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    Liposuction is currently the most commonly performed cosmetic surgery in the United States. The term liposuction or liposuction surgery refers to the removal of fat with a slender hollow instrument called a cannula.  The cannula looks like a long metal straw. This tubular instrument is inserted through very small incisions and attached to a suction machine to literally suck out the unwanted fat. Over the past several years there have been many improvements and advances in liposuction surgery. These advances have greatly increased the safety and improved the results of liposuction surgery. The most common areas sculpted with liposuction are the thighs, hips, abdomen and neck. In the Las Vegas area, the most common area requested for liposuction (liposculpture,) is the flanks, commonly known as “love handles.” However, almost any area of the body with excessive fat can be liposuctioned.

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    BENEFITS OF LIPOSUCTION SURGERY

    Many patients have areas or pockets of fat that are resistant to diet and exercise. In women these areas are most commonly hips/flanks, thighs, upper arms and abdomen. In men they are usually the abdomen, neck and flanks (“love handles”). These resistant and troublesome areas of fat are often due to hormonal and/or genetic influences, especially in women. Women may find that they have “saddlebags’ just like their mother did. In patients with problems like these, liposuction may be the best solution. In selected patients, we may be able to accomplish more with liposuction in one day then they have been able to accomplish with years of diet and exercise.

    WHAT IS LIPOSCULPTURE (BODY CONTOURING) SURGERY?

    Liposculpture is the process whereby liposuction is used not only to remove fat but to sculpture the shape of the body. For example, in a woman with a straight waist and no curves, when liposuction is used to create a more curvy figure, this would be a form of liposculpture or body contouring surgery. Dr. Lane Smith’s artistic abilities make him extremely proficient at body contouring surgery (liposculpture.) Sometimes when performing body contouring surgery (liposculpture,) is necessary to leave some fat behind to get a better appearance and a better shape.

    CAN THE FAT GROW BACK AFTER LIPOSUCTION OR LIPOSCULPTURE? 

    One question Dr. Smith is frequently asked is whether or not the fat cells can grow back after liposuction.  Fortunately the answer to this is no. Once a person is fully-grown they do not add or subtract fat cells unless they become massively obese. Hence the number of fat cells a person has is fairly constant after reaching adulthood. The fat cells act like little balloons, in that they can greatly expand when weight is gained, and they deflate as weight is lost. Once we have removed fat cells; the area from which we have removed them will forever be more resistant to weight gain. This is a great benefit of liposuction. However; a patient can still gain weight from the fat cells that remain and generalized weight gain can occur, but the problems areas from which Dr. Smith liposuctioned the fat should no longer be problem areas unless the patient gains a large amount of weight.

    WHAT LIPOSUCTION SURGERY CAN AND CANNOT ACCOMPLISH

    Liposuction is ideal for contour problems and areas which are resistant to weight loss such as the thighs, knees, hips, love handles (flanks,)  neck or upper arms. The ideal candidate for liposuction is someone who is thin, average or slightly heavy who has problem areas such as prominent “love handles,” “Saddlebags,” or “turkey neck” etc.

    Liposuction is not useful for generalized weight loss or obesity. Liposuction cannot make a fat person thin. At most we are able to suction a little more than a gallon (five liters) of fat at one time. If you are very overweight and see liposuction as a cure for your obesity, then liposuction is not for you. It is possible to do serial liposuction, which can have impressive results. Serial liposuction is the process whereby we suction a gallon of fat and then wait three months and suction another gallon and then wait three months and then suction another gallon etc. By this method we can actually remove very large amounts of fat, however it requires multiple surgeries and is quite expensive and there is a strong risk of loose or hanging skin when this is done. In general, unless you are willing to undergo serial liposuction, it is best to think of liposuction surgery as a being useful for contour problems and areas that are resistant to diet and exercise.

    Liposuction (liposculpture,)  will not remove stretch marks or loose skin such as occurs after pregnancy. In fact, liposuction will make an area of loose skin and stretch marks worse. If you are concerned about stretch marks or loose skin, see the section on abdominoplasty in this website. Also liposuction or body contouring cannot remove cellulite. It may improve cellulite in some cases, but it is extremely rare to completely get rid of all cellulite.

