Liposuction Guide: Top Questions & Answers
Liposuction is an invasive (yet minimally scarring) surgical procedure that improves body contour by removing fat cells between the skin and underlying muscles. It’s one of the most popular procedures on RealSelf and one of the most frequently performed around the world.
If you’re considering liposuction, you probably have a lot of questions. We’ve tapped into the expertise of RealSelf doctors to bring you answers to the most commonly asked questions about the procedure.
In This Overview:What Is Liposuction?
Is It Right for Me?
How Does It Work?
What Are the Different Types?
How Much Does It Cost?
How Do I Choose a Surgeon?
Does Liposuction Hurt?
What’s Recovery Like?
What Results Can I Expect?
How Long Will the Results Last?
What Are Common Side Effects?
What Else Do I Need to Know?
What Is Liposuction?
Liposuction is an invasive procedure used to improve body contour by removing areas of excess fat. Common treatment locations include the abs, love handles, thighs, arms, back, and underneath the chin. Though it’s frequently thought of as a weight loss solution, “liposuction is not indicated to treat this problem,” explains Newport Beach plastic surgeon Dr. Larry Nichter. Rather, he notes, “liposuction is intended to improve your body contour by reducing isolated collections of body fat that do not generally respond to diet and exercise.”
In some cases, liposuction can be used to jumpstart a weight loss program, but patients should not expect to lose more than five to ten pounds from the treatment. The procedure is also not effective for cellulite, stretch marks, or sagging skin. “In fact, these problems may be worsened by liposuction,” says Dr. Nichter. Back to top
Is Liposuction Right for Me?
The best candidates for liposuction are men and women who are close to their ideal weight, but still have unwanted bulges of fat. Although liposuction can improve body contour at any weight, those with a BMI over 30 are typically not good candidates for the treatment.
While there are no definitive restrictions for who can and can’t undergo liposuction, it’s important to consider your skin’s elasticity. In general, younger non-smokers with minimal sun damage and darker skin tones have the best elasticity. As we age, our skin loses its ability to bounce back after being stretched, so older patients or those removing a large amount of fat could be left with sagging skin following the procedure. Consult with a board-certified plastic surgeon to determine if liposuction is right for your unique situation. Back to top
How Does Liposuction Work?
Almost all liposuction procedures use what’s called a tumescent technique to minimize bruising and blood loss. First, a diluted fluid of local anesthetic and epinephrine (capillary constrictor) is injected into the fat being treated. Thin metallic tubes called cannulas are then inserted into the body through tiny incisions in the skin. Using the cannula, the surgeon makes controlled motions to dislodge the fat, which is suctioned out with a surgical vacuum or syringe.
Small areas of liposuction are often done using local anesthesia, with or without oral sedation. Larger areas are typically performed under IV sedation or general anesthesia. The procedure rarely requires an overnight stay at a hospital, unless a large amount of fat is being removed. Liposuction is often combined with other procedures, like a tummy tuck.The fat that’s removed can be purified and transferred to the buttocks, face, or other areas to restore volume loss or create a desired body shape. Back to top
What Are the Different Types of Liposuction?
Many different techniques can be used during a tumescent liposuction procedure. Each comes with its own benefits and risks. That said, “No matter which technology is used, it’s the training, experience, and judgment of the plastic surgeon that makes the difference in outcome,” explains Atlanta plastic surgeon Dr. Stanley Okoro. “The surgeon should select the method that will deliver the best result for the patient.”
- Power-assisted liposuction (PAL) uses the same technique as tumescent, with the addition of a vibrating tool that speeds up the breakdown of fat and allows it to be removed more easily in dense areas like the back and upper abdomen.
- Ultrasound-assisted liposuction (UAL) transmits ultrasonic energy through a handpiece, which loosens and melts the fat, making it easier to remove larger volumes or dense fat through the cannula. It takes longer to perform liposuction using this technique, as the fat still needs to be removed with a cannula after it’s been melted. This method also poses a risk for burns, so it’s important to choose a plastic surgeon who’s very experienced in this technique.
- Vaser liposuction is a variation of UAL in which a grooved cannula evenly disperses the energy, improving the breakdown and removal of fat.
- Laser-assisted liposuction (LAL) works much like UAL but uses low-energy waves to liquefy fat, which is then removed through the cannula. In areas with very thin layers of fat, like the face and neck, the cannula might not be used at all. In these cases, the liquefied fat cells will be absorbed by the body. As with UAL, this method takes longer to perform and needs to be done by someone experienced in the technique. Back to top
How Much Does Liposuction Cost?
The average cost of liposuction ranges anywhere between $2,000 and $8,000, depending on factors like the number of areas being treated, the experience of the plastic surgeon, and the geographical location where the procedure is performed.
