Liposuction, also known as lipoplasty, liposculpturing is a cosmetic operation that removes fat from different sites on the human body. Areas affected are:abdomen, hips, pubis, outer thighs (saddlebags), flanks (love handles), back, inner thighs, inner knees, calves, upper arms, cheeks, submental (chin) and gynecomastia (male breast tissue). Liposuction is suitable for removal of local fat abundances, usually it is not supposed to remove all fat tissue and make patient slender.

Candidates for liposuction surgery share certain important characteristics. They need to have appropriate skin elasticity so the skin can conform to its new, improved contours. They ideally have a well-defined underlying structures to provide support and contribute to satisfying results. It is mandatory for patients to have a realistic expectations, they should understand not only what liposuction can accomplish, but also the limitations of the procedure.

Several factors limit the amount of fat that can be safely removed in one session. There are negative aspects to removing too much fat. There is a recommendation of the American Society of Plastic Surgery to keep the maximum 5 liters of fat removed in one session. When removing more fat, there is an increasing risk of serious systemic complications such as metabolic breakdown etc. The more fat removed, the higher the surgical risk. The safety of the technique, however, relates not only to the amount of tissue removed, but to the choice of anesthesia and the patient’s overall health.

The invention of modern liposuction procedure is linked to the name of two Italian gynecologists, Arpad and Giorgio Fischer, who created the blunt tunneling method in 1974 and the French surgeon, Dr Yves-Gerard Illouz, in 1982 who featured a technique of suction-assisted lipolysis after tumesing or infusing fluid into tissues using blunt cannulas and high-vacuum suction.

The basic surgical challenge of any liposuction procedure is to withdraw the right amount of fat, causing the least disturbance of neighboring tissues, such as blood vessels, nerves and connective tissue and making nice smooth skin surface.

In general, fat is removed via a blunt cannula (a hollow tube) and aspirator (a suction vacuum device). Liposuction techniques can be categorized by the amount of fluid injection and by the mechanism in which the cannula works. Suction-assisted liposuction is the standard method of liposuction. In this approach, a small cannula attached to a vacuum device is inserted through a small incision. By pushing and pulling the cannula in a forwards and backwards motion, carefully through the fat layer, breaking up the fat cells and drawing them out of the body by suction. In Ultrasound-assisted liposuction, a specialized cannula is used which transmits ultrasound vibrations within the fat tissue. This vibration bursts the walls of the fat cells, emulsifying the fat and making it easier to suction out. The Power assisted liposuction uses a specialized cannula with mechanized movement, so that the surgeon does not need to make as many manual movements. Otherwise it is similar to traditional liposuction. Water assisted liposuction uses a thin fan-shaped water beam, which loosens the structure of the fat tissue, so that it can be removed by a special cannula. The Laser assisted liposuction uses laser beam to melt the fat in the target area, making it easier to remove. It is believed that these techniques can also reduce bruising and bleeding, as it also cauterizes to a certain extent and also cause more effective skin retraction.

The procedure may be performed under general, regional, or local (tumescent) anesthesia. It is ideal for the patient to be as fit as possible before the procedure. The aforementioned surgical procedures require, according to the extent of liposuction, number of body areas involved and technique used, from 1 hour (mental region) to 3 hours.