The benefits of removing excess fat can be enormous, literally and figuratively! Liposuction is among the cosmetic surgery procedures with the highest rate of patient satisfaction. Many patients experience an immediate improvement in their self-esteem and overall confidence.Liposuction may be performed alone or with plastic surgery procedures such as a face and neck lift, breast reduction or tummy tuck. The procedure was first performed in 1974 and there have been many advances in techniques over the enduing 38 years, making it one of the most predictable and popular body-contouring surgeries in the world. Who is a suitable candidate?The ideal liposuction candidate is at, or near their ideal weight, with good skin elasticity and is seeking reduction of diet- and exercise-resistant localised pockets of fat. Common sites include the upper arms, hips, outer thighs, abdomen, mid back, buttocks, knees, neck and chin. Some men have excess fatty tissue in and around the breast, or gynaecomastia, which can also be removed.Liposuction is not a way of losing weight. If you have excess loose skin, liposuction can actually make it worse. If this is the case, a surgical body lift procedure may be required instead. Your surgeon will advise the best options. It should also be noted that liposuction does not improve cellulite (the dimpled appearance of the skin of commonly seen on the buttocks and thighs) or stretch marks (caused by pregnancy or rapid weight gain). What does it involve?Liposuction surgically removes deposits of subcutaneous fat from specific areas of the body such as the thighs, hips, abdomen, buttocks, knees, upper arms, neck and chin. While the terms are often used interchangeably, liposculpture implies more subtle shaping and contouring. There are generally three ways to remove the fat: the traditional cannula method, the syringe technique and the energy-assisted method, which can further be broken into numerous sub-categories. The basic procedure involves the insertion of a small tube-like instrument, called a cannula, into the layer of subcutaneous fat via tiny incisions made by the surgeon. The cannula is connected to a clear plastic hose that leads to a suction source. The surgeon moves in a specific pattern through the fat layer to break up fat cells, which are then vacuumed or suctioned out.The overlying skin remains attached to the connective tissue and underlying muscles of the skin during the operation. A thin blanket of fat is left under the skin to help prevent rippling or bumpy skin occurring afterwards.There are two main layers of subcutaneous fat: superficial and deep. Liposuction is primarily focused on the deeper layer of fat, since suctioning is thought to be safer and easier there. Suctioning in the superficial layer allows the surgeon to achieve subtle benefits in the procedure but, because of its proximity to blood vessels and nerve endings, it can increase the risk of contour irregularities and injury to the skin. Some surgeons believe superficial liposuction enhances skin retraction. Although the cannula is designed to slide through fat tissue and cause minimum damage to blood vessels and nerves, some may be injured during the procedure. If only a small amount of fat and a limited number of body sites are involved, liposuction can be performed under local anaesthetic, usually in conjunction with intravenous sedation. If a large volume of fat is being removed, some patients prefer general anaesthetic. In addition to fat, body fluid is also removed during the procedure. Because of this, patients are given fluids intravenously during the operation.The aim of liposuction is to decrease the bulk of fat in a specific area, but not to remove all fat. Removing too much can cause loose skin and surface irregularities. Depending on the size and number of the areas being treated, as well as the technique employed by the surgeon, the procedure can last from around 1-5 hours.