Liposuction is optimally performed on individuals who have achieved a stable weight with desire for reduction in localized adipose (fatty) tissue deposits.
It can be applied to nearly any anatomic location of the body. Strictly speaking liposuction is the application of a negative pressure (vacuum suction) to remove fat through small incisions in the skin using a small metal tube of various shapes (cannula).
The cannula can be moved back and forth (like a jack-hammer) with the assistance of a oscillating machine (Power assisted liposuction) or through microscopic movements using ultrasound energy (Ultrasonic Assisted Lipoplasty).
When the fat is destroyed using a small cannula and laser fiber, we call it laser assisted lipolysis.
It’s difficult to speak in generalities so let’s speak specifically about liposuction of the stomach area as an example. An office visit/consultation is mandatory prior to scheduling the procedure. We have 300lb individuals and 120lb individuals who ask about liposuction.
Even if it is the same location, this procedure would not be performed in the same fashion. What you may consider is one body part such as the STOMACH/ABDOMEN area may consist of upper and lower abdomen, hips, flanks, upper buttocks, back, etc.
It would be two or more distinctly different operations despite being performed on one body part. During the consultation we may determine that other procedures are better suited for your optimal outcome such as a thigh lift or tummy tuck.
The amount of fat to be removed is a complex decision process determined based on your desires, anatomy, practicality, and wound healing. Ultimately, your body shape is determined by more than the fat layer and truly depends on a relationship of your skeleton, muscle mass, fat, and skin components.
An important consideration is your skin tone which may vary according to genetics, tobacco use, sun exposure, pattern of weight gain/loss, age, etc. Furthermore, if you have been pregnant, your condition may require skin removal and muscle tightening (“tummy tuck” also known as abdominoplasty).
Removal of too much fat with poor skin tone can produce loose, sagging, dimpled skin. (Otto Joseph Placik, MD, Chicago Plastic Surgeon)
Liposuction is best to remove specific areas resistent to diet and weight loss
Liposuction is best used to remove focused areas of fat that are not responding to weight management and exercise. The skin in these areas needs to be healthy and elastic so it will shrink well after the procedure.
Those patients who can point to their areas of interest with one finger will be much happier with their results than patients who paint brush across a broad area with their entire hand. In other words, a patient with saddle bags but who is otherwise happy with their thighs will be MUCH happier with their result than a patient who has always hated their entire thighs and is hoping that liposuction (“liposculpture” is the same thing) will sculpt out of them something it simply cannot. (Richard P. Rand, MD, FACS, Seattle Plastic Surgeon)
Liposuction for Body Contouring
Liposuction is best for those patients who are at their usual weight and have an area or bulge that is out of proportion with the rest of their body. For example: A good candidate would be a 5 feet 3 inch 160 lb. woman, who has been stable at that weight for a few years, but has a disproportionately large saddle bag or lateral thigh area. She would be ideal to contour that area so that she can achieve a smoother transition from her hips to her thighs.
Or a 6-feet-tall male who is 180 pounds with a more protuberant belly. He would be ideal to contour that abdomen so he feels that he doesn’t have to purchase a larger sized T-shirt to cover up that bulge, when the rest of him is generally evenly distributed.
Liposuction is not a weight loss solution but a means to provide a more pleasing silhouette and contour to the body. It would be unrealistic to go from a size 6 to a size 4, but if the waist is bulgier that the hips, than this may help contour those bulges. (Sofia Rubbani, MD, Tucson Ophthalmologist)
Best candidate for Liposuction
A good candidate for liposuction is someone who is fairly close to their ideal body weight but has localized fatty deposits that are resistant to diet and exercise.
Also, a person must have relatively good skin tone and elasticity in order to ensure a good result with minimal contour irregularities.
Liposuction is not a weight loss procedure and should not be performed in someone who is extremely overweight.
Liposuction is intended to improve contour and shape, it is not intended to reduce a person’s body weight. (William Bruno, MD, Beverly Hills Plastic Surgeon)
Patients who would benefit from liposuction procedures, are in a good healthy state and have overall maintained their weight. Liposuction in certain fatty isolated areas of the body can improve the body countours. It is not meant for weight loss, liposuction is only beneficial to certain patients.
