What determines how much/how dramatic results can be when performing liposuction on someone? What is realistic & safe?

Question

The examples I think of are of lipo in the dominican republic. How are they able to lipo so much off and get those results without a TT? What determines how small someone can be lipo'd? Why is it that there are big patients where mass volumes are removed but then on smaller patients only a little of a difference was able to be made? Does it depend on the style of the surgeon? I am getting liposuction and am worried about not getting the more dramatic results I envision.

Jason Emer, MD · Answer

Liposuction is a body contouring procedure. For best results with liposuction, it is best to be at or near your stable weight. Depending on skin laxity, a tummy tuck may be needed which could be done at the same time. Skills, expertise and technique also factor into successful liposuction results. For best results, I recommend a hi definition procedure like VASER liposuction. I use VASER HI DEF with ThermRF and fat grafting to get the most fat removal, skin tightening, contour and definition. This combination will give you the most toned result. I recommend getting a formal evaluation with a hi definition physique expert. Results are determined by the persons skin, athletic build, and if they have bone structure that allows for a tight small look.  Best, Dr. Emer

George Marosan, MD · Answer

Thank you for your question and posted photos of patients you use for examples. I answered similar posts before. There are two kinds of liposuction: 1. debulking and 2. revealing. Most surgeons in this country are trained to do debulking liposuction. This means that they decrease the bulk of fat you have regardless of your underlying anatomy. Some surgeons, like myself, who are trained, do revealing liposuction. This is a more artistic sculpting technique where the anatomy of the patient is recognized and revealed with deep and superficial liposuction. You see this in the photo you posted from the DR. That patient not only had liposuction down to the rib cage, abdominal muscles, obliques, but also had fat transfer to her hips and buttocks to create the dramatic hourglass figure. No preop photo of her was posted, so we do not know her original shape. Now, not everyone is a candidate for this procedure. You must be a BMI of 30 or less, otherwise you might need a debulking procedure first (like the other photos you posted) before sculpting can be done. See a board certified plastic surgeon experienced in advanced body sculpting techniques for an in person consultation/evaluation. Good luck.

Aaron Stone, MD · Answer

The first 4 photos prove what we know about liposuction as a sole procedure. It is not for weight control and works best if it does not leave behind a lot of extra skin. The darker skinned individual had less excess skin than the lighter skinned individual. That lighter skinned individual obviously had something more than just a liposuction and the scars from that surgery are hidden by their under garment that sits just below belly button level as well as a blurry photo. The reason you see a large difference in big patients where mass volumes are removed but then on smaller patients only a little of a difference may be because the marketing is fraudulent and the patient had more than just liposuction. The last photo of the hourglass shaped torso obviously had liposuction and fat grafting but without a before surgery photo it is impossible to say how much excess skin was present before surgery but I doubt there was much. The most important thing about liposuction is what is left behind not what is removed and you have alluded to that in your post. You need to leave a thin layer of fat under the skin because except in the eyelids skin directly on muscle does not look good, can hamper range of motion and is prone to scarring and abnormal skin contour. The hourglass shaped person in the last photo may have some problems down the road including bizarre appearance if she gains weight in her thighs.You are correct in your premise that different surgeons get different results but it is not due to their "style". Just like no 2 people have the exact same handwriting no 2 surgeons do liposuction exactly the same way. Although one needs the right tool for a job the carpenter is more important than the hammer. It is conceivable that 2 different surgeons using 2 different methods and tools of liposuction can get equivalent results in a given patient. However, when you widen that to 100 surgeons some surgeons are going to miss the mark and if you add a different patient different surgeons in that group of 100 will miss the mark. No one said picking the right surgeon for you is easy but at least you have a choice in cosmetic surgery. You no longer have that choice with insurance covered surgery in the US.Without any photos of you before surgery on knowing what dramatic results you envision it is hard to say what would be realistic or safe for you.Lastly, without trying to cast dispersion on specific Dominican surgeons there have been problems with people in the northeast US who had cosmetic surgery in DR and returned with serious infections. If as I stated above it is hard to pick a surgeon in the US it has to be just as hard or harder to pick one in DR, especially if you don't see them face to face prior to picking him/her as your surgeon.

