Liposuction (5 Liter Limit)

Yes, it’s surgery, but since its introduction to the world of plastic surgery in the 1980s, liposuction is still considered the gold standard for permanent fat reduction. It’s certainly not the only scientifically proven way to reduce fat – see Sculpsure and Coolsculpting. However, liposuction is always amongst the top five most popular cosmetic surgeries.  So here’s the scoop.

There are three types of liposuction: tumescent, ultrasonic, and laser:

  1. Tumescent liposuction is the technique that most plastic surgeons use when they perform liposuction.  This procedure involves two steps. First, the surgeon makes a small incision in the skin and injects anesthetic fluid to decrease postoperative pain and limit bleeding. Next, the plastic surgeon uses a long, hollow rod (called a cannula) hooked up to a suction device to mechanically disrupt the deep fat and literally suck it out. The fat that is removed is gone.  Permanently.  The patient is placed into a spandex garment to decrease swelling and bleeding, which he or she wears for the next 3-4 weeks.  This is typically a very efficient way to permanently remove fat cells from the body.
  2. Ultrasonic liposuction was developed in the late 1990s and currently goes by brand names like Vaser and Lysonix.  The first step (infusion of anesthetic) is the same, and the last step (sucking out the fat) is the same as the tumescent technique, but there is a middle step.  In the middle step, the surgeon inserts an ultrasonic cannula which looks similar to the liposuction cannula, except that the end emits ultrasonic energy.  This allows the plastic surgeon to melt fat and connective tissue fibers and theoretically remove fat more efficiently.  It can help a surgeon more effectively remove fat from areas where it is dense and fibrous (like a man’s breast or in a person with a lot of scar tissue), but at added expense and the rare risk of burns. I rarely use ultrasonic liposuction anymore since its benefits for most people overall are pretty minimal.
  3. Laser liposuction was developed most recently, over the past several years, and goes by the brand names Smart Lipo, Slim Lipo, and others.  In this surgery, the first and last steps (infusion of anesthetic and sucking out the fat) are the same as in tumescent liposuction, but, like ultrasonic liposuction, there is a middle step. In laser liposuction the plastic surgeon takes a thin laser fiber and passes it under the skin numerous times, in order to heat up the skin overlying the fat.  Theoretically, the heat causes the skin to tighten.  The big question is: How much does the skin actually tighten?  It depends on who you ask. Doctors who own the laser liposuction devices often claim that the skin tightening can be dramatic. Doctors who don’t own the devices often claim there is no tightening at all. I suspect that the truth is likely somewhere in between, but probably leaning more towards the little-to-no tightening side.  My recommendation is that if you are considering paying extra for laser liposuction, choose a small area where even a modicum of skin tightening will be noticeable and worth the additional expense. This could include the skin under your chin and your arms. The Smart Lipo device arguably has the most safety mechanisms built in, so the risk of burns is lower with this device than with the others. So if you choose to have laser liposuction, I recommend that you find a board-certified plastic surgeon who uses Smart Lipo.

So should you have liposuction, and which type of liposuction is best for you? If you have small stubborn areas of fat that are resistant to diet and exercise, and the cost and invasiveness of liposuction aren’t deterrents, then you may be a good candidate for the procedure. Ninety percent or more of people who are good candidates for liposuction do just fine with the tumescent technique, saving time and money in the process.

If you’ve had liposuction before and need a second revision procedure, then ultrasonic liposuction may be right for you. If you just want to reduce fat in a small area (such as under the chin or the upper arms) and have a little loose skin, then it may be wise to look into laser liposuction, specifically Smart Lipo.

The cost of liposuction varies, typically starting at about $1000 for a small area to $10,000 plus for extensive liposuction. Adding ultrasonic or laser to the procedure also adds costs, which could run in the thousands of dollars.

Keep in mind that liposuction isn’t a weight loss procedure and is not a valid substitute for diet and exercise. The maximum amount of fat that the FDA recommends to be removed in one outpatient setting is about 5 Liters, or 11 pounds of fat. Anything more than this can be dangerous, with the potential need for blood transfusions.

To learn more about Dr. Youn performing liposuction, click HERE.