Liposuction is the most commonly performed cosmetic procedure in the Western world, including United States. It is also referred to as liposculpture, lipoplasty, and suction-assisted lipectomy. The ideal candidate for liposuction is physically fit and eats well-balanced meals but is unable to reduce a fatty deposit that is well localized and often seems to involve a genetic susceptibility. Significant disease conditions (e.g. diabetes, infections, heart or circulation problems) weigh against the eligibility of a person for the procedure.

Liposuction is a method of choice for reduction of the fat cell number and thereby, the resistant fat. Liposuction removes the resistant fat by two mechanisms:

1. Removal of fat cells during suction.
2. Damaging the fat cells by the to-and-fro motion of the cannula. These remaining damaged fat cells get absorbed slowly over the period of time, generally in 6–12 weeks and hence, the final result after liposuction is more pronounced after 6–12 weeks, a fact which needs to be emphasised during counselling.

Several factors limit the amount of fat that can be removed safely in one session without adverse effects. Ultimately, the operating physician and the patient make the decision. Over fat removal during liposuction can result in unusual “lumpiness” and “dents in the skin”. The more fat removal also increases surgical risks associated to the procedure.

The basic challenges of liposuction procedure are:

• To suck out the right amount of fat.
• To cause the least disturbance to the neighboring tissue, such as blood vessels and connective tissue.
• To leave the person’s fluid balance undisturbed.
• To cause the least discomfort to the patient.

In “Tumescent Liposuction” a large volume of very dilute lidocaine (local anesthetic) and epinephrine (capillary constrictor) is injected into subcutaneous fat, and the targeted tissue becomes swollen and firm, or tumescent.

The tumescent liposuction technique is a method that provides local anesthesia to large volumes of subcutaneous fat and thus permits liposuction totally by local anesthesia.

The tumescent liposuction technique eliminates both the need for general anesthesia and need for IV narcotics and sedatives.

Tumescent liposuction is less painful and more pleasant than liposuction under general anesthesia or IV sedation. With tumescent local anesthesia, patients are able to avoid the post-operative nausea and vomiting associated with general anesthesia.

Tumescent anesthesia is so efficient at providing fluid to the body that the need to use IV fluids is totally eliminated.

Before receiving liposuction procedures, no anticoagulants should be taken for two weeks before the surgery.

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