OverviewDo you work out and diet religiously but still can’t get rid of stubborn body fat? If so, you may be a good candidate for liposuction surgery. Liposuction is a way to remove unwanted fat and achieve a more proportionate body contour by directly treating problem areas that are not addressed by diet or exercise alone. (1) Some of the most common areas treated include the thighs, hips, buttocks and abdomen.
You may be a good candidate for liposuction if you are: (1)
- Healthy and have no major medical issues
- Near your goal weight but have specific areas you wish to target for fat removal
- Between the ages of 30 and 60, although liposuction has been successfully performed on both younger and older patients
- Informed about the benefits and risks
- Have good skin elasticity, which helps the body to adapt to its changing contours
- Have realistic expectations
Liposuction surgery can be performed on patients who are overweight but whose weight has been stable over the past several years. You may not be a good candidate if you are:
- In poor health or have serious medical conditions
- Mentally unstable or have unrealistic expectations
- Taking certain medications
- Planning to become pregnant
- Planning to lose a significant amount of weight in near future
- Have excess skin with poor elasticity, as this may worsen after liposuction
When considering liposuction, it is important to have realistic expectations. This procedure cannot make you look like a supermodel and will not remove every ounce of fat from your body. Patients should not think of liposuction as a fast-track to weight loss, but as a way to create more aesthetically pleasing silhouette by removing five pounds or less of targeted fat. Liposuction is often combined with other procedures to achieve a more desirable outcome. Some procedure commonly performed in conjunction with liposuction include abdominoplasty, breast lift surgery.
- Liposuction is not an effective weight loss strategy. Good candidates for liposuction are close to their ideal body weight. Liposuction is an enhancement, not a transformation.
- It does not prevent future fat accumulation. In the absence of exercise and a healthy diet, liposuction will be ineffective over the long term.
- The procedure can make cellulite look worse. Although liposuction does not cause cellulite, uneven removal of fat may worsen the appearance of existing cellulite.
- Liposuction may cause sagging skin. If your skin does not have sufficient elasticity, it may not adapt to your new shape. In some cases, additional surgeries may be required to remove or tighten excess skin.
- You may want to save some of your unwanted fat. Fat grafting (also known as lipo-injection) is the process of using fat from one area of your body to augment another part of your body. The face, breasts and buttocks are common sites for fat grafting.
- Final results are not immediately obvious. In most cases, final results take 3-6 months to become fully apparent.
There are many variations on traditional suction-assisted liposuction that allow for easier or more precise fat removal. The type of liposuction method used depends on the type of fat you have, your skin elasticity, your medical history and other factors. Your surgeon will make the best decision on what type of liposuction method is needed for your body to match your personal goals. The following provides a brief overview of the different liposuction methods: (2)
- Suction-Assisted Liposuction (SAL) SAL is the standard method and most widely used liposuction technique.
How it works A small tube (known as a cannula) is inserted under the skin into the fat layer. The surgeon moves the cannula back and forth to break up the fat layers, then suctions out the excess fat tissue. Pros Ideal for targeting larger amounts of fat deposits Can produce very dramatic results Cons Not ideal for delicate areas such as in the face, neck and chin
- Ultrasound-Assisted Liposuction (UAL)
How it works A special cannula emits sound waves that break down the fatty tissue that is being targeted for removal. Some brands include VASER Lipo and UltraSculpt. Pros Fat cells are broken down allowing for easier removal, so there is less bruising and swelling Reduces the surgeon’s work effort so he/she can concentrate on smoothness of contour and finesse in results May assist in tightening the overlying skin A good option on more fibrous areas such as the upper back and male breasts Cons Increased cost because ultrasound introduces an additional step in the operation and increases the duration of the procedure by 25% or more Since ultrasound uses high energy to melt the fat, it is possible to cause a burn of the skin or elsewhere
- Power-Assisted Liposuction (PAL)
How it works This technique uses a high-speed vibrating cannula to break up the fatty tissue which is then vacuumed out of the body. Similar to traditional UAL, but the surgeon does not need to make so many manual movements. Some brands include Tickle Lipo, MicoAire, and LipoSculptor. Pros Duration of the operation is shorter because the fat is suctioned more quickly by the powered cannula Surgeon can focus more on the sculptural aspects of the procedure and less on having to extract the fat Does not use heat, so there are no concerns for the accidental burning that can occur with other techniques Cons Does not help tighten skin
- Laser-Assisted Liposuction (LAL)
How it works Involves the use of laser energy to liquify or “melt” the fat for easier removal. Some brands include Smartlipo, SlimLipo, and CoolLipo. Pros Less invasive than some other techniques Reduced swelling and bruising resulting in faster recovery Positive effect of tightening the overlying skin Cons If the temperature becomes too hot, it could cause burning and scarring of the skin Unwanted fat cannot be used for fat transfer procedures More costly because of the additional steps involved in the operation
