1.What is liposuction? Liposuction, short for fat suction, is a surgical method that removes excess subcutaneous fat through tiny skin incisions by means of surgical techniques in order to achieve body sculpture. Currently, the commonly used methods are negative pressure suction (including electric negative pressure suction and syringe suction), ultrasonic liposuction and laser lipolysis. Regardless of the method, a metal tube is used to enter the subcutaneous area through a very small skin incision to suction or oscillate the subcutaneous fat out. With the application of swelling anesthesia technology, the damage caused by negative pressure suction is greatly reduced, and it has become a safer and popular procedure. Zhang Lu, Department of Plastic Surgery, The Ninth People’s Hospital of Shanghai Jiaotong University School of Medicine, Shanghai, China. 2. What kind of people and parts of the body can undergo liposuction? Liposuction is adapted to those who are relatively normal weight, but localized obesity, disproportionate. These localized fat accumulations do not respond to weight loss and physical exercise. Liposuction is also indicated in patients with moderate obesity and sagging skin. For obese patients with sagging skin, liposuction can be performed at the same time as excision of loose skin to achieve better surgical results. There are many parts of the body that can be liposuctioned, and the parts that are often suctioned are: abdomen, iliac waist, buttocks, chest (including male mammary gland hypertrophy), back, thighs, upper arms, back of calves and jaw, etc. 3.What are the complications of liposuction? Common complications include: localized unevenness, bilateral asymmetry, insufficient suction and so on. Other complications may occur: infection, seroma, skin sagging, pigmentation changes, damage to surrounding tissues, postoperative pain and walking affected, fat embolism and so on. With the continuous improvement of medical technology, liposuction is a relatively safe cosmetic surgery, however, the physician who performs the surgery should undergo rigorous training, master the indications for the surgery, and have perfect medical equipment. In recent years, tens of thousands of patients have successfully undergone liposuction in Shanghai Ninth People’s Hospital with satisfactory results and no serious complications. 4.Will it rebound after liposuction? According to the biochemical theory, the number of fat cells is fixed when a person is born, and it is constant with age until adulthood, the weight of adult changes with the change of fat cell volume, non-surgical methods to lose weight can only make the volume of swollen fat cells become smaller, while the number of cells remains unchanged. Liposuction is the removal of part of the adipose tissue, reducing the number of adipocytes. For normal-weight human beings, liposuction does not change the balance of energy metabolism in the body, and the metabolic efficiency does not increase, so that the regeneration of adipose tissue does not occur. If the patient’s weight increases significantly, the thickness of fat in the liposuction area will increase, but it is much smaller than the unsuctioned area. Therefore, it is still necessary to control diet and strengthen physical exercise after liposuction. As long as the weight after liposuction can be maintained, the effect of liposuction is permanent. 5.How much weight can I lose after liposuction? Due to the small specific gravity of fat, for normal weight patients, after liposuction, there is a more than change in body shape but not much change in weight, for overweight patients, there is a reduction in weight after liposuction, but there is a great change in body shape. Liposuction is mainly body sculpture, whether fat or thin, body shape is the most attractive. 6.What is the effect of liposuction on human body? Obese patients often have high blood pressure, high blood cholesterol and diabetes, central obesity patients have a higher risk of morbidity. Some statistics show that: men with waist circumference of 85cm or more, women with waist circumference of 80cm or more the risk of hypertension is about 3.5 times that of those with waist circumference below this limit, and the risk of diabetes is about 2.5 times. Abdominal fat breaks down easily and enters the liver through the portal vein, causing dyslipidemia and forming a risk factor for atherosclerosis. Liposuction, especially of large amounts of abdominal fat, can increase insulin sensitivity, reduce blood sugar and lower blood lipids. Liposuction is not only harmless to the body, but also can reduce the occurrence of the above diseases and play a preventive role. 7.What should I pay attention to before and after liposuction? (1) Understand liposuction comprehensively and have a correct understanding of the surgery. (2) Undergo examination to determine whether your physical condition is suitable for the surgery. (3) Discuss with the doctor about the parts of liposuction, put forward your own requirements, and make a comprehensive and reasonable surgical plan if there are many parts to be suctioned. (4) Surgery should be avoided during menstruation. (5) Due to the large amount of local tumescent fluid injected during the operation, the external dressing may be infiltrated on the day after the operation, and in case of liposuction of the lower abdomen, there will be edema in the perineum, which are all normal phenomena. Postoperative activities can be appropriate, do not advocate strenuous exercise or long-term bed rest. After the liposuction site is bandaged with pressure for 5~7 days, replace the elastic corset for 1~3 months. (6) In the short term after the operation, the liposuction area may become hard, slightly uneven, deepen the skin color and feel numb, etc. These are normal phenomena, and usually recover in about 3 months. 8.How many parts can be suctioned at one time? Liposuction is a relatively safe and reliable cosmetic surgery, but it can be dangerous if more than one area is suctioned at a time. Depending on the patient’s specific situation, usually 1-2 parts are suctioned at a time. 9. Will liposuction affect my work? Because of anesthetic effect, fat suction surgery will not feel pain on the same day, but there will be liquid oozing, these liquids are injected expansion fluid and a small amount of bleeding, oozing more will soak through the dressing, which is a normal phenomenon, can be replaced on the next day of the dressing, 5-7 days after the change of tights can be. During this period, you should avoid strenuous exercise, advocate normal activities, you can go to work. Therefore, liposuction is a kind of cosmetic surgery with little pain and almost no effect on work. 10. What is the best time for liposuction? Liposuction is feasible all year round, but since it needs to be bandaged with cotton pads for 5-7 days after liposuction and then tight clothes need to be worn for 1~3 months, liposuction is most suitable to be carried out when the weather is cool. 11. What is fat injection grafting? Fat injection transplantation is a surgical procedure in which fat tissue extracted from one part of the body is injected and transplanted to another part of the body for deformity repair or body sculpture. Since the injected fat is your own tissue, there will be no rejection reaction, so fat injection is safe and reliable. Fat injection can be used for breast augmentation, lip augmentation, temple augmentation, and filling up the hollow deformities in certain parts of the body. Because the injected fat can’t be fully viable, so in order to achieve the ideal surgical effect, it is often necessary to inject several times, and the interval between the two operations is usually about two months. 12.What else can liposuction be used to treat? In addition to body shaping and weight loss, liposuction can also be used to treat armpit odor, macromastia, male breast enlargement, paratesticular breasts and repair scarring. Because liposuction is simple, safe and reliable, with small skin incisions and inconspicuous scarring, it is accepted by more and more patients as they get older.