Since the introduction of liposuction technique in the mid 1980s such procedures have become the most frequently performed plastic surgery in America. Through minimal puncture wounds entire areas of the body can be sculpted, effecting significant contour improvements.

Liposuction is not done for weight reduction. It cannot smooth out surface irregularities such as seen with cellulite formation in the thighs, and it will not eliminate excess skin remaining from previous cycles of weight gain and loss. But it does dramatically alter fullness of contour and trim down disproportionate bulging of the abdomen, thighs, buttocks, back, chest, neck, arms and knees.

It is performed by suctioning an excess of fat cells, which may be overdistributed in specific places on the trunk or extremities. In some patients such an abnormal concentration of fat cells may be genetically predermined as is commonly seen in "saddle bag"; fullness of the outer thighs. This deformity can be present even in young athletic women. Many women have a gender specific fat storage zone of the abdomen. This appears in the early thirties after childbearing. Men may show similar fat accumulation in the lateral low back area. No matter what efforts are made at weight loss and exercise these fat depots behave as camel humps. They appear to be the body's selective fat storage warehouses and are the last to absorb even when conscientious weight reduction is undertaken. Liposuction removes the excess fat cells, reducing both the existing bulge and the capacity to re-store the excess of fat in that area.

Liposuction is medically safe when performed by a trained and qualified plastic surgeon in an accredited surgical operating room. Safety guidelines for performing liposuction have been recommended by The American Society of Plastic Surgery, and these should be scrupulously observed by the surgeon you choose. They limit the total volume of fat suctioned in a single procedure, as well as the performing of large volume liposuction done simultaneously in combination with another major surgical procedure.
The surgeon must be aware of body fluid shifts taking place so as to skillfully supervise fluid replacement without overloading a patient's heart or lungs. This is of paramount medical importance when large amounts of fat are suctioned. Patients must be observed for a safe postoperative interval whether their procedure was performed under general anesthesia or by so-called "tumescent local technique";.

In my early years of practice, patients would jokingly ask, "Why can't you just suck it all out?"; At that time operations to change body contours such as thigh fullness were limited to large-scale excisions, which always left conspicuous scars. I would laugh along at their question, never dreaming that such a simple procedure would become the most commonly performed in my practice.