“There are two main variables in cost for liposuction,” says Raleigh plastic surgeon Dr. Jeremy Pyle. “The first is the location on your body. Difficult areas to treat well, such as the chin, arms, and inner thighs, can cost a few thousand dollars for a relatively small amount of fat. Large, fairly forgiving areas such as the abdomen and back can be the same cost for high volumes of liposuction.”
The second major factor influencing cost is who’s performing the surgery. “Liposuction seems to have attracted a host of poorly qualified non-plastic surgeons who advertise as cosmetic surgeons. To get your attention, they often offer lower prices and specials that seem too good to be true,” he explains. “Do not allow cost to be the most important factor in an irreversible and life-changing surgery. See a few board-certified plastic surgeons and make your decision based on trust and qualifications.” Back to top
How Do I Choose a Surgeon for Liposuction?
Here are some guidelines to follow when researching doctors:
Check Their Qualifications
While any doctor can legally offer liposuction, you want to look for a board-certified plastic surgeon who performs the procedure frequently and has proven safe results. “There are a lot of doctors who are cosmetic surgeons or board-certified in other fields,” says Atlantic plastic surgeon Dr. Johnny Franco. “They do not have the same training as a plastic surgeon.” Check the American Board of Plastic Surgery website to verify certification.
Verify Hospital Privileges
“Hospitals often examine qualifications of doctors applying for hospital staff privileges and restrict these to only surgeons best trained and qualified to do certain procedures,” explains Dr. Nichter. “Non-surgeons and other physicians that are not plastic surgeons (e.g. OB/GYN, dermatologists, emergency physicians, general surgeons, etc.) circumvent this process by performing surgery in their offices or in outpatient surgery centers, where the credentialing is less rigorous or nonexistent. In these settings, non-plastic surgeons may perform procedures in which they have no formal training.”
While Dr. Nichter does not warn against having procedures performed in-office or at outpatient centers, he recommends you verify that your physician does have hospital privileges for liposuction.
Ask About the Operating Facility
“It is critical to ask about the surgery center where your procedure will be performed,” explains Raleigh plastic surgeon Dr. Michael Law. “You need to know about accreditation, sterile processing procedures, and who will be with you in the surgery.”
You can check accreditation with the American Association for Accreditation of Ambulatory Surgery Facilities [AAAASF] or another nationally recognized body.
Look at Before & After Photos
Ask how many liposuction procedures the doctor has performed and how frequently they do them. Then “insist on seeing before and after photos,” says Dr. Law. “A plastic surgeon with experience and expertise should have dozens of images from different angles, all with the same lighting, distance from the camera, and cropping.” Also consider looking at before and after photos posted online by other patients, to be certain you’re seeing real results.
Make Sure You Feel Comfortable
Once you have screened and met with a potential surgeon, ask yourself if you feel fully comfortable and confident with your choice. If something feels wrong, keep looking. Back to top
Does Liposuction Hurt?
Pain is normal after liposuction and often requires prescription medication. The more fat removed, the more pain you’re likely to feel. Most people say the first two days are the most uncomfortable, and that they continue to feel small amounts of pain for several weeks to several months following the procedure. Severe pain after liposuction is unusual and may be a sign of a complication. If this occurs, call your plastic surgeon to make sure you’re healing properly. Back to top
What Is Liposuction Recovery Like?
The results of liposuction typically come in stages, varying by individual. You’ll likely see some results immediately after surgery, but swelling and bruising are normal and take weeks to resolve. “Some residual swelling will persist for several months,” says Dr. Nichter. “It’s also common to have some weight gain due to swelling and the tumescent fluid that was injected. This will resolve over time.” Most people see final results six months after surgery, but you may continue to see improvements for up to a year.
Most doctors recommend taking at a week off from work and your regular routine. (Those who undergo a small amount of liposuction may only need a few days.) In order to prevent blood clots and discourage swelling, light walking is usually recommended starting the day of surgery. Heavy exercise and other strenuous activities should be avoided for two to three weeks.
The use of a compression garment is often recommended for anywhere from three to six weeks. These garments are beneficial for decreasing the amount of bruising and swelling, and helping loose skin to retract. “Some plastic surgeons do not use garments,” adds Dr. Nichter. “But in my experience, the final result is achieved sooner with the use of these garments.”
It’s important to follow your doctor’s post-surgery instructions closely to ensure your safety and good results. Back to top
What Final Results Can I Expect From Liposuction?
As with all cosmetic procedures, results will vary from person to person. It takes several months, and sometimes up to a year, to see final results. This is why many doctors recommend waiting at least 12 months before considering any revision. If lumpiness or uneven areas are still present after this time (typically seen in 5-10% of patients), a touch-up procedure can be performed.
