Liposculpture Terms Defined

Aspirate – When used as a verb, it means to suction fluids and fat. When used as a noun, it refers to the fluids and fats that are suctioned from the body via an aspirator.

Aspirator – A machine that suctions fat from the body via a cannula, through hoses and filters and into collection bags or containers, where the aspirate accumulates and settles.

Board Certified – A certification that an individual (in this case, a doctor or surgeon) has passed a test given by a “board of authoritative individuals.” Board examinations restrict a doctor to practicing only the certain types of procedures for which s/he is qualified.

Body Sculpting or Body Contouring – A variety of surgical techniques and procedures that can be employed to enhance body appearance. These include removal of fat cells via suctioning (and, sometimes, repositioning that fat to another body area via injection), inserting implants to augment the shape of a body area and/or removing excess skin with a variety of “lift” procedures. While exercise remains the best way to achieve an optimal body shape and tone, body sculpting procedures can effectively eliminate excess fat and skin that is unresponsive to diet and exercise.

Cannula – A straw-like instrument (usually made of metal or plastic and consisting of a tip, a shaft and a handle) that a cosmetic surgeon manipulates within the patient’s body to remove fat.

Cellulite – A soft “dimpling” of skin, usually in the thighs-and-buttocks region, is much more common in women than men. Liposuction is not an effective treatment for cellulite and may, in fact, exacerbate the problem. The non-invasive endodermologie treatment (defined below) may improve cellulite appearance, but it should be noted that its effect is usually temporary.

Certified Registered Nurse Anesthetist (CRNA) – A registered nurse who is specially trained and certified to administer anesthesia.

Cosmetic Surgery – A branch of plastic surgery that utilizes various surgical and medical techniques to improve appearance.

Half face sculpture
Creative Commons License photo credit: leafar.

Dermatologic Surgery – A branch of dermatology in which doctors are trained to perform surgical treatments applied within and between the different layers making up the skin: the epidermis, dermis and subcutaneous fat. Tumescent liposuction, widely accepted as the safest and most effective form of liposuction, was invented and developed by dermatologic surgeons.

Dermis – Comprised of collagen, elastic fibers, and extrafibrillar matrix, this skin layer has two sub-layers — the papillary and reticular dermis — and lies just below the epidermis. It serves to protect the body from injury, to bind and store water, to maintain temperature and to house nerves which detect sensation and feeling.

Dry Method – Reference to an antiquated liposuction technique whereby no fluids are pumped into the tissues prior to liposuction. The dry method was usually performed under general anesthesia, usually resulted in significant blood loss (transfusions were common with this method) and had increased risk for life-threatening pulmonary embolism (since patients’ restricted mobility due to pain made them prone to blood clots).

Endodermologie – A non-surgical, non-invasive “deep massage” cellulite treatment, the effect of which is to gently pull on the surface of the skin and loosen or stretch its tethers. While endodermologie does not remove cellulite, it may reduce its appearance temporarily. Not every patient realizes satisfactory improvements, however, and those who do usually require continued endodermologie treatments in order to maintain the improvement.

Entrance wound – An incision made in the skin into which the cannula is inserted for fat aspiration. Since the epidermis and dermis must be violated in this process, the entrance wound will form a scar and may pigment. The degree to which scarring and pigmentation occurs depends largely on cannula size (width), the applied friction and whether or not the wounds are closed with stitches. Typically, entrance wounds where wide cannula and/or increased friction are used are more susceptible to scarring and pigmentation.

Fat – In reference to the skin (as opposed to other areas and parts of the body), fat is stored in cells and usually makes up the bulk of the subcutaneous layer of the skin where liposuction treatments are administered.

Fluid Injection Liposuction – A technique whereby a special medicated solution containing an intraveneous saline solution, lidocaine (a numbing medication) and a drug to contract blood vessels (usually epinephrine) is injected into targeted areas before the fat is removed by liposuction. The injected fluid helps the surgeon remove the fat with less trauma, provides anesthesia for pain control, helps to reduce blood loss during the surgery and also helps to reduce bruising following the surgery.

Lipo – Greek root meaning “fat” or “fatty.”

Lipoplasty – Another word for liposuction.

Liposculpture – Another word for liposuction which connotes and emphasizes an artistic approach to the procedure. This word is also sometimes used to describe an “autologous fat transfer” which is performed as part of a liposuction procedure and whereby fat removed from one area of a patient’s body is “cleaned” and then re-injected into a different body area for contouring purposes (e.g., fat might be removed from the abdominal area, processed and then injected into the patient’s face for wrinkle reduction or elimination).

