Patients should be aware that, when liposuction is combined with other procedures, their risks for post-surgical complications will be a bit higher. Some doctors will space the procedures out to avoid these potential effects. Others may suggest removing less fat when liposuction is combined with other treatments. Although a few surgeons do not advise combining multiple procedures, most will do so, simply using extra precautions to protect their patients' safety. Although recovery time will be longer when procedures are combined, patients will only have one recovery rather than two separate procedures and two separate periods of downtime.
Although liposuction is used to get rid of fat, it's not a weight-loss solution. Liposuction works best on deposits of fat that are concentrated in particular areas and resistant to exercise, particularly around the stomach, thighs, hips and buttocks. You might lose a little weight, but it's not likely to be significant. Liposuction also won't fix a bulging stomach that's caused by weakness in the abdominal wall, and it won't tighten loose skin. For toning and flattening the abdominal area, however, liposuction is sometimes combined with abdominoplasty, also known as a tummy tuck, in which fat is removed from the belly, the muscle wall repaired and excess skin removed.
A technique called "tumescent liposuction" is the most common method for removing fat around the stomach, buttocks, thighs and ankles. It's also considered the safest. "Tumescent" means that large amounts of buffered salt water are injected into fatty tissue beneath the skin. The doctor makes a cut in the fatty area to be treated, then inserts beneath the flesh a strawlike tube called a cannula that is attached to a vacuum. At the end of the cannula is a stiff wand. The doctor moves it back and forth in rapid motions to loosen fat. The procedure takes 45 minutes to two hours, with a recovery time of up to two weeks. The full effect of liposuction is seen six to 12 weeks after the procedure is performed. After the procedure, the area is bandaged and the patient must wear a compression garment for one to two weeks. Pain and bruising may last up to two weeks, and swelling may last for two weeks to two months.

If you have been told that you require liposuction for medical reasons, you can be certain that insurance will only cover the extent of treatment needed to relieve your symptoms. In many cases, this amount of treatment is not going to result in flattering aesthetics. As such, you should consider the benefits of paying for further treatment that will help you not only achieve relief, but also an aesthetic enhancement that can help you feel confident about your appearance. Many practices, including mine, will work with patients in need of liposuction for medical reasons to determine a more comprehensive treatment plan, often at a discounted rate.
The expected time and effort that is required to accomplish a liposuction surgery is the most important factor in determining the cost of liposuction. Factors that typically affect the surgeon’s time and effort include 1) Number of areas being treated, 2) Size of the patient, 3) Anticipated degree of difficulty. Thus, cost of liposuction of the abdomen alone is less than the cost of doing liposuction on both the abdomen as well as the inner thighs and knees. Similarly, the cost for abdominal liposuction on a patient who weighs 80 kilograms (176 pounds) might be more than the cost for liposuction of the abdomen of a patient who has never weighed more than 60 kilograms (132 pounds). Liposuction is more difficult and requires more time if the patient has previously gained and then lost a significant amount of weight. In any area previously treated with liposuction, the fat often contains scar tissue which makes liposuction in the same area more difficult.