To get an idea of the kind of results you can expect, here are three of the most-viewed before and after photos on RealSelf. Back to top
Photo courtesy of Seattle plastic surgeon Dr. Shahram Salemy
Photo courtesy of Orange County plastic surgeon Dr. Larry Nichter
Photo courtesy of Raleigh plastic surgeon Dr. Jeremy Pyle
How Long Do Liposuction Results Last?
With rare exceptions, such as those with morbid obesity, the number of fat cells adults have in our bodies stays the same. We do not produce new cells, nor do we get rid of them naturally. Diet and exercise may shrink the size of our cells, but they don’t make them disappear. For these reasons, the number of fat cells removed during liposuction remains permanent. However, factors like weight gain and pregnancy may still increase the size of remaining cells.
“[Undergoing liposuction] doesn’t mean you can go hog wild eating Ben & Jerry’s,” warns Palo Alto plastic surgeon Dr. Lauren Greenberg. “If you gain more than five to ten pounds, your body will store this energy in remaining fat cells. Before you do liposuction, make sure your weight is stable. You need to have good exercise and eating habits in place for months prior to surgery” and stick with these habits after your procedure to maintain your results. Back to top
What Are Common Side Effects of Liposuction?
When liposuction is performed at an accredited facility by an experienced plastic surgeon, complications are infrequent. That said, all surgical procedures come with some degree of risk. The most common complications are contour irregularities like lumpiness and rippled skin, especially when aggressive liposuction is performed. Less common complications include adverse reaction to anesthesia, infection and bleeding, hematoma or seroma, sensation changes in the skin, permanent skin color changes, and scarring both above and below the skin (more common with laser- and ultrasound-assisted procedures). Back to top
What Else Do I Need to Know?
Are There Non-Surgical Alternatives to Liposuction?
What Will My Scarring Be Like After Liposuction?
Liposuction involves a series of small incisions less than a centimeter long. Just like scarring from any other type of injury, these incisions will go through a maturation process, likely over the course of a year. “For the first few months, the scar will be red and possibly raised and/or firm,” says Dr. Nichter. “As the scar matures, it becomes soft, pale, flat, and much less noticeable. Some people are prone to hypertrophic scars or keloids, which are abnormal scars that become prominent. If you or a blood relative have a tendency for these types of scars, please inform your doctor.”
Your plastic surgeon may suggest a scar lightening cream, silicone scar sheets, laser treatments, or injections to further minimize the appearance. Use sunscreen and avoid any prolonged exposure to the sun for at least two months, as UV rays can darken the appearance of scars.
What Happens If I Get Pregnant After Liposuction?
Liposuction should pose no risk to any future pregnancies. It’s important to keep in mind, however, that every woman’s body reacts differently to pregnancy. “There are many women who choose to have liposuction before starting a family and they do just fine,” says Seattle plastic surgeon Dr. Shahram Salemy. “But pregnancy is likely to change your body significantly. You may very well wish to have a cosmetic procedure afterward. Getting liposuction before the pregnancy will not eliminate that possibility.”
Should your liposuction results change following pregnancy, you may want to consider a mommy makeover to restore your results or a tummy tuck to address post-pregnancy issues like sagging skin.
Liposuction is still considered the gold standard for body contouring: it’s the most predictable, and it’s performed in a single treatment. However, there are minimally invasive alternatives — though they won’t give you as dramatic results. The most effective non-invasive options use heat, cold, or ultrasound on the surface of the skin. These alternatives include, but are not limited to:
- Kybella (currently only FDA-approved for use underneath the chin)
Have a question we didn't answer in this guide? Let us know in the comments or ask an expert plastic surgeon.
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This guide has been medically reviewed for accuracy by Orange County plastic surgeon Dr. Larry Nichter. Dr. Nichter is triple-board certified, including by the American Board of Plastic Surgery. Following separate residencies at UCLA and the University of Virginia, he went on to train other plastic surgeons at the University of Southern California, where he was a tenured Professor of Plastic Surgery, as well as Chief of Plastic Surgical Research. Dr. Nichter is the president and founder of the Plasticos Foundation, a non-profit organization that provides reconstructive plastic surgery to those in need around the world, and trains local surgeons to do the same. Learn more on his RealSelf profile.
Disclaimer:This content is for educational and informational purposes only. It is not a substitute for medical advice, diagnosis, or treatment provided by a qualified healthcare professional. Your reliance on any information or content provided in the guide is solely at your own risk. You should always seek the advice of your physician or healthcare professional for any questions you have about your own medical condition. RealSelf does not endorse or recommend any specific content, procedure, product, opinion, healthcare professional or any other material or information in this guide or anywhere on this website.
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