“Mid-body” liposuction might be used in conjunction with an abdominoplasty

Translating from the Latin, this means “sucking out the fat, which gives the unfortunate impression that anyone can do it, and unfortunately some unskilled persons attempt it. It makes more sense to call the procedure lipoplasty for a degree of remodelling is usually required; there is more to it than merely sucking out the fat, the skill comes in knowing which fat, and how much.

In the live person, the fat is contained within a cell envelope (lipocytes) and is fluid; the procedure of liposuction removes the cells and the fat, so on a purely theoretical basis, the fat should not return if the cells have been removed.

The aspiration is performed through a metal tube (cannula) of a few mms diameter which is inserted through an incision no larger than needed, and moved moderately vigorously in the tissues to be removed. Fluid with local anesthetic and hemostatic epinephrine might be used as a preliminary to swell the tissues (tumescent lipoplasty) and the area might be warmed or energy otherwise applied to make the fat more fluid (laser, ultrasound, radio waves etc.). The aspiration is by a vacuum source attached to the cannula, or some surgeons use a syringe attached to it. There are power assisted cannulae with rotating tips to open the fatty tissues more effectively, with less physical effort, and perhaps more precisely.

The “mid body” is the waist region. Liposuction might be used here in conjunction with an abdominoplasty, or might be used as the sole procedure. This is one of the areas where fat is first laid down (“the waist thickens”) and one of the last to relinquish it, so that despite dieting or weight reduction there may still be substantial pads of fat obscuring the waist line.

The abdomen is appropriate for liposuction treatment if the excess fat is in rolls or pads; if it is diffuse then an abdominoplasty, (tummy tuck) will be required, although this might also be assisted, particularly laterally at the waist level by lipoplasty. The “pinch test” is a good guide – if a roll can be picked up with index and thumb, lipoplasty might be appropriate; if not, then not!

Subsequent to an extensive liposuction which creates cavities between skin and fascia, the patient may be advised to wear a compression garment for a few weeks.