Because not everyone benefits from the same type of surgery, and some people aren't good candidates at all, every liposuction procedure starts off with a consultation. The doctor will evaluate your health (both physical and psychological) and determine whether your skin elasticity and fat placement makes you a good candidate. Then he or she will help you decide which liposuction procedure is most appropriate for you.
Liposuction can be performed in a surgeon's office, an outpatient surgery center or in a hospital. Smaller liposuction procedures are usually performed on an outpatient basis, which tends to be less expensive.
Before the procedure, the doctor marks the skin to indicate from which area(s) the fat will be removed. Then, as with most types of surgery, liposuction requires anesthesia. But the type of anesthesia depends upon how much of the body is being worked on. For small areas, doctors can use local anesthesia (which numbs only the area involved). Usually, the doctor administers a sedative (either orally or via injection) along with the local anesthesia to relax the patient.
Alternately, the doctor may give the patient an epidural, which is given intravenously and blocks sensation to an entire part of the body (for example, from the waist down). General anesthesia may be used in a hospital setting when a large amount of fat is to be removed, but it is not recommended by the American Academy of Dermatology. With most liposuction procedures performed today, the doctor injects a local anesthesia as part of a fluid mixture.
During the surgery, the doctor makes a small incision (or several small incisions) and inserts the cannula into the fat layers of the targeted areas. The cannula moves rapidly back and forth to loosen fat cells, which are suctioned out -- typically using a vacuum device attached to the cannula -- and placed into a flask. The cannula creates tunnels in the fat layer that need to collapse in order to heal and create the new body shape. For this reason, the patient must wear a compression garment after surgery. Because fluid is also lost during the procedure, patients sometimes require intravenous fluids following the surgery.