- Water-Assisted Liposuction (WAL)
How it works A large volume of a water-based solution is used to loosen fat cells for easier removal. Some brands include Body-Jet and AquaLipo. Pros Removes fat more gently than some other techniques Little to no damage to surrounding tissues resulting in less bruising and swelling and a shorter recovery period If desired, fat cells can be saved and used to plump up other areas of the body Cons Not ideal for individuals with large amounts of body fat Does not contour loose or hanging skin Increased cost because of the additional steps involved in the operation
There are a number of non-surgical alternatives to liposuction that are available, many of which can provide excellent results with minimal discomfort and downtime. However, less invasive liposuction alternatives are unable to deliver the same degree of contouring that liposuction provides and are more suited to small fat deposits. Most non-surgical alternatives to liposuction work by disrupting fat cells that are below the surface of the skin. However, the disrupted fat cells remain in place until your body can remove them, which may take several months, whereas liposuction removes the fat cells immediately. Some non-surgical alternatives to liposuction include:
- Cryolipolysis (eg. Coolsculpting)
- Radiofrequency Lipolysis (e.g. Vanquish)
- Injection Lipolysis (e.g. Kybella)
- Laser Lipolysis (e.g. Sculpsure)
Liposuction continues to be the gold-standard for body sculpting and can deliver dramatic results after a single session, while most alternatives require multiple sessions. In addition, liposuction may be more cost effective than non-surgical alternatives.
The following provides a basic overview of how a typical liposuction procedure is performed: (3)
- First, your plastic surgeon will mark the areas of your body where the fat will be removed.
- You will be given local or general anesthesia.
- After you are anesthetized, the surgeon injects the marked areas with a large amount of sterile “wetting solution” that will minimize bleeding and make fat cells easier to remove.
- The fat is removed using a narrow tube called a cannula. There are several different ways to vacuum out the fat. They include traditional suction-assisted liposuction as well as newer ultrasound-assisted, power-assisted, laser-assisted and water-assisted liposuction methods.
- The incision is stitched up and a compression bandage is applied to the treated area.
In order to receive the desired results, it is important that you take the time to find the best surgeon for you. Look for a surgeon who has demonstrated excellence in performing liposuction in the area(s) that you want treated. Make sure that your surgeon is board-certified and is a member of one or more of the following organizations:
American Board of Plastic Surgery (ABPS)
American Society for Aesthetic Plastic Surgery (ASAPS)
American Society of Plastic Surgeons (ASPS)
While board-certification and society membership do not guarantee a successful outcome, they indicate that you are working with a highly trained, experienced surgeon who will minimize risks that are associated with surgical procedures. You may also contact your state’s medical board to confirm that your surgeon is licensed to practice in your state and to learn whether any disciplinary actions have been taken against them.
Liposuction is relatively safe, however, there are potential risks that you should be fully aware of before proceeding with surgery. Some possible risks and complications include: (4)
- Contour deformities (bumpy or uneven results)
- Loose skin
- Nerve damage
- Fat embolism (a piece of fat becomes lodged in a blood vessel and blocks blood flow)
Depending on the type of liposuction procedure, there may be other risks involved. To reduce the possibility of complications, it is recommended that you choose your plastic surgeon carefully. Side effects of liposuction are experienced in the days and weeks following surgery. Common side effects include:
Your doctor can provide you with pain medications to help you manage post-surgery pain and discomfort.
Liposuction is considered to be an outpatient procedure, meaning that most patients will go home the same day that they had the surgery. Patients are sent home in a compression garment that helps to minimize swelling. Most people are comfortable returning to work and normal daily activities within a week of surgery. Exercise can generally be resumed 3 weeks after your surgery or as directed by your doctor. It is imperative that you carefully follow all instructions provided by your surgeon in order to achieve the best possible results. First 48 hours following surgery:
- You will likely experience some pain, swelling and bruising
- 48 hours following surgery your compression garment will be replaced, at which time you can shower
- You should be able to walk around and carry out simple tasks that do not elevate your blood pressure
5-7 days after surgery:
- Your surgeon will examine all sites to ensure they are healing normally
- Continue to wear the compression garment as directed (usually 24/7 for the first week)
- You should notice a reduction in swelling and bruising
2-3 weeks after surgery:
- Compression garments are worn overnight
- Most swelling should have resolved, allowing you to see initial results
Avoid sunbathing and exercising at the gym for at least 6 weeks following your surgery. If you have any questions or concerns about your surgical results, contact your surgeon and discuss it with him or her directly.
