How is Body Fat Accurately / Concretely Measured Before Suctioning It out Through Liposuction?

I haven't read anything about how body fat is measured to accurately determine how much might be safely suctioned out from each target area. How do doctors concretely know how much of a patient's BMI is muscle, how much is fat, and how much is skin?

Doctor Answers 17

% fat

The % body fat depends on the thicknessof fat measured in various areas with a caliper, combined with weight and height ,I am no expert but I think serious weight lifters like to have 5% body fat. I am more interested in cms of fat. I use my index finger to go thru the fat to the underlying fascia and record the layer of fat in centimeters. Then I give the patient an educated guess what lipo will do in centimeters to be removed. I tend to be conservative, trying to stay away from irregularities, leaving enough fat for insulation.

Lafayette Plastic Surgeon
5.0 out of 5 stars 2 reviews

Measuring amount of fat to remove by liposuction

It is actually simpler than you think. Just pinch the skin and measure the difference between your index and thumb. That distance is a double layer of fat under the skin. 2 people can have the same BMI but one has more fat in the love handles and the other has more in the lower abdomen. The only way to know where to remove the fat from and how much to remove is to examine the patient.

I hope you realize that this format of posting questions and receiving answers lacks the face to face direct communication required for you to make an informed decision regarding your surgery.

My response to your question/post does not represent formal medical advice or constitute a doctor patient relationship. You need to consult with i.e. personally see a board certified plastic surgeon in order to receive a formal evaluation and develop a doctor patient relationship in order to know if this assessment is valid.

Aaron Stone, MD
Los Angeles Plastic Surgeon
5.0 out of 5 stars 2 reviews

How much fat is there to remove with liposuction?

There are no accurate ways to determine how much fat is to be removed during liposuction.  The most important issue is to determine which patients are good candidates and then to have a skilled and experienced board certified plastic surgeon in the operating room.  The tools that are used are of much less importance than the experience of the hands holding them.  The concept is the creation of tunnels through fat which then collapse over time, yielding the desired change in shape.  Certain areas of the body respond better than others, depending on skin type and tone and anatomic area.

Daniel Greenwald, MD
Tampa Plastic Surgeon
5.0 out of 5 stars 46 reviews

Estimating Amount of Fat to Be Aspirated in Liposuction

Your question is very interesting and very important.  BMI is only an index that helps the doctor decide whether a patient is suitable for suction lipoplasty, or whether they need to first lose weight, or have other procedures done.  Of course it is only an index and is not a replacement for the doctor's experience and proper judgement.  It is only experience and proper judgement that mainly come into play in such decisions.  For example, we see many patients who mainly need a tummy tuck, but undergo suction lipoplasty by unexperienced and unqualified individuals and either do not gain anything or refer to us "after the fact" with all sorts of deformities and irregularities.

Ruben B. Abrams, MD, FACS
Beverly Hills Plastic Surgeon
5.0 out of 5 stars 19 reviews

Fat estimation for liposuction

Actually, when it comes to liposuction, there is no exact calculation.

The most important thing is the doctors skill as a surgeon and a listener.

The doctor must really listen to what the patient goals are, and then be sure that that they can be achieved.

Secondly, liposuction works by removing fat, but the skin must be able to re-drape or shrink to the smaller sized person (thus the doctor must carefully assess this pre-operatively, and balance amount removed vs. ability of skin to re-drape).  On top of that, the surgeon must think three dimensionally so that the final shape looks good and there are no significant surface irregularities.

Regarding BMI, lipo is not a weight loss procedure, so that is not really a consideration.

When it comes to the result, really it comes down to the surgeon's skill anad experience.

Scott E. Kasden, MD, FACS
Dallas Plastic Surgeon
4.8 out of 5 stars 106 reviews

How is Body Fat Accurately / Concretely Measured Before Suctioning It out Through Liposuction?

