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Liposuction is one of those words that constantly swirls around the beauty world. After all, it’s one of the longest standing cosmetic treatments on the market. But, do you actually know what lipo is? Or, better yet, what effects it leaves behind? To uncover just that we chatted with a few board-certified plastic surgeons for the 4-1-1 on all things liposuction, from how much it costs to how long the results last.
What Is Liposuction?
Liposuction is a surgical, cosmetic procedure designed to remove unwanted body fat—specifically of the subcutaneous variety (read: fat under your skin). “It involves sucking out small areas of fat that are hard to lose through exercise and a healthy diet,” says London-based consultant plastic, reconstructive, and aesthetic surgeon Dr. Olivier Amar. “It is most effective for people whose weight is [within healthy range] and who have firm, elastic skin.”
While the fat removal technique has been around since the 1970s, double board-certified plastic surgeon Paul G. Ruff IV points out that it’s evolved significantly since then. “Many options now exist for improving how the fat is removed including power-assisted devices, ultrasonic systems such as VaserLipo, laser-assisted, water-jet assisted, nutational, and radiofrequency,” he explains, noting that Vaser is his tool of choice due to the efficiency and tissue-protective nature of the energy when delivered properly.
Benefits of Liposuction
- Removes unwanted fat
- Contours the body
- Enhances curves
- Can remove lipomas (non-cancerous tumors of fatty tissue)
“The obvious benefit of liposuction is the ability to remove and contour stubborn or resistant areas of fat almost all over the body,” Ruff, who has been in private practice for over 20 years and owns the largest plastic surgery practice in the DC area, West End Plastic Surgery, explains. “This can have tremendous effects on body proportion and appearance.” What’s more, he explains that fat is a living tissue with regenerative cells, so, once removed, it can be used to correct contour issues or enhance other areas of the body—some patients choose to reallocate fat into their buttocks, breasts, and cheeks.
Liposuction vs. CoolSculpting
Liposuction has been around since its inception in 1974—CoolSculpting didn’t enter the market until 2010. Nevertheless, the new and improved fat contouring technique gives liposuction a run for its money. That’s because where liposuction is the most common cosmetic plastic surgery procedure, CoolSculpting offers the ability to similarly contour without so much as creating an incision.
“CoolSculpting is the best non-surgical body contouring device,” Ruff says. “The application of various treatment paddles allows contouring of many areas of the body and neck.” This is done by freezing fat to a particular depth, all while protecting the outer layer of skin. “This fat then dies away through a process called apoptosis (programmed cell death) leaving little to no scar tissue and a thinner, happy patient,” Ruff explains. What’s more, Ruff points out that, unlike liposuction, CoolSculpting is completely non-surgical, it doesn’t require any anesthesia, and patients can do multiple areas in a single setting. “Each area requires about 45 minutes, on average to treat,” he says. Most areas will require multiple treatments (two to four) to achieve a full treatment result, and treatments are usually six to eight weeks apart.
Now, while the non-invasive nature of CoolSculpting may seem fab, Ruff reminds us that liposuction takes but one session to blend and/or transition areas by physically removing the fat. “Smaller areas and patients with a high pain threshold can often manage with only local anesthesia and limited downtime,” he adds.
Number of treatments and downtime aside, Amar says there’s one key factor you must keep in mind when choosing between liposuction and CoolSculpting: “CoolSculpting is much more useful for removing small areas of fat, whereas liposuction is more suitable for removing large portions of fat.”
Liposuction vs. Laser Liposuction
Yup, there are multiple types of liposuction. Where classic liposuction uses a tube (read: cannula) to suction fat out of the body, laser lipo employs (you guessed it) lasers to non-invasively destroy fatty tissue, toning the skin in the process.
“Laser liposuction causes an immediate contraction of the skin, making it ideal for normally hard-to-reach areas in classic liposuction surgery,” Amar says. “Because it is such a precise procedure, it enables refined retouching of unsatisfactory previous liposuction treatments.” What’s more, he says that laser liposuction can be combined with conventional lipo to promote a faster, more effective healing response in large treatment areas.
As far as which is better, Amar has some thoughts. “In ‘classic’ liposuction, there is more trauma and bleeding as the fatty deposits are treated through a cannula,” he explains. “The main advantage of laser lipolysis over classical liposuction is that it involves a much quicker and less painful recovery because the inflammation is much less aggressive, and the overall procedure is not as invasive.”
Who Is a Candidate For Liposuction?
Curious if you’re a good fit for a liposuction treatment? Board-certified plastic surgeon Dr. Alexis L. Parcells says that anyone who has elastic skin and is close to their ideal body weight and is confident they can maintain that weight after the procedure is a good fit. Additionally, she says those with overall good health and an active lifestyle can benefit most. “Although fat removal with liposuction is usually permanent, any cells left behind can continue to grow with weight gain,” she explains.
Lastly, she reminds us of the importance of realistic expectations. After all, liposuction can help contour, but not completely change a person’s body without their effort and commitment to maintaining the new weight.