For tumescent liposuction, the most common technique, your doctor will make one or more small (one-quarter inch or less) incisions in the area to be treated and inject a large quantity of a mixture of saline (salt water), local anesthesia, and epinephrine into your tissue. The fluid causes the fat to become swollen, firm, and easier to remove. (It also constricts your blood vessels, which reduces bruising, blood loss, and recovery time.) The surgeon then inserts the cannula through the same incision and passes it back and forth under the skin to break up the fat before suctioning it out. For a very small area, the procedure takes around 30 minutes, while a 360 liposuction—which includes the abdomen, flanks, back, and all around the torso—lasts three to four hours. 
Dr. George Marosan, a board-certified plastic surgeon in Bellevue, Washington, prefers VASER liposuction in most situations. “Fat comes out more easily with VASER—especially in men, where it’s more fibrous,” Dr. Marosan says. He also points out another great advantage of VASER lipo: While fat that’s liquified by laser lipo isn’t usable, fat broken up by VASER is still viable for transfer to the breasts, butt, or anywhere you want more fullness. “The VASER allows me to sculpt the body, revealing the underlying muscle and bony anatomy. This is an advanced technique that goes way beyond liposuction for fat removal only,” says Dr. Marosan.
Some surgeons recommend lymphatic massage starting at about four weeks post-op, to help drain fluid and bring down swelling. “I don’t suggest self-massage, because you can counteract the surgery,” Dr. Mesa says. “But going to a massage therapist who specializes in post-surgical massage does make the healing process faster and prevent irregularities.”
It may take one to three months for swelling and bruising to subside and up to six months for skin to tighten over the area from which fat has been removed. The finished liposuction results should be visible after six months. Following recovery, patients could enjoy a trimmer figure, more defined muscle tone, reduced cellulite, and a more youthful appearance. Of course, the results are not the same for everyone, but most patients enjoy a huge boost of self-confidence after undergoing liposuction.
Because of the large pattern of skin cutout with the Inverted T scar (Wise-pattern) the scar complication can look really bad. Here is a photo of one of these wounds using this surgical technique. Although it is not a life threatening problem, this wound complication at the incision location could certainly look very scary to the patient. In addition to scars, this procedure also tends to flatten the breast, instead of making them perky. I no longer perform this technique in my practice as I feel that the other surgical techniques are far superior.
The most common dangers of liposuction include risks associated with removing too much fat from targeted areas at once, as well as having too much liposuction performed in a single day. Excessive liposuction can cause problems including dents, lumps, and sagging skin. In order to minimize surgical complications and the side effects of overexposure to anesthesia, when patients are looking to remove larger portions of fat, they should schedule multiple liposuction procedures at least several days apart.

Some people choose to have liposuction revision, a second procedure, due to irregularities in the results of the original procedure. These might include asymmetry between one side and another, dimpling, or bumps, to name a few common reasons for revision lipo. According to Dr. Mesa, liposuction revision is often needed when the provider was inexperienced—but it can also just be the result of the way a person heals. 
At first, liposuction results may seem minimal. This is standard, as swelling and bruising can obscure the final effects. Skin in the treated area may also appear loose, as it takes time for your body to adjust to its new, slender shape. Most physicians will ask the patient to wear a compression garment to aid in recovery. This will help reduce the long-term effects of post-liposuction swelling, bruising, and scarring.
Cellulite is caused by fat cells pushing through the collagen, the connective tissue directly beneath the skin's surface, causing a dimpled appearance. The appearance of cellulite is not related to the amount of body fat an individual has and is prevalent even in healthy and underweight people. Cellulite is more common in women because men have a tighter collagen mesh pattern beneath their skin. Liposuction can help aid cellulite removal in both men and women, but it is important to remember that there is no permanent "cure" for cellulite. The success of cellulite removal is dependent on many factors, including genetics. Because of this, patients should not expect liposuction to eliminate cellulite from their bodies.
A patient may think twice when they receive an estimate from a surgeon using advanced technology, but that individual would be well advised to reconsider the results that surgeon has provided for others. If paying more for an advanced treatment by a reputable surgeon is more likely to provide beautiful results that will not need revision surgery for undesirable contours or scarring, it could be considered a much more conservative option than paying a cut rate for a less reputable surgeon and having to undergo additional surgeries to achieve the results you really wanted in the first place. It is also important to note that a revisional body contouring surgery is usually more expensive than the original. Correcting errors made in a previous surgery requires more planning and more time to perform, which naturally incurs a greater expense.

If you have a significant amount of loose skin around your midsection, or if pregnancy, weight loss, and/or age has weakened your abdominal muscles, you may want to consider a tummy tuck. However, if you have healthy skin that adheres to the natural contours of your body, you are probably a better candidate for liposuction. Ultimately, the only way to determine the right procedure for you is to schedule an appointment with an experienced cosmetic surgeon.
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