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Liposuction, also known as lipoplasty ("fat modeling"), liposculpture suction lipectomy ("suction-assisted fat removal") or simply lipo is a cosmetic surgery operation that removes fat from many different sites on the human body. Areas affected can range from the abdomen, thighs and buttocks, to the neck, backs of the arms and elsewhere. Several factors limit the amount of fat that can be safely removed in one session. Ultimately, the operating physician and the patient make the decision. There are negative aspects to removing too much fat. Unusual "lumpiness" and/or "dents" in the skin can be seen in those patients "over-suctioned". The more fat removed, the higher the surgical risk. While reports of people removing 50 pounds (22.7 kg or around 3.6 stone) of fat have been claimed, the contouring possible with liposuction may cause the appearance of weight loss to be greater than the actual amount of fat removed. The procedure may be performed under general, regional, or local anesthesia. The safety of the technique relates not only to the amount of tissue removed, but to the choice of anesthetic and the patient's overall health. It is ideal for the patient to be as fit as possible before the procedure and not to have smoked for several months. Relatively modern techniques for body contouring and removal of fat were first performed by a French surgeon, Charles Dujarier. A 1926 case that resulted in gangrene in the leg of a French model in a procedure performed by Dr. Dujarier set back interest in body contouring for decades to follow.