Nick Masri, MD, FACS · Answer

Thanks for your question, Jennybbx.
Though the goal of liposuction is to produce a trimmer figure with a more defined muscle tone, the actual results vary from person to person. A person may get fantastic results from liposuction alone, while another may need to have an additional tummy tuck to improve her appearance. In short, there is no single answer to your question, as it will always depend on each patient’s condition.
That is why it’s important to consult a board-certified and reputable plastic surgeon before your liposuction. He can tell you exactly what you can expect from your surgery and let you know whether the dramatic results you’re envisioning are achievable or not.
Make sure that you have a good talk with your surgeon so that he can address all your concerns and allay your fears.
Good luck on your liposuction!

Mats Hagstrom, MD (license on probation) · Answer

Your bring up many important and interesting points.
Liposuction is somewhat unique in that many patients are not good candidate for this procedure.
I like procedures like breast augmentation more less any woman who wants to have larger breasts can I have implants placed and obtain almost any size they desire.
My practice is exclusively devoted to only liposuction and fat transfer procedures.
I would say an average have to patients I see are only moderate or poor candidates for liposuction.
Liposuction that's one thing and one thing only it removes subcutaneous fat(The fact that you can pinch or the fat between the muscle and skin.)
If the primary reason someone does not have an ideal aesthetic figure it's because of subcutaneous fat the liposuction it is the ideal treatment.
If there are other causes of someone not looking their best, in other words their primary diagnosis is not excessive amounts of subcutaneous fat in the wrong areas, then liposuction will not treat the primary problem.
The most common scenario when I see patients who are not good candidates for liposuction it is typically a middle-aged woman who is had several pregnancies, has muscle separation, skin laxity, excessive amounts of intra-abdominal fat and relatively thin layers of subcutaneous fat.
These patients need a full abdominoplasty with or without weight loss to look their best.
The ideal candidate for liposuction has tight skin, thick layers of subcutaneous fat and no other issues keeping them from looking their best.
It's a little bit difficult to decipher the relationship between the four pictures you have posted.
If the third and fourth picture represent before and after pictures that I would say with 100% certainty they are not realistic.
Unfortunately some clinics are tempted and do manipulate before and after pictures.
This is not difficult to do.
In fact at one of my resident conference is a professor showed a series of before and after pictures
And asked the question, what do all of these patients have in common?
The answer was that none of them had any surgical procedure.
They were simply manipulated pictures showing how important being honest with photographic evidence is.
I have a little interest in meeting with dissatisfied Who is goals were not met patients six months after the procedure.
I would much rather lower the patient's expectations or simply deny the patient or recommend not having surgery.
The most common photographic manipulations are asking to patients to suck in their abdomen during the after picture, asking the patience to race to arms straight up in the air during their after picture tilting the chin up or down on the after pictures, Taking pictures from different distances are used in different angle cameras, selecting patients who did an immense amount of exercise and had weight loss during their postoperative course giving them phenomenal improvements but only part of the improvement was from surgery.
The majority of plastic surgeons show honest and realistic pictures though almost everyone select their best before and after pictures.
Personally I show patients consecutive results and try to find before pictures that match the patient being consulted as much as possible.
This helps set realistic expectations which leads to overall high patient satisfaction.
This is true with so many things in life if it seems too good to be true it often is.
Perhaps 10% of patients I see during consultations are ideal candidates for liposuction.
When this is the case I can with honesty express excitement and the sure the patient they will have a transformative procedure that will drastically change their aesthetic outcome.
Doctors in the Dominican republic work hard at convincing patients cosmetic surgery tourism is a good idea because of great results in lower costs.
I personally have quite strong believes that traveling for cosmetic surgery is generally not a very good idea.
Patients do not believe the complications, the need for follow up or revision rates apply to them.
When they do happen they find themselves desperately seeking help posting questions on real self or asking local plastic surgeons to help which is often met with low  enthusiasm.
There's no question that results vary dramatically from doctor to doctor.
This is really not much different than other aspects of life.
Some restaurants serve spectacular food with excellent service while other restaurants failed miserably.
Some contractors cut corners don't follow rules or even finish jobs after having taken payments.
Other contractors stand by their work and will finish projects on time and revise anything that is less than perfect.
Doctors are not all that different.
Unfortunately the cosmetic and history as a whole has a somewhat higher level of unethical behavior with overpromising and under delivering.
Most doctors went to medical school to help patients others saw this as a means to an end of making a high income.
In my practice I follow the Golden rule and treat each and every patient asked if they were a family member.
This has  serve me well in regards to being successful, having lots of referrals, good online reputations and I sleep well at night.
The best take-home message I can give you is to review before and after pictures of patients who have very similar bodies to your own when interviewing doctors.
Best,
Mats Hagstrom M.D.