To determine if you are a good candidate for the procedure, consult with a board certified plastic surgeon. Depending on the elasticity of the tissue and the quality of the skin, liposuction could be an option for certain patients. (Tom J. Pousti, MD, FACS, San Diego Plastic Surgeon)
Liposuction – who is best suited?
Liposuction is best suited for patients who have localized fat deposits. Liposuction is not good for overall weight loss. In fact, patients can accomplish more on their own in two weeks in the gym than I can accomplish safely in the operating room.
However, most of my liposuction patients will never be able to dislodge the stubborn areas of fat no matter how much they work out. These areas are simply “stuck”. Patients are frustrated and often demoralized by these areas.
Patients who are at their “baseline” weights may be candidates for liposuction. Baseline weight is the weight where the patient “lives” when they are doing their best with diet and exercise, not the “ideal weight”, the weight we would all like to be, but, for most of us, cannot realistically maintain.
Many patients seek “aggressive liposuction” in hopes of removing lots and lots of fat. It is with this aggressive liposuction that we see the worst contour problems, lumpiness, sagging skin, etc, that often cannot be fixed.
For the right patient, liposuction can literally be life-changing. (Brent Moelleken, MD, Beverly Hills Plastic Surgeon)
Lumps and bumps of excess fat.
Liposuction was not designed to make fat people skinny. It’s best use is to take people who have excess fat in places that they can not get rid of with diet and exercise. The ideal patient is a normal weight, or a few pounds over who has an area such as the lateral thighs, love handles, medial thighs or poochy stomach that needs some attention.
Men’s common areas are the chest (gynecomastia) love handles and abdomen. It will not remove abdominal fat that is inside the abdomen, just the excess fat under the skin. In general, we will not take off more that 5,000ml or 5 liters at one sitting.
28 Year Old Woman Treated With Liposuction Of Neck And Lower Face With Dr Kris M. Reddy, MD, FACS, West Palm Beach Plastic Surgeon
Although this seems like a lot, on an overwieght patient, 12lbs of fat can seem like a drop in the bucket. Diet and excercise should be the course of action for overweight patients. There is no quick fix for years of overeating. (William B. Rosenblatt, MD, New York Plastic Surgeon)
Liposuction is simple. In fact when I am describing it to a potential patient I cite this simplicity as its best asset and its worst liability. Lipo best addresses fat and has minimal effects on skin.
If the skin over an area treated with lipo is loose and saggy, it tends to stay that way afterward. So liposuction is “fat contouring” best performed for people with pretty “tight” overlying skin. The power assisted (ultrasound and laser) lipo technologies really don’t change this much but can help occasionally in borderline cases. (John P. Di Saia, MD, Orange Plastic Surgeon)
Body contouring not weight loss
Liposuction is a tool for body sculpturing. Liposuction removes localised fat from areas of the body. It is not a tool for weight loss. It is also not a good option in cases where is excess skin.
There is a limit on the amount removed safely per session. The society recommendation is not to remove more then 5L of lipoaspirate at one time. (Hisham Seify, MD, PhD, FACS, Orange County Plastic Surgeon)
A common misconception is that liposuction is for weight loss. However, it really should be viewed as a contouring procedure. It is good for patients with steady weight, but with a little extra bulk in specific areas.
You should also have good skin elasticity. If you have loose skin, then there is a good chance that performing liposuction will not help you. In this case, you would be better served by abdominoplasty or skin excision. (David Shafer, MD, FACS, New York Plastic Surgeon)
Liposuction or liposculpture is best at removing small to moderate thickness localized fat pads. It really works best in those who don’t really need it. Sounds funny, but it is true. It is not a treatment for obesity.
As a guide, you need fat to remove (this is important because sometimes other things look like fat, for example a hernia), and you need to have good skin tone that will shrink to the smaller size.
The best candidates are those with little fat, and excellent, elastic skin. (Scott E. Kasden, MD, FACS, Dallas Plastic Surgeon)
Liposuction is great for areas of isolated fat excess that do not go away in the gym. It is ideal for those areas that are recalcitrant to getting smaller with weight loss. (Steven Wallach, MD, New York Plastic Surgeon)