      There is not a compelling need to know the body fat percentage prior to liposuction as liposuction is used to target stubborn areas not for overall fat reduction.  The relative volume to be removed from an area is less important than achieving contour improvement.  Find a plastic surgeon with ELITE credentials who performs hundreds of liposuction procedures each year.  Then look at the plastic surgeon's website before and after photo galleries to get a sense of who can deliver the results.  Kenneth Hughes, MD Los Angeles, CA

Kenneth B. Hughes, MD
Los Angeles Plastic Surgeon
4.9 out of 5 stars 496 reviews

Safe Liposuction

There is no accurate method available to predetermine exactly how much fat will be removed from each target area.

An experienced plastic surgeon makes an estimation based on the evaluation of the patient. The total amout  removed has a safe limit and the amount removed safely from  each are is a clinical judgement by the surgeon during surgery.

Ronald Iverson, MD
Pleasanton Plastic Surgeon
5.0 out of 5 stars 3 reviews

Measuring Fat before Liposuction

Fat is not measured before it is liposuctioned. We may estimate the total to be removed in order to determine whether it will be safe to send you home or not. If we do, this is by experience and is an estimate. Liposuction is designed to reduce specific areas that are out of proportion with the rest of the body. The amount removed is what comes out while leaving the area smooth and blending with the rest of the body. This is an artistic assessment done at the time of the liposuction and depends on how the area feels and looks. We always remove a minimal amount first and then, using smaller cannulae, sculp the area to the desired appearance.


Robert T. Buchanan, MD
Highlands Plastic Surgeon
5.0 out of 5 stars 6 reviews

Fat measurement before liposuction

Thank you for your question about liposuction.

  1. The purpose of liposuction is to improve the appearance.
  2. Plastic surgeons rely on the appearance and feel of the fat during liposuction to decide how much fat to remove.
  3. Future 3D technology may be able to predict how much fat will be removed.
  4. But such technology might not affect actual liposuction results.

​Hope this helps answer your question. Best wishes.

Elizabeth Morgan, MD, PhD
Atlanta Plastic Surgeon
4.6 out of 5 stars 43 reviews

One of the most reliable methods for analyzing body composition is based on the bioelectric impedance

One of the most reliable, simple, and direct  methods for analyzing body composition is  based on the bioelectric impedance, which involves measuring of  the resistance to electrical current applied through  electrodes, the resistance is inversely  proportional to  total body water which travels through the stream.
Muscles, blood vessels and bones are body tissues having a high water content which conducts electricity easily, body fat is tissue that has little electric conductivity, the Body Fat Analyzer sends an extremely weak electrical current to the body to determine the amount of fat tissue, weak electrical current is not felt while operating the Body Fat Analyzer. The body fat percentage is calculated by a formula that includes five factors: electric resistance, height, weight, age and gender.
At present there are several brands that offer household equipment to calculate the weight and percentage of body fat fairly reliable, a couple of examples: the balance fat monitor Omron HBF-400 Inner Scan and balance BC551 Tanita
Physical examination can not accurately measure the amount of fat that can be removed in an  determined  anatomical area , but based on the body mass index, the thickness of the skin (as determined by pinch test) and the surgeon's experience can give a fairly close idea , however, I should clarify that liposuction is not a weight loss procedure but to shape and contour the figure.
The most important factor to consider is not only  the total volume of extracted fat but also  the  fat that is left  in the different areas to maintain harmony. If you want to  know which is  the maximum amount  of fat that can be  securely removed in a certain area I can tell you that the reference  is until  the skin and subcutaneous tissue has a thickness of 0.5 to 1 cm depending on the area (when  thickness of skin is lower , skin damage may ocurrs by affecting the blood supply.)
The  total volume of fat that can be extracted will depend on hemoglobin levels before surgery, medical history ( health condition ) and the amount of bleeding during the procedure, I have had cases where I have been able to extract up to 11 liters of fat without the need for transfusion and with excellent results. As a rule when extracted more than 5 liters of fat (mega liposuction) increase the risk of bleeding and need for transfusion as well as the risk of  complications.
However, in the medical reports are very few cases that have had disastrous results. As calculated, the possibility of a fatal outcome is 1 person between 5000 (ie 0.02%), which implies a reduced risk. In any case, it is best to always be in the hands of physicians with recognized expertise and prestige.

Jose Luis Acosta Collado, MD
Dominican Republic Plastic Surgeon
5.0 out of 5 stars 29 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.