Close your eyes and picture fat. Just fat. The stuff that fills those love handles you hate and takes your chin count up past the desired number of one. Is it a liquid? Solid like a lump of butter? Something else? As a plastic surgeon offering liposuction, Chicago’s Dr. Lawrence Iteld meets a lot of people who know they want to get rid of pockets of fat, even if they don’t know exactly what fat is or how it works in the body.
Why does that matter? If the plastic surgeon is the one performing the actual procedure, who cares if somebody thinks their excess fat can be tapped into and drained like syrup from a maple tree?
As the old saying goes: Knowledge is power. Understanding how fat works—and how fat-removal surgery works—can actually help a liposuction patient know what to expect in terms of the experience, potential risks and benefits, recovery, results, and more. Informed patients make informed choices and tend to be more satisfied with the outcome.
So first: What is fat? When talking about the culprit behind a bulging belly, fat can be defined as a collection of cells that store energy and primarily make up what is known as “adipose tissue.” Fat cells are actually found throughout the body, with their total number being generally set by the time a person reaches adulthood.
It may be easiest to think of the fat cells as tiny balloons, except instead of being filled with air, they’re filled with lipids made up of molecules known as triglycerides. Like balloons, they can swell or shrink depending on how much is inside them.
Unlike balloons, fat cells don’t just bob around and float freely. They stay in place where they grow—even when the person they’re inside manages to stick to that new year’s resolution to eat better and work out more. Slimming down doesn’t mean the number of fat cells in the body is dropping. It means that the size of the individual fat cells are shrinking.
This shrinkage is not guaranteed, however. Some fat cells lose lipids to become smaller easily, which may lead to thinner thighs or slimmer arms. Others, for some reason, stubbornly cling to their lipids, refusing to change in size. (The problem is likely genetic, so feel free to blame the parents.) This is why a double chin may continue to show up in every selfie, despite a flatter belly and smaller waistline..
To truly make a change in these stubborn areas, outside help is needed. This is where liposuction comes in. Remember, though, that the fat is not a free-floating substance waiting to flow. Getting those stubborn fat cells out of the body takes a little more effort.
A liposuction procedure starts with a very small incision made in the skin, so the plastic surgeon can insert a specially designed wand known as a cannula. This cannula is one part tool used to loosen the fat so that it can be sucked out, and one part vacuum tube to actually suck out the fat.
It should come as no surprise that fat does not really want to go easily. It requires a little persuading in the form of the cannula’s back-and-forth motion. This action was traditionally performed by the surgeon’s own muscle power, but modern advances in medicine and technology led to the development of “power-assisted liposuction,” which automates the motion. Once freed, those fat cells can be removed, never to swell with lipids again.
Another modern technique dispenses with the physical battering of the fat cells altogether, instead using sound waves to break them apart for removal. Known as “Vaser,” this method involves the high-frequency vibrations caused by ultrasound, leaving fat molecules shaken, not stirred. The freed lipids can then be suctioned out via a cannula with precision results.
After liposuction, patients should avoid strenuous physical activity for a few days to a few weeks, depending on the surgeons’ techniques. Dr. Lawrence Iteld is committed to a gentle, fast, and opioid-free recovery, employing carefully researched and implemented strategies that aim to prevent pain, rather than expect it.
When it comes to the months and years after a liposuction treatment, while fat cells removed from the body are gone for good, the remaining fat cells can grow larger if given the chance. Eating more calories than are burned off can ultimately lead to new, unwanted changes in contours. Long-lasting results depend on sticking to a healthy lifestyle. That said, if a patient does veer off course and gain some weight, liposuction can be repeated.