Preliminary results of liposuction will be visible immediately, but postoperative swelling will take a few weeks to subside. The type of liposuction, the treatment area, and the quality of postoperative care all influence how quickly your swelling will resolve. It will take between 3 and 6 months before stable liposuction results are apparent.
On average, the cost of liposuction is between $1,500 and $7,500 per area. (5) The variability stems from individual differences (amount of fat, location of fat), the type of liposuction, and expenses associated with the surgical procedure. Without a consultation, there is no simple way to estimate how much your liposuction surgery will cost. There are a number of factors that influence the final cost of liposuction, including:
- Surgeon’s fee
- Anesthesia fees
- Hospital or surgical facility costs
- Medical tests
- Post-surgery garments
- Prescriptions for medication
- Type of liposuction
- Size of the treated area
- Amount of fat removed
It is important that your quote include all applicable expenses, not just the surgeon’s fee. Make sure you understand the total cost of your surgery before it is scheduled. Liposuction is generally not covered by health insurance. Many plastic surgeons offer financing options to help people achieve their desired look. If cost is an issue, check with your plastic surgeon regarding any financing options he or she may have or know of that can help you get your desired look.
Q: How safe is liposuction? A: Liposuction is a very safe procedure that continues to gain popularity. According to the American Society of Plastic Surgeons, there were 258,000 liposuction surgeries performed in 2018, a 5% increase from 2017, making it the second most popular cosmetic surgery in America. Q: Which liposuction procedures are the safest? A: All liposuction procedures have a similar risk profile. The best way to ensure that your liposuction surgery is safe and effective is by working with a board-certified plastic surgeon who has demonstrated consistent excellence. Q: Is liposuction a good option for weight loss? A: No. Liposuction is not effective for individuals who are obese or looking to lose a significant amount of weight. Ideal liposuction patients are close to their target body weight but are frustrated by smaller areas of fat deposits that cannot be removed by diet and exercise alone. Q: Can fat come back after liposuction? A: Yes. After liposuction, it’s important for patients to maintain a healthy lifestyle. Liposuction permanently removes fat cells from the treated areas, however if you gain weight after surgery the fat will accumulate in areas that were untreated. Also, it is impossible to remove every single fat cell; the remaining cells can enlarge with weight gain. A successful outcome for liposuction is dependent upon the patient maintaining a healthy lifestyle. Q: How much fat can be removed with liposuction? A: The maximum amount of fat that can be removed safely in a single liposuction session is 6 to 8 pounds (3 to 4 liters). The risk of serious complications increases with the amount of fat that is removed. If a patient requires removal of more than 6 to 8 pounds of fat, it is safest to divide the liposuction into separate surgical procedures that are separated by 3 to 4 weeks. Q: What will happen to my results if I get pregnant after liposuction? A: Pregnancy does not permanently alter the results of liposuction. If a woman has liposuction and subsequently becomes pregnant, gains weight, gives birth and finally loses the excess weight of pregnancy, then her original liposuction improvements will return, just as if she had never been pregnant.
- American Society of Plastic Surgeons. Liposuction. Available from: https://www.plasticsurgery.org/cosmetic-procedures/liposuction
- Chalekson, C, et al. (2019). Liposuction Techniques. MedScape. Available from: https://emedicine.medscape.com/article/1272642-overview
- Tabbal, G. N., Ahmad, J., Lista, F., & Rohrich, R. J. (2013). Advances in liposuction: five key principles with emphasis on patient safety and outcomes. Plastic and Reconstructive Surgery Global Open, 1(8), e75. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4186292/
- Housman TS, et al. (2002). The safety of liposuction: results of a national survey. Dermatologic Surgery. 28(11):971–978. Available from: https://www.ncbi.nlm.nih.gov/pubmed/12460288
- American Society of Plastic Surgeons. (2018). 2018 Plastic Surgery Statistics Report. Available from: https://www.plasticsurgery.org/documents/News/Statistics/2018/plastic-surgery-statistics-full-report-2018.pdf