few years, simply using a large syringe which is locked into the "open" position has resulted in less trauma to small blood vessels and better control of the amount removed.

  • The "tumescent technique": By injecting large quantities of a solution containing very diluted local anesthetic, adrenaline and salt water, bleeding is reduced, there is less bruising, and in some cases it is possible to do the surgery under local anesthesia.

  • Ultrasonic-assisted liposuction (UAL): UAL, as it is known, uses ultrasonic energy to liquefy the fat first, then gentle suction to remove the fat. The advantages are that it requires less effort for the surgeon: it is supposed to result in less bleeding, allowing the removal of larger quantities of fat; and more easily removes fat in areas where there is a lot of tough fibrous tissue, such as in male breast development and deep in the lower back of men. The technology is still evolving, but it appears to be a significant advance in terms of giving a better, smoother result in former "problem" areas.

  • Laser-assisted liposuction: This technique uses burst of laser to enter the fat tissues and to dissolve the fat, making it easier to remove. Some of the side effects include burns, bruising, swelling, bleeding, and numbness. Laser-assistant liposuction may be more appropriate in certain areas of the body, including male breasts, hips, and back. For a larger area of the body, laser-assisted liposuction may be more suitable as an adjunctive treatment to traditional liposuction.
Benjamin Gelfant, MD, 
with updates by the MediResource Clinical Team