Surgical Procedures and techniques

Liposuction is reserved for patients who are healthy and without significant illnesses. Although difficult to determine absolute contraindications, significant medical history should necessitate discussion with the patient's primary physician and/or anesthesiologist prior to approval of any procedure. The abdomen is the most common area of the body to be treated by liposuction among both men and women. Important factors that affect the success of abdominal liposuction include: the amount and location of abdominal fat, history of weight gain and weight loss, history of pregnancy, and the age and the sex of the patient. An extensive number of liposuction cannulas are available to the surgeon that can be used depending on the area, volume, and type of tissue to be treated. . Liposuction totally by Local Anesthesia performed by an expert is safer and usually associated with less pain overall than general anesthesia. On the other hand, for patients who are terrified by the prospect of needles and surgery, General Anesthesia might be more easily tolerated. Historically, 4 types of wetting solutions have been used for liposuction: Dry, Wet, Super wet, and Tumescent. The essential difference between these techniques focuses on the amount of infusate into the tissues and the resultant blood loss as a percentage of aspirated fluid. The Superwet Technique involves instillation of fluid with epinephrine in equal volume to the amount to be removed, eg, 1:1 ratio (supranatant fat and infranatant fluid) ultrasonic-assisted liposuction or UAL, is an advanced procedure used in removing body fats more efficiently and effectively. By using this tool to assist in breaking up the fat cells the surgeon can remove more fat, more easily. The most traditional liposuction treatment involves removal of the deeper layers of fat. However, superficial liposuction is performed in an attempt to improve skin contour in individuals with flaccid skin or cellulite in specific areas. These issues revolve around fluid delivery and lidocaine /epinephrine dosing. With large-volume liposuction, defined by the National Board of Cosmetic Surgeons is  5 L, significantly greater fluid shifts occur as a result of tumescent fluid infusion and fat removal.