    The nature of a patient’s skin tone plays an important role in liposuction. Skin tone is mostly affected by age, but also by such things as sun exposure, large fluctuations in weight, genetics, cigarette smoking and excessive alcohol intake. Once the bulges have been removed and a new thinner contour is achieved, the excessive skin must shrink to fit the smaller area. Skin that lacks elasticity will sag and form irregular contours that are difficult to correct. If we feel a patient lacks good skin tone, we may recommend a different procedure, such as a tummy tuck or thigh lift. Also, the amount of skin shrinkage after liposuction may limit how much fat Dr. Smith is willing to liposuction during surgery. Dr. Smith will have to remove less fat if he thinks that the skin will not adequately shrink. In other words, poor skin tone may limit the amount of liposuction that can be performed.

    HOW LIPOSUCTION (BODY CONTOURING) SURGERY IS PERFORMED

    Most liposuction procedures are performed safely and comfortably under general anesthesia. However; any area of the body can be liposuctioned under local anesthesia with the patient awake if he or she desires. When multiple areas are being liposuctioned, then it is best to do the procedure under general anesthesia. When just one or two areas are being liposuctioned, local anesthesia can be used. Liposuction is performed by making a very small poke hole or incision usually about 1/5 of an inch in size. When these incisions heal they are usually small enough not to be noticed. Next we typically Next we typically infiltrate the area to be liposuctioned with a special I.V. fluid. This means we pump fluid into the area that we are going to work on. This is called the tumescent technique. The tumescent technique is felt to be the safest technique for liposuction. Infiltrating with fluid allows the fat cells to be suctioned out with less trauma, less bruising and less postoperative discomfort.  After the infiltration, a small hollow metal tube called a cannula is inserted through the small poke hole. The cannula is attached to a special suction. At this point we literally suction out the fat and contour the area. The fat and some of the fluid is suctioned out. Some of the infiltrated fluid remains after liposuction and is absorbed and excreted by the body. Some of fluid will drain out of the small poke holes. This usually stops after 24 to 28 hours.  This can be quite alarming to the patient if they are not aware of this. The drainage will be slightly pink in color and is mostly water, not blood. It is not dangerous. After liposuction surgery (liposculpture), the patient is usually placed in a compression garment. Depending on the area that was liposuctioned, the compression garment is similar to a girdle or tight nylons. The compression garment helps the skin contract and prevents waviness after liposuction.

    WHAT TO EXPECT IN TERMS OF PAIN, RECOVERY AND HEALING AFTER LIPOSUCTION

    Liposuction is one of the easier surgeries to recover from. After liposuction surgery you should be able to be up and around that same day. Typically, if this surgery is done on a Wednesday or Thursday you can return to work on Monday. However, like all surgeries, there will be some bruising, pain and discomfort. The bruising may persist for 7 to 14 days, rarely longer. The bruising and discomfort are made less by using the tumescent technique (see above). Some of the tumescent fluid will leak out of the incisions for the first 24 to 48 hours.  Often the drainage can be fairly significant, but it is normal after liposuction surgery. The drainage is usually a pink color because it is mostly water with a small amount of blood. Because of the drainage, it is important to wear old clothes that can be stained and not to sleep on your best sheets during the first couple of days after your liposuction surgery. After liposuction Dr. Smith’s staff will put you in a compression garment. This is similar to spanx or tight biker shorts. Typically we want you to wear this day and night for at least 2 to 4 weeks after liposuction. The garment helps the skin to tighten and keeps the liposuctioned area smooth. The garment can removed for short periods of time, such as to shower. Most patients can return to full exercise 2 weeks after liposuction surgery.

    Laser (Smart) Liposuction

    Laser liposuction (Smart Lipo) is the newest and most advanced type of liposuction. This type of liposuction is often called “smart lipo” due to the name of the specialized laser liposuction machine that is used to perform laser liposuction. This machine actually combines two lasers for maximum effect. There are several advantages to laser liposuction over conventional or tumescent liposuction. Laser liposuction (smart lipo) involves using a special laser to destroy the fat cells which are then suctioned out with a metal cannula similar to regular liposuction. Laser liposuction is done by inserting a thin laser fiber through small poke holes. The laser is turned on and produces a beam of light which is very hot. The heat from the laser beam destroys the fat cells. After lasering the fat cells, a regular metal liposuction cannula is inserted through the same poke hole and the damaged fat cells are suctioned out.

