Q. What is spot liposuction?

A: That term refers to having liposuction on one little area the person doesn't like. It is a very small focus that requires only a little anesthetic. It can also be done after people have had liposuction and find one tiny area of fat remaining that they want removed.

Q: What forms of sedation are used for liposuction?

A: Shots can be given in the muscle to deliver narcotics and anti-anxiety medication. They can be given by mouth or injected intravenously - the choice is up to the physician and the anesthesiologist

Q: Are there many different sizes of cannulas?

A: In the beginning, cannulas were 10 millimeters, which is 1 centimeter, more than a third of an inch in diameter.

Today, surgeons are using a cannula that is much smaller, about a sixteenth of an inch. A 10 millimeter cannula is about the size of a pretzel rod. The smaller ones in use today are about the size of the smaller pretzel sticks. The size of the insertion hole relates to the size of the cannula used in that area.

The openings of the cannulas are also different. There are more aggressive cannulas to work on deeper planes when surgeons want to get more fat out. And there are less aggressive cannulas for working on superficial planes, where they don't want to create indentations. The size used also depends on the pattern, size, and number of the openings in the patient's skin.

Q: Are sutures required after liposuction?

A: True tumescent liposuction is purposely done without suturing the insertion sites. This allows an exit for the fluid, permitting it to drain out. But some doctors prefer to sew the incisions closed with sutures.

Q: Are there scars when suturing is not used?

A: There are scars whether stitches are used or not, but they can often be treated in the future if they bother the patients. In many cases, they are hidden, so no one sees them to begin with.

Points To Remember

The dry technique, with general anesthetic and no injected fluids, had unwanted side effects and is no longer performed.

The wet technique uses injected fluids and is very safe.

Tumescent liposuction uses injected fluids that cause tissues to swell and allow patients to remain awake during the procedure.

Tumescent anesthetic combines lidocaine to numb and epinephrine (adrenaline) to constrict blood vessels and minimize bleeding.

Ultrasonic liposuction heats and liquefies fat. The internal form requires special surgical skills; the external form can be used to liquefy fat prior to treatment with tumescent liposuction.

Surgeons can remove fat with syringes or with machine-powered cannulas.

Powered liposuction uses a high-powered cannula that moves back and forth to make fat removal faster and easier.

High-volume liposuction, with removal of more than 4 or 5 liters of fat at one session, is not recommended.

Different forms of sedation are available, administered by mouth or by injection.

Cannulas come in different sizes and leave different size insertion openings.

Some surgeons allow insertions sites to drain, while others sew them up with sutures.