Vincent D. Lepore, MD (retired) · Answer

You are correct, that there are limitations as to how much any individual can achieve with any cosmetic surgery, including liposuction.  Further, it pays to realistic as to what to expect form the surgery.  The "wish" photos you have shown may or may not be representative of what can be achieved in your case.  Ask your surgeon to show you before and after photos of patients similar to your situation.  This should give you a good idea as to what you can reasonably expect.  Results can vary based on several factors including one's own body characteristics, the quality and tone of the overlying skin, the type of liposuction preformed and the skill of the surgeon. Seek out a board certified plastic surgeon who has extensive liposuction experience.  Best wishes, Dr. Lepore.

Jon A. Perlman, MD (retired) · Answer

The degree of improvement from liposuction is determined mostly by two or three factors.  Number one is the thickness of the subcutaneous fat pad beneath the skin that can be contoured and reduced with liposuction technique.  Second is the natural skin elasticity which is determined by your genetics and history of weight gain, weight loss and pregnancies.  Factors such as creation of an hourglass figure are determined by the underlying bony and muscle structures which will not be altered by liposuction.  My best advice to you is to seek complementary consultations with one or more board-certified plastic surgeons experienced in the field of liposuction to determine what potential exists for you.  Remember many offices post their "best" photographs and although this is reasonable remember that results vary amongst individuals.  Best wishes and enjoy the video above for more information regarding liposuction that you will find of interest.

Ronald V. DeMars, MD (Retired) · Answer

Safety is the same no matter who is doing the surgery but pre and post op photos are most definitely not the same. Be critical when viewing the photos. The photos with the black background are honest, posted in the same posture, the same coverage of the skin and the camera the same distance from the patient. The photos with the white background are done to mislead the viewer. The post op posture is dramatically more upright, the arms are lifted and the camera is at a further distance and the muscles are flexed, all appearing to give a thinner upper torso. The underwear is pulled up covering what is an obvious roll under it. And finally it may not even be the same patient as the belly button is a different shape postop, a result that is impossible from liposuction. The last photo....either an alien or dramatically photoshopped.  After over 40 years of being a surgeon, seeing tens of thousands of my own patients and many time that in journal articles regarding cosmetic surgery, I have yet to see a single human that looked like that. Also, before you visit the DR for surgery do a little research regarding  the life threatening infections that are seen in US citizens returning from there, especially the mycobacterium ones that take months of IV therapy and sometimes as much as a  hundred thousand dollars in care to cure.

What determines how much/how dramatic results can be when performing liposuction on someone? What is realistic & safe?

Answers (8)

More Liposuction Questions

WE SEND PRETTY
EMAILS

Answers (8)

More Liposuction Questions

Upper abdomen liposuction for fat pockets under breast. (photos)

What's the difference between Local and General Anesthesia?

How many pounds is 4 liters of fat in a liposuction procedure?

How can I remove deltoid fat?

How do I begin to find a good liposuction doctor in my area? Not sure what to trust anymore?

WE SEND PRETTY EMAILS

WE SEND PRETTY
EMAILS