If you have areas of stubborn body fat that just won't budge, no matter how much time you spend in the gym, take heart. Liposuction, popularly known as lipo, is a simple, yet very effective form of cosmetic plastic surgery.

Liposuction:

• Can be done right in the doctor's office
• Involves minimal downtime and scarring
• Gives immediate, dramatic results

According to the American Society for Aesthetic Plastic Surgery, liposuction is the most popular cosmetic surgical procedure in the U.S., with 403,684 procedures performed on women and men in 2006.

The photos below show an actual patient who had liposuction by Dr. Sterry.

For more examples, visit our photo gallery

Which areas can liposuction treat?

Liposuction can treat localized fat deposits in virtually any part of the body, including:

• Abdomen
• Buttocks
• “Bra bulge” in the mid-back
• Upper arms
• Inner and outer thighs
• Buttocks
• Breasts (in men and women)
• Neck and under the chin
• Upper chest near the armpit
• Upper and lower back
• Calves and ankles
• Knees
• Back of thighs above the knees

What is liposuction?

“Liposuction, also called lipoplasty or suction lipectomy, is a minimally invasive plastic surgery procedure that sculpts the body by suctioning away unwanted fat deposits.”

How does liposuction work?

“Basically, liposuction is done by making tiny incisions—only 1/8 to 1/2-inch each—in the skin and inserting a hollow, blunt rod called a cannula so the tip penetrates the underlying fat. The cannula is attached to a flexible plastic tube connected to a high-powered vacuum machine. I then use the cannula to suction away excess fat.”

Who are the best candidates for liposuction?

“Liposuction works best for someone who is reasonably fit, but has an area that just doesn't respond to diet and exercise. Many normal-weight people have stubborn deposits of body fat.

“Some women complain, ‘If I lose weight, my saddlebags stay, but my breasts get smaller.’ Men tend to have problems in the flank area—the ‘spare-tire syndrome.’

“There's something about these areas—a genetic preference for the body to put fat there. So when we suck out that fat and get those fat cells out of the area, when you gain or lose weight, you do it more evenly—it's more equally distributed throughout your body.”

Are people simply programmed to carry fat in certain places?

“I'm a strong believer in ‘genetic fat’ or ‘diet-resistant fat,’ whatever you want to call it. It really does exist. I have weight-loss patients who have lost 100, 150, even 250 pounds. Of course, I evaluate them and take photographs.

“Their faces are drawn-out; they have ‘turkey necks’ hanging. Their breasts are empty sacks of skin. If you look at their lab values, they're on the verge of malnutrition. They have to take vitamin supplements every day and they're constantly trying to get enough protein into their body.

“But when I examine them, I find that their hips and buttocks are still tremendous, despite their weight loss. You can't convince me that there's not something about our genes that makes us put fat there, because God does not want you to let go of that.

“So now you extrapolate that to normal-weight people, and it's no surprise that many women can't get rid of their saddlebag hips without liposuction. We all know people like that—they're pear-shaped for whatever reason.”

How has liposuction evolved over the years?

“Today we have much smaller, narrower cannulas than ever before. Even though these smaller cannulas make liposuction take a little bit longer, we find that we get smoother, more consistent results.

“And we don't suction nearly as much fat as we used to. We've learned over the years that it can be dangerous to remove too much fat.”

Which liposuction technique do you prefer and why?

“I perform tumescent liposuction—a classic, tried-and-true method that works very well. First, I inject a saline, or saltwater-based, solution directly into the fatty tissue. The solution contains a local anesthetic, Lidocaine, as well as ephinephrine or adrenaline.

“The adrenaline constricts the blood vessels so you don't bleed as much during the procedure—and don't bruise as much afterwards.

“After I inject the solution, I wait 15 or 20 minutes—I will not start at 14 minutes—because I'm waiting for that adrenaline to kick in. Anyone who has done a lot of liposuction has learned that you'll save a lot more time if you just wait a couple of minutes.

“The advantage of the local anesthetic is that patients who undergo tumescent liposuction need no general anesthesia; many get up and walk out of the office without assistance.”

How much fat can you remove during liposuction?

“I will remove up to five liters of fat in one session, but never more than that. I typically remove 2,000 to 3,000 cc's—which is 2-3 liters.”

Can liposuction help you lose weight?

“No. It's important to realize that liposuction is not intended as a weight-loss technique. It's for spot reduction; it's to help you improve your shape. You'd be surprised at how much that fat doesn't weigh.

