Most liposuction operations involve the use of tumescent solution to numb & distend the tissues and reduce bleeding. This solution contains local anaesthetic, adrenaline and sodium bicarbonate in normal saline. Some surgeons (with co-operative patients) can rely on this alone for anaesthesia. Others prefer general anaesthesia or at least some degree of sedation.

Once the tissues are numb and the adrenaline has caused the blood vessels to constrict, the surgery proceeds through tiny holes spaced at various points over the operation site.

A long, thin cannula is inserted, and the surgeons moves it backwards and forwards to suck the fat over the entire treatment area. A cross-hatch pattern is preferred, so each area is approached from 2 directions. This is thought to produce a more even result.

The fat is suctioned off into a bottle, where it slowly seperates. The top layer is pure fat, the bottom a mixture of blood and tumescent fluid. Initially, the fat comes out clean, but as treatment in one area progresses, there is often some degree of bleeding. Excessive bleeding is an indication to move to a different area, as there is often little fat remaining.

The surgeon keeps an eye on the contours as the operation proceeds, stopping and moving to the next section once the desired amount of fat has been removed. The final stage of the operation involves checking that the final result is even and pleasing.

Sometimes stitches are needed to close up the holes, and occasionally a drain may even be left behind.