How Much Does Liposuction Cost?
Point blank: It depends on where you go, what you’re having treated, and how long it takes.
That said, Parcells points out that The American Society of Plastic Surgeons published an average cost of liposuction in 2018 to be $3500. “Again, it is just the surgical price based on the area being treated,” she says. “This price does not include the cost of anesthesia, operating room facilities, or other related expenses.”
“At West End Plastic Surgery, I charge by time which is a far more transparent way to price a procedure,” he says. “My usual hourly rate is $3,500 and most procedures take two to four hours. There is also a facility and anesthesia fee when applicable. But that includes the procedure, all post-op care for the first year, two garments, and some immediate perioperative nutritional and hydration supplements.”
Regardless, keep in mind that, while technically a medical procedure, liposuction is not routinely covered by health insurance, though, as Parcells points out, many plastic surgeons offer 0 percent interest financing plans, so be sure to ask.
How to Prepare For Liposuction
As with all surgical procedures, those who wish to undergo a liposuction treatment will be expected to come in for a consultation first. During the consultation, a physical exam will be performed and questions will arise around the topic of whether or not you’re a good candidate—namely, whether or not you’ll do the work to maintain the new weight.
“The surgeon will make a note of any illnesses you have or have had in the past,” Amar says. “They will also make a record of any medication you are on, including herbal remedies and medicines that are not prescribed by your doctor. Your surgeon will examine you and may take some photographs for your medical records. They will ask you if you want to have someone with you during the examination, and ask you to sign a consent form for taking, storing, and using the photographs. They will measure your height and weight to make sure that it is safe to do an operation. If you are [not within a healthy weight range] or are planning to become pregnant, your surgeon may suggest delaying your operation.”
Outside of (and, honestly, before) the consultation, Parcells says your number one prep step should be finding a board-certified plastic surgeon. This will ensure your body is in good, capable hands.
What to Expect During a Liposuction Treatment
First things first: anesthesia is on the table. “Liposuction may be performed under general anesthesia, IV sedation, or local anesthesia depending on both surgeon and patient preference and expectations,” Ruff says. “Most patients have a limit or threshold for the sensations they may feel during a procedure, therefore limiting what may be achieved under local anesthesia.” Where smaller areas—less than two body regions—are quite manageable under local anesthesia in the right patient, he says that larger areas may call for general anesthesia.
“As long as enough time has been allowed for the local anesthesia to take effect, the feeling of pain should be minimal unless the surgeon treats beyond the area,” Ruff says. “Sensations patients describe are tugging or pulling. Odd but not terrible; however, after some time the body and mind may start to anticipate this as impending pain, limiting the ability to complete the procedure.”
On average, Parcells says the liposuction surgery can take several hours depending on the area of the body being treated. “Most patients experience mild to moderate discomfort as well as bruising and swelling for several days following surgery,” she adds.
Potential Side Effects
Speaking of bruising and swelling, let’s talk about side effects. As with just about any surgical procedure, side effects are possible. “Patients may have an unacceptable cosmetic result, scars that they do not like (seasoned surgeons will place these in discrete areas and make then quite small), asymmetries, contour irregularities, pain, prolonged swelling, loose skin, fluid collections called seromas, and infection,” Ruff warns. “As with almost any surgery, there are more insidious complications such as death, pulmonary embolism, however, with proper patient selection and surgical management, this should be rare.”
Additionally, you might not notice major bodily improvements within the first two to three weeks, as swelling can be quite dramatic. In fact, Amar says that bruising and swelling can last up to six months, numbness can last up to six to eight weeks, and scars can last forever.
Lastly, if lipo is combined with another surgery such as a tummy tuck or butt lift, Parcells says that you are at an increased risk for blood clots. “For this reason, you may be monitored overnight in a hospital and/or placed on blood-thinning medication for up to a week,” she explains.
Given swelling, incision weeping, and bruising can last for weeks on end, some practices require you to have a short hospital stay depending on the amount of fat removed. “It can be short (a few hours) for small liposuctions under local anesthesia, or longer (one or two days) for larger liposuctions under general anesthesia,” Amar says. “The necessary time needed to recover from surgery is proportional to the amount of excess fat removed.”
Once you’re out of the hospital, Ruff says that you should wear some sort of compression garment over the treatment area for two to six weeks—your surgeon will tell you which. Additionally, you should take your time before returning to strenuous exercise—Ruff recommends waiting one to three weeks depending on the size of your treatment area.
The Final Takeaway
As a whole, it’s important to remember that liposuction is not a weight-loss procedure. “At most, you may lose a few pounds,” Parcells explains. Because of this, she says that it’s best viewed as a body-sculpting procedure. That said, downtime and pain are minimal, and results can be gratifying, so it may very well be the next bucket-list cosmetic treatment to check off your list. Only you and your surgeon can decide. As part of your decision, remember that this is a serious surgical procedure