    WHAT ARE THE ADVANTAGES OF LASER LIPOSUCTION (SMART LIPO) OVER REGULAR LIPOSUCTION

    The laser liposuction surgery offers three possible advantages over conventional liposuction surgery. First the heat from the laser may help tighten the skin. The second advantage is that laser liposuction is less painful during the actual procedure. When a patient is under general anesthesia this does not matter, but if a patient wants to do the procedure under local anesthesia, it is easier to do it with the laser liposuction. Another advantage is that the laser is able to laser even the very fibrous fat that is found in gynecomastia (male breast tissue) or found in calves.

    WHAT ARE THE DISADVANTAGES OF LASER LIPOSUCTION

    A disadvantage to the laser is that there is a small risk of burns with the laser and this risk is not present with standard liposuction. Also it takes longer to perform laser liposuction so there is more cost to the procedure.

    LASER LIPOSICUTION WORKS MUCH BETTER THAN OTHER FORMS OF LIPOSUCTION SURGERY FOR THE CALVES, GYNECOMASTIA AND THE SUBMENTAL (NECK) AREA

    Smart Lipo or Laser liposuction surgery works much better than conventional or tumescent liposuction surgery in certain areas of the body. The calves are very difficult to contour with tumescent liposuction due to the fact that the fat in the calves is very fibrous. Conventional liposuction cannot penetrate and suction out the fibrous tissue located in the calves. Fortunately, the laser is able to blast through the fibrous fat and destroy the fat cells in the calves. For this reason, laser liposuction surgery is much better for the calves than tumescent or conventional liposuction. The laser also works much better for gynecomastia (male breast tissue). This is also because the fat in male breast tissue is very fibrous. Once again, because of the fibrous nature of gynecomastia, laser liposuction works much better than conventional liposuction surgery. Laser Liposuction  also works particularly well for the submental or neck area. This is because the skin in the neck area tightens better with the laser and because the laser is able to sculpt the neck better.

    WHAT IS THE RECOVERY LIKE AFTER LASER LIPOSUCTION

    Recovery after laser liposuction is similar to conventional liposuction. Laser liposuction one of the easier surgeries to recover from. After laser liposuction surgery you should be able to be up and around that same day. Patients who have laser liposuction on a Wednesday or Thursday can usually return to work on Monday.   However, like all surgeries, there will be some bruising, pain and discomfort. Usually there is very little bruising. But when there is bruising it can persist for 7 to 14 days. Just as with conventional liposuction, after laser liposuction, Dr. Smith’s staff will put you in a compression garment. This is similar to Spanx or tight biker shorts. Typically we want you to wear this day and night for at least 2 to 4 weeks after liposuction. The garment helps the skin to tighten and keeps the liposuctioned area smooth. The garment can removed for short periods of time, such as to shower. Most patients can return to full exercise 2 weeks after Laser liposuction surgery.

    Scheduling an Appointment for a Lipo or Smart Liposuction Consultation

    Only a few plastic surgeons in the Las Vegas and Henderson area have the Smart Lipo Machine and can perform laser liposuction. Dr. Smith, a board-certified surgeon, has been using the laser liposuction for almost four years and is very experienced with this technique. The results of any type of plastic surgical procedure depend a lot on the surgeon. It is nice to know that Las Vegas has one of the best plastic surgeons in the country. People come from all over Las Vegas, Henderson, Nevada, Utah, California and the world to have Dr. Lane Smith perform surgery on them. If you are wondering if you are a candidate for laser liposuction surgery, it is best to make an appointment with Dr. Smith. Appointments can be made by calling the Smith Plastic Surgery Institute at 702-838-2455 or by contacting us on the web at info@smithsurgery.com. For patients that live a long distance from the Las Vegas and Henderson area, phone consultations or email consultations are available.