Liposelection – An advanced liposuction method where ultrasound is used to differentiate body fat from other tissues like blood vessels and nerves. It breaks up and liquefies the fat, which is then removed by massage and suction. (See also “Ultrasonic Liposuction.”)
Liposuction – Suction-assisted fat removal whereby cannula are inserted into the patient’s skin through entrance wound(s) and are manipulated to displace fat which is then removed by a vacuum pump (aspirator).

Local Anesthesia – The injection of anesthetic by needle or probe to numb a specific part of the body, in this case the liposuction entrance wound. Local anesthesia is less risky than sedation, which is less risky than general anesthesia. Even when the intention is to use only local anesthesia, however, it may be preferable to have a CRNA (or an anesthesiologist) present in case further drugs need to be administered.

Omental Fat – The soft, “cushiony” layer of fat (also called the omentum) which can encase one’s bowel system deep in the abdomen. There is presently no safe way to remove omental fat without risking severe, life-threatening bowel problems.

Risk – As with any medical or surgical procedure, complications occur in a certain percentage of patients. A qualified surgeon will provide patients with a detailed discussion of all associated risks (including, but not limited to, infection, allergic reaction to medication, contour irregularities, lidocaine toxicity, fluid imbalances, etc.) in consultation prior to a liposculpture procedure and should provide the patient a written list of complication symptoms to watch for, along with thorough instructions for post-operative self-care.

Scar – Any surgery or entrance wound will result in some scar formation, and this subject should also be addressed in the pre-operative consultation with your physician. Scar appearance can often be minimized by incorporating the incision with pre-existing wrinkle lines and/or natural anatomy lines, but certain genetic factors over which a surgeon has no control can also affect the prominence of your scarring.

Sedation – A medical procedure in which a sedative drug is administered in order to calm a patient and/or to reduce his/her anxiety, activity or excitement. Doctors review a patient’s medical history in order to assess the optimum degree of sedation.

Skin – The outer covering of the body and its largest organ, skin is composed of the epidermis, the dermis and the subcutaneous fat. The adjective cutaneous literally means “of the skin” (from Latin cutis, skin).

Stitches – Liposculpture suturing is handled in different ways by different surgeons. As the incisions are usually small and since proper healing requires unimpeded drainage of the injected fluids, some doctors simply leave entrance wounds open. Others may partially suture the wound or wait to suture until one or two days after the procedure after most of the fluid has drained.

Wet
Creative Commons License photo credit: jurek d.

Subcutaneous – The skin tissue lying below the cutaneous (dermis) tissue which is usually composed of fat cells and the structures that run through it (i.e., blood vessels, nerves, etc.).

Subcutaneous Fat – This fat resides just below the skin’s surface (as opposed to the deep, omental fat of the abdominal area).

Super-Wet Liposuction – This is usually considered the preferred technique for high-volume liposuction as it better balances hemostasis and the potential for fluid overload. It may require either intravenous sedation in addition to the local lidocaine or even general anesthesia.

Tumescent Anesthesia – A numbing fluid injected into the targeted body part prior to suctioning. This anesthetic solution is composed of (1) saline to assist suctioning of the area’s fat cells; (2) lidocaine to temporarily numb the targeted area during suctioning; and (3) epinephrine to constrict blood vessels and minimize blood loss. Since the tumescent fluid remains in the patient’s body for up to 24 hours following the procedure and drains gradually and naturally in due course, it also alleviates post-surgical pain.

Tumescent Liposculpture (and/or Tumescent Liposuction) – In reference to liposuction, tumescent refers to the ballooned or swollen appearance of the tissues after large volumes of fluids have been pumped into the targeted fat just before (and sometimes during) liposuction. Tumescent liposuction is widely considered the safest and most effective form of liposuction as these injected fluids, usually containing a local anesthetic, allow the procedure to be performed with less pain, trauma and bleeding.

Ultrasonic Liposuction – A form of liposuction in which high frequency vibrations created by an ultrasound generator shake the cannula. This vibration breaks the fat cell walls, effectively liquefying the fat for more efficient suctioning. While ultrasound-assisted liposuction techniques used in the 1980s and 1990s were often associated with tissue damage (usually a result of excessive exposure to the ultrasound energy), no serious complications have been reported in more than 70,000 procedures performed with the newer, third-generation “Vaser Lipo” device.

Wet Method – This references the first step of a tumescent liposuction procedure wherein the surgeon administers a local anesthesia containing epinephrine directly into the tissue in order to reduce patient discomfort and blood loss.

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