Your liposuction questions answered

Written by Andre Rafizadeh, MD
Reviewed by: Jordan Frey, MD

What is Liposuction and fat transfer liposuction?

Liposuction is one of the most common procedures performed by plastic surgeons. It allows patients to achieve a refined silhouette by removing excess adiposity. In essence, liposuction targets the removal of unwanted fat from specific body areas to reshape and contour the body, which is crucial for regions resistant to diet and exercise. It is an irreplaceable tool in the aesthetic surgeons practice and adds valuable contouring to areas such as the neck, breast, and body. Aside from standalone procedures, it can be used in conjunction with breast reconstructions as well as upper and lower extremity reconstructions. Additionally, new innovations have led to the addition of modifications to the standard suction-assisted liposuction (SAL) procedure, these include the use of wetting solutions, changes in cannula designs, ultrasound-assisted liposuction (UAL), power-assisted liposuction (PAL), VASER-assisted liposuction, and laser assisted liposuction (LAL). Along with advances in these tools, appropriate safety guidelines have advanced to provide thorough recommendations for liposuction and other body contouring procedures. These focus on deep venous thrombosis (DVT) prophylaxis and fluid resuscitation which help make these procedures safe and effective. 

Setting realistic goals and expectations is vital before proceeding with liposuction. It is designed more for enhancing body contour than for significant weight loss. This procedure is therefore ideal for those who are close to their target weight, in good health, and have realistic expectations.

Fat transfer liposuction removes fat from the body, which will then be reprocessed and used to augment other areas to enhance their overall aesthetic appeal. This technique is coupled with small incisions and typically performed on an outpatient basis.

Who is licensed to perform liposuction?

Choosing a board-certified plastic surgeon with extensive liposuction experience is crucial.

During consultations, potential candidates should discuss their goals, ask questions, and understand the risks and benefits. Liposuction, as with all invasive procedures, is not without risk. Body contouring requires a complete knowledge of the anatomic, biochemical, and physiological components of the different modalities and their limitations. Choosing a board-certified plastic surgeon will ensure that the procedure is done under the correct indications to follow a safe and controlled manner. In this way, liposuction can be performed safely with predictable results and outcomes. 

Reviewing the surgeon’s before and after liposuction gallery can provide insight into their results. Additionally, reading reviews about your surgeon can help guide you to find the right person for your procedure. During your consultation you will have time to meet and discuss your goals and concerns to see if your surgeon is right for you before proceeding with surgery. 

A thorough preoperative evaluation will include assessing the patient's physical condition, checking for asymmetries, dimpling, cellulite, and areas of adherence, and taking standard photographs of areas to be treated. Other preoperative considerations emphasize the importance of a complete blood count for large-volume procedures, IV antibiotics, and deep venous thrombosis prophylaxis.

Who is liposuction best for?

In the field of plastic surgery, there are invasive and non-invasive ways of dealing with excess adiposity. While liposuction is an invasive procedure, it is not as invasive as an abdominoplasty, which besides removing excess fat, can remove excess skin and tighten your abdominal muscles. When considering liposuction, it is important to appropriately convey your expectations, concerns, and/or complaints prior to proceeding. Specifically, liposuction is performed in healthy patients who have realistic expectations about surgery. The best results have been found amongst those who are committed to a positive lifestyle change, ie. healthy diet and regular exercise, or those who are already practicing these elements of a “healthy lifestyle”. Additionally, these candidates are of stable weight and not morbidly obese. Preoperative consultation with a dietician may be beneficial for some patients who need more information on maintaining a healthy diet pre and post operatively. Liposuction is mainly contraindicated in patients who are pregnant, or poor general health. 

Which liposuction technique suits your goal the best?

Liposuction techniques have evolved to meet diverse patient goals beyond the standard suction assisted liposuction (SAL) also referred to as traditional liposuction. Various liposuction techniques have been developed to cater to specific patient needs and anatomical areas:
  • Suction-assisted liposuction (SAL), is the traditional method of liposuction involving a cannula with a suction cannister and a wetting solution to reduce blood loss in the aspirate; it is efficient with multiple cannulas to choose from along with tried and tested model, however more difficult in fibrous areas and secondary liposuction.
  • Power-assisted liposuction (PAL), involves the use of an externally powered cannula, which oscillates at rates of 4000-6000 cycles / min to harvest lipoaspirate; it is effective for large volumes fat harvesting, fibrous areas, and revision liposuction; ultimately reduces surgeon work and increases speed however at the expense of larger handles and vibration during procedure.
  • Ultrasound-assisted liposuction (UAL) involves ultrasonic energy to break down fat therefore allowing suction removal to effectively emulsify fat. Skin is covered with a towel to prevent thermal injury as acoustic energy acts to achieve adipocyte fragmentation; it is effective in fibrous areas and in secondary procedures. Disadvantages are related to its cost, slightly larger incisions, longer operative times, and risk of thermal injury. 
  • Laser-assisted liposuction (LAL) involves the insertion of a laser fiber (housed within a cannula or as a separate fiber) through a small incision transferring laser energy to tissues in the form of heat. The most common wavelengths are 924/975nm, 1064nm, 1319/1320nm, and 1450nm. In addition to the normal stages of infiltration, application of energy to the tissues, and evacuation, the final stage is subdermal skin stimulation. During application of laser energy, the laser fiber acts to disrupt fat cell membranes and emulsify the fat. Once the fat is evacuated, the sub dermal tissue is heated causing a skin tightening effect. 

Other techniques: 
  • VASER liposuction employs newer generation ultrasound assisted liposuction technology which uses less energy with more efficient probes. This reduces the chance of skin injury. It is beneficial for large volume liposuction to reduce blood loss and is also efficient in fibrous fatty tissues. 
  • Smart liposuction uses laser energy for skin tightening in addition to fat removal. 
  • For facial concerns, submental liposuction targets under-chin fat. 
  • Awake liposuction, under local anesthesia, keeps patients conscious, while 360 liposuction provides a comprehensive torso treatment for a reshaped effect.

Which body areas can be targeted?

Your surgeon will discuss the target areas for liposuction based on your goals. Common areas include the breast, abdomen, inner thigh liposuction, arms, buttocks, love handle liposuction, and cheek liposuction. Preoperatively, your surgeon will elucidate the areas of lipodystrophy and contour deformities, skin tone, asymmetries, dimpling and cellulite, myofascial support, and zones of adherence along your body. 

Chin liposuction, face liposuction, and neck liposuction are popular for facial contouring.
Double chin liposuction cost is frequently inquired about by those looking to enhance their facial profile and silhouette. 
Liposuction for men, or male liposuction, has surged in popularity, with techniques like abdominal etching creating a more athletic appearance. Men's liposuction before and after photos often demonstrate the procedure's capability to address male-specific aesthetic desires.

How much does liposuction cost?

Liposuction cost is a significant factor, with many seeking information on face liposuction cost, neck liposuction cost, and 360 liposuction cost.

These costs can vary widely based on the procedure's scope, location, and the surgeon's experience. Prospective patients should thoroughly research and discuss options with their surgeons to align aesthetic goals with financial considerations, ensuring a satisfying outcome without undue financial strain.