Liposuction and nonsurgical fat reduction modalities (ie, body contouring) are among the most commonly performed cosmetic procedures in the United States. Liposuction is an invasive surgical procedure in which adipose tissue is dislodged and suction is used to remove it. The procedure originally was performed with a regional nerve block or general anesthesia; a tumescent technique for local anesthesia now is used. There are several types of liposuction, each uses application of energy to allow for removal of fat. These methods include laser-assisted, power-assisted, and ultrasound-assisted liposuction. Abdominoplasty can be performed in combination with liposuction for management of loose skin. Nonsurgical fat reduction modalities include cryolipolysis, use of radiofrequency lipolysis devices, and ultrasonographic modalities. Cryolipolysis uses cold temperatures to achieve lipolysis, whereas radiofrequency lipolysis devices use heat to destroy adipose tissue. Nonthermal low-intensity, low-frequency ultrasonography uses mechanical methods to destroy fat cells. High-intensity focused ultrasound uses thermal methods. Body contouring procedures can be performed alone or in combination with other procedures.
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