What should I expect with my liposuction surgery?

In contrast to common beliefs, liposuction is not a weight reduction method; liposuction is in actuality a body sculpting procedure.  It is best for people with relatively stable weight and localized areas of the body that tend to retain extra fat.  For women these areas tend to be the outer thighs, the top of the hips, flanks, abdomen, inner thighs, and inner knees.  In men, it is usually the love handles, flanks, abdomen, and breasts.  The lower face and neck of both men and women benefit greatly from liposuction.

What type of anesthesia is used?

General Plastic Surgeons are accustom to operating on their patients under general anesthesia.  Although under general anesthesia there is no pain awareness by the patient, local anesthesia provides more natural results and faster-healing.  Under general anesthesia, the surgeon can perform liposuction using oversized cannulas very quickly.  An abdominal and flank liposuction that requires 4 hours in the office under local anesthesia may take as little as 45 minutes to perform under general anesthesia.  However, the consequences of this speed include trauma to the muscles just under the fat ― this translates into a prolonged recovery period.

Tumescent liposuction, performed under local anesthesia, uses tiny cannulas that are used are no wider than 2 mm.  Some are only the size of the needles used to deliver the dilute local anesthetic.  Because the patient is awake for the procedure and only the fat to be removed is numb, the patient can report discomfort if the cannula approaches the underlying muscle. This prevents the muscles from being traumatized by surgery.

Typical recovery course and physical restrictions

Under general anesthesia, liposuction with a large cannula can take 6 to 8 weeks before you feel normal.  In contrast, the same liposuction performed under dilute tumescent local anesthesia is associated with almost no blood loss.  Recovery is very rapid compared to the same procedure performed under general anesthesia..

It is common to experience a lumpy firmness after liposuction due to the inflammation caused by the surgery in the fatty areas. This inflammation gradually subsides in 4 to 6 weeks, as the body begins to heal from the surgery.  Due to long term remodeling of the fat, the body continues to improve over a period of 4 to 6 months.  It is common to experience soreness and bruising after the procedure. Generally most people take two or three days off from work and many return some form of exercise in two days.

Compression garments are provide with the procedures and are used for 5 to 6 days. Compare this with other liposuction techniques were compression garments need to be worn for 6 to 8 weeks.

Common complications after surgery

Liposuction with a large cannula can cause a significant amount of blood loss compared to liposuction with the 2 mm cannula.  Blood loss can become so severe that sometimes  a blood transfusion becomes necessary.  Deaths have occurred in association with both tumescent liposuction as well as liposuction under general anesthesia.  Currently it is thought that the rate of death associated with liposuction under general anesthesia is some where between one in 5,000 cases and one in 40,000 depending on the study.  Liposuction under pure tumescent anesthesia is associated with a much lower death rate that is estimated to be approprimately one in 40,000 cases to less than one in 300,000 cased depending on the study.

The time frame before full recovery

The compression garment that is worn for 6 weeks after liposuction under general anesthesia is only needed for 5 or 6 days after tumescent liposuction.  The downside is that tumescent liposuction takes significantly longer for the surgeon to perform and the surgeon needs to be prepared to talk with their patient during surgery.  This means more contact time with the surgeon and ultimately a more expensive procedure. However, the increased safety and rapidity of recovery makes this a very easy choice.

About Dr. Steinsapir

Dr. Steinsapir is an expert cosmetic surgeon who has skillfully performs liposuction procedures in Los Angeles with 20 years of experience.  He only performs tumescent liposuction under local anesthesia because of its superior results and fast, comfortable recovery time.  He is a board certified in ophthalmology and fellowship trained in oculoplastic surgery and cosmetic surgery in Southern California where he specializes in balanced cosmetic surgery for natural results, with an emphasis on minimally invasive techniques, fast recovery time, and leadership in medical technology.  Dr. Steinsapir has a private practice and also serves as an Associate Clinical Professor of Ophthalmology at the Jules Stein Eye Institute, at the David Geffen School of Medicine at UCLA. Contact us today to schedule a personal consultation with Dr. Steinsapir to learn if liposuction is right for you.

Services described may be “off-label” and lack FDA approval. This article is informational and does not constitute an advertisement for off-label treatment. No services should be provided without a good faith examination by a licensed physician and an informed consent with a discussion of risks, benefits, alternatives, and the likelihood of treatment success.  Only you and your treating physician or surgeon can determine if a treatment is right for you.

FDA Warnings Against Lipodissolve False Advertising

If you are considering getting lipodissolve, also called mesotherapy and liposhape, please first consider the recent FDA warnings issued against this untested, unproven procedure.  In April, 2010—shortly after our article warning readers that lipodissolve has not been proven safe—the FDA contacted six different medical spas in the US to warn them not to make misleading claims about lipodissolve.  Lipodissolve and the other catchy names it goes by are becoming popular trends in some circles, but the procedure raises ethical questions against those who persist on providing it despite lack of medical support.