“It always amazes me. I remove volumes of fat during liposuction, and it really doesn't weigh very much. But if I gain 10 pounds, it's enormous.

“You've probably heard that 10 pounds of fat takes up a lot more volume than 10 pounds of muscle. It's true.”

Is liposuction a good method to trim women's tummies after pregnancy?

“That's something that needs to be evaluated on an individual basis. Some women, even when they manage to lose the weight they gained during pregnancy, tend to have a different shape—particularly in the flank area. A little suctioning right there certainly helps them out quite a bit.

“But as for suctioning the abdomen itself, it depends. Sometimes when women are left with a lot of loose abdominal skin, they don't need liposuction—they need a tummy tuck.”

Would you ever combine liposuction with a tummy tuck?

“People have read on the Internet that you can't do both. It depends. I can certainly do liposuction on the flanks and do a tummy tuck at the same time. I can suction the hips and do a tummy tuck at the same time, and nobody would ever care.

“The question that arises is, ‘Can you suction the abdomen if you're doing an abdominoplasty?’ That is a little bit more tricky. I will do it, but only if I have done my tummy tuck in a specific way. I try to leave a lot more blood vessels intact; then I have a lot more faith that liposuction on the abdomen will do well.”

Do you ever combine liposuction with other procedures?

“Yes. I often combine liposuction with other plastic surgery and use it as part of:

• A lower body lift to help mobilize the tissues on the outside of the thighs, to lift them
• A breast reduction
• A facelift in some cases, to remove jowls
• A neck lift, to clean up a ‘turkey neck’
• An arm lift, in some cases

“Many times, liposuction is sort of like the finishing touch—feathering out the changes in contour that we've made so that things fall into place a little bit more gracefully.”

What should you know about choosing a surgeon to do liposuction?

“I would caution patients against having liposuction performed by anyone other than a board-certified plastic surgeon. Other physicians may not have been trained in liposuction, and can get into unexpected trouble.

“Liposuction is easy to do—but hard to do well. I'm a stickler for symmetry; I've invested in equipment to make sure I get it.

“Liposuction is not just a matter of pushing a cannula back and forth and sucking out fat. You really have to pay attention to where you're taking the fat from. For instance, you need to stay deep, not superficial—otherwise you'll get divots and grooves.”

Do you perform liposuction in your office or at the hospital?

“I offer both options. You can choose to have liposuction done under local anesthetic in my office, or under general anesthesia at Mount Sinai Hospital in Manhattan.”

How long does it take to recover after liposuction?

“The funny thing about lipo is that the incisions in the skin are very small, but the wound is large, depending on what you're having suctioned. The local anesthesia remains in the treated tissue, which helps minimize discomfort, but you will be sore. Sometimes people are a little bit surprised at just how sore they are.

“You may have some light bruising or swelling, but scarring is minimal due to the tiny size of the incisions.

“Recovery takes anywhere from three days to a week, depending on the area you've had done. You may not want to work out right away or go jogging—that might take a few weeks.

“In my experience, if I suction you on a Friday, you're going back to work on Monday if you have a desk job. If you're digging trenches, it might take a little longer.

“A few patients have told me that massage has helped them—but I wouldn't recommend it until two or three weeks after surgery.”

How soon after liposuction will you see the results?

“On the day of surgery, you can see an effect. But by the next morning, you'll be swollen to probably as big as you were before liposuction. The day after surgery, some patients might say, ‘It looks like you didn't do anything to me. What is this?’

“You need to wait several weeks to see results. Some of the swelling will start to go down in two weeks, but it takes six weeks to three months before you start to have a good idea of what liposuction has accomplished. And the final effect is not apparent until about a year later.”

What happens if you gain weight after liposuction?

“If you gain weight after liposuction, it's much more likely to be evenly distributed. Once we suck out those fat cells, they're not there anymore, so they can't get bigger. Society doesn't accept that we make more fat cells; they just get bigger.

“When I do liposuction on patients, they really have a hard time gaining weight in that spot again. Any weight they gain should be distributed more evenly. Of course, you should maintain a healthy regimen of diet and exercise after liposuction to maintain your results.”

Are most patients happy with their liposuction results?

“Yes—liposuction has a pretty high patient satisfaction rate. My little comment to patients when they come in for lipo is, ‘It's the greatest gift that God ever gave to man.’ It's very handy.

“To tell you the truth, I want to get suctioned this fall because I'm tired of my flanks—I want to get rid of them already. If I really work out and stay on top of myself, I can keep it off. But you know, you can't live that way all the time and forever. So I think lipo is helpful for people in that situation.”