Liposuction Before and After Photo

Liposuction Before and After Photo

What is Lipodissolve?

Lipodissolve and its many other titles involves injecting chemicals into locations where one hopes to lessen the amount of fat present.  There are many chemicals and combinations of chemicals that may be injected into the body, and the most common two are phosphatidylocholine and deoxycholate.  The medical spas and even some physicians who advertise this procedure call it safe and effective; some even claim it is better than liposuction.  This is dishonest at best, because lipodissolve has not been demonstrated to be safe or effective.  Because there is not enough scientific basis to medically sanction this procedure for human use, it is not FDA-approved.  Furthermore, the reported complications make it unlikely that the FDA will approve it anytime soon, and they probably won’t ever.

What Are the Risks of Lipodissolve?

With such little scientific knowledge about lipodissolve, we cannot quantify the risks of lipodissolve, but those receiving it have experienced complications such as scarring, skin irregularities, blood vessel damage, and subcutaneous nodules that cause pain.  Perhaps even more dangerous than these reports is the fact that those who insist on offering lipodissolve may have little respect for other scientific and medical safety conventions.

Without a broad and precise understanding of the exact risks and effects of lipodissolve, it is virtually impossible to administer the treatment using the amount of control needed to deliver the best results, and it is also difficult to know the best way to treat complications. Science is not on the side of lipodissolve injectors, so the best a practitioner of lipodissolve can do is guesswork.

What Warnings Did the FDA Give?

In April we saw that the FDA gave warnings to the following spas:

•    Monarch Medspa in King of Prussia, Pennsylvania
•    Spa 35 in Boise, Idaho
•   Medical Cosmetic Enhancements in Chevy Chase, Maryland
•    Innovative Directions in Health in Edina, Minnesota
•    PURE Med Spa in Boca Raton, Florida
•    All About You Med Spa in Madison, Ind.

A Brazillian company also received warning letters because of its marketing tactics online:

•    www.zipmed.net
•    www.mesoone.com

The FDA takes false advertising seriously, as it should, because misleading the public about their health is a serious and dangerous offense.  In these cases, spas and websites were reprimanded for making unsupported claims.  Take, for example, the letter that went to All About You Med Spa that included this statement: “The claims made for your lipodissolve products are false and misleading in that they are not supported by substantial evidence or substantial clinical experience.”  The FDA further instructed the above businesses to cease their unproven and misleading claims, and to notify the FDA within 15 work days of how they are correcting their violations.

What Are the Alternatives to Lipodissolve?

Lipodissolve has been touted as a safe and nonsurgical alternative to liposuction, but the truth is that liposuction is the safe, proven, and effective alternative to lipodissolve.  Liposuction has an established and respected reputation for a reason; as a body-sculpting technique, it improves the distribution of fat across your body, and it has been tested, studied, practiced, evaluated, and demonstrated to be a very valuable and effective treatment.

There has been much misinformation about liposuction safety, which has likely driven many to seek new fads like lipodissolve.  But when we look at the facts, we find that tumescent liposuction is a reliable and safe procedure associated with swift recovery time.  This type of liposuction is performed under local anesthesia, which is not only easier on the body, but also enables the doctor and patient to communicate with each other and ensure that the muscles beneath the fat are not damaged or are only slightly, and there is almost no blood loss.

The bottom line is that a few media reports that have spread like a child’s game of telephone have scared many people away from a safe procedure and toward one that is potentially dangerous.  In this case, it is essential that you seek reliable medical advice from a qualified doctor who respects medical safety practices and FDA advice.

Liposuction Can Achieve Your Desired Contour

If you have a stable weight with a few stubborn problem areas that dieting and exercise have not improved, you may be a good candidate for liposuction in Los Angeles.  Liposuction is not a weight-reduction method, but a proven way to shape and contour the body and correct those bulges that just won’t go away, making the fat distributed across the body in a more attractive way.

As a specialist in tumescent liposuction, Dr. Steinsapir does not perform liposuction under general anesthesia because tumescent liposuction has been proven even safer.  He is a highly trained oculofacial plastic surgeon and cosmetic surgeon with multiple fellowships, and he currently practices in both Beverly Hills and at UCLA where he works as an assistant clinical professor at one of the most respected medical hospitals in the world.  Dr. Steinsapir always approaches you as an individual, taking the time to listen to your concerns, needs, and goals, while medically evaluating your situation to find the least invasive solution and custom-plan your treatment.  Please contact us today to learn about how a no-risk, no-commitment personal consultation with Dr. Steinsapir can help you understand the best scientifically based solution for you.