Area to Have Liposuction Done First?

I have an apple-shaped body. I am a very active and healthy person with defined arms, legs, and very little body fat except in my belly and love handles. I work out regularly and eat healthy but my body looks very disproportionate. I saw a plastic surgeon and was advised to have two Liposuction treatments: one in my belly and one for my love handles in the back. Are both necessary? If so, which should I do first?

Doctor Answers 12

Define liposuction areas--number or order shouldn't matter

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Assuming liposuction is done properly, the key to patient satisfaction is knowing what liposuction does and what it doesn't do as well as understanding what area is going to be done and what degree of change and improvement is expected in that area.

Since liposuction is nearly always a cosmetic choice, there is no correct answer to which area to do, how many, or in what order. The patient has to look at any area that is suitable and decide which area is the most important or worth the cost. Particularly if the liposuction is done under local anesthesia, it is perfectly reasonable to do one area that is of most concern first and then see how that goes before deciding on another area. On the other hand, if the patient is certain that she wants to do two or three areas eventually, then it costs less to do them together rather than separately.

I disagree with the statements implying that the results will be better using laser or Vaser lipo. Liposuction is the removal of excess fat cells permanently from the subcutaneous layer (between the skin and muscle) and it doesn't matter how they are removed.

Boulder Plastic Surgeon

Do them together.

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This a very common problem we see in our Manhattan practice. You probably will benefit by having both liposuction of the abdomen and liposuction of the love handles or flanks. We always do these two areas together, and the recovery is easy.

If for some reason you only want to do one area, then do the stomach.

George J. Beraka, MD (retired)
Manhattan Plastic Surgeon

Liposuction of abdomen and love handles is usually done at the same time

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Typically liposuction of the abdomen and the second area "love handles" is done at the same setting.

Of course it is elective and your decision. I agree with the value of obtaing a second opinion.

See before and after photos of Laser Lipo.

See at least 2 other doctors

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It is always good to get a few opinions when you undergo liposculpting since it varies so much depending on the technique and areas to be done. If you have a large tummy then maybe only that area can be done at one time. It is better to be thorough and get a good result than to slop through and get a so-so result. If you are not that large, then it is most common to do the abdomen and the love handles together at the same procedure. If they must be separated due to volume restrictions, then the soonest you can get the 2nd procedure done is 1 week later. Abdomen (upper and lower) and love handles run about $6000 for 1 surgery as an estimate.

Good Luck!

David Hansen, MD
Beverly Hills Dermatologic Surgeon
4.7 out of 5 stars 46 reviews

These 2 areas are usually done at the same time.

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 Most surgeons do both at the same time and the savings of doing both at one time is substantial. You might want a second opinion.

Toby Mayer, MD
Beverly Hills Facial Plastic Surgeon
4.8 out of 5 stars 38 reviews

Lipo is often done in two areas

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Liposuction can often be done in two areas. The area that bothers you most should be done first. The examination, by the physician, determines which areas can be done.  Talk with your doctor.

Ronald Shelton, MD
Manhattan Dermatologic Surgeon
4.9 out of 5 stars 39 reviews

Contouring your midsection with liposuction is best if it is done circumferentially.

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I always treat the whole midsection at the same time .This will give you the best shape and skin tightening. Surgeons who divide these into little areas and subareas are most likely not board certified plastic surgeons.A lot of doctors do body liposuction such as dentists, oral surgeons, general surgeons, gynecologists, otolaryngologists and even family practitioners. They all can call themselves plastic or cosmetic surgeons. If your doctor wants to do this procedure under strictly local anesthesia, than I can understand why he/she would divide this into two operations. I personally would not do this in two operations, because the second surgery will need to blend in with the first one and this could be difficult to achieve and and give you a good result under just local anesthesia. You should gwet a second opinion. A consultation fee is less then a corrective surgery fee.

Do them both together as long as you don't exceed 5 liters of removal

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I see no reason to separate the two areas as long as your surgeon does not exceed about 5 liters of removal at one setting. That safety factor would be my main consideration since excessive blood loss and fluid shifts can happen when more than that is removed in one setting. I assume you are in good health and you have no anemia. Best of luck.

Francisco Canales, MD
Santa Rosa Plastic Surgeon
5.0 out of 5 stars 35 reviews

Liposuction of abdomen and flanks

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Dear pepgirl,

If you collect fat like most women, you probably have fat collections in the love handles and belly. Thus, although it's not necessary to have liposuction of either area, if you're planning on having liposuction, your results will be better if both areas are treated.

Virtually all board-certified plastic surgeons would treat your entire trunk at the same procedure (i.e. back, love handles and belly). This is because we are certified to perform these procedures in accredited facilities with the aid of anesthetists. If you are having this done as in office procedure, it's possible that your doctor wants to break up the procedure to minimize your discomfort. Make sure you verify the credentials of your surgeon before proceeding.

Best of luck!

Staged liposuction

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If you are going to do it in separate procedures, which some patients will do if it were do be done as an outpatient under tumescent anesthesia or as a laser assisted liposculpture procedure and the physician wants to limit the "xylocaine" exposure, then do the part that bothers you the most first. You can have the other done as early as 2 weeks later if desired, or wait to see the final results of the first. It is likely you will want both areas done. I have many patients that want to avoid a general anesthetic and specifically desire laser assisted liposculpture. In smaller cases I can do multiple areas, but in others they are content to stage the procedures.

Theodore Katz, MD, FACS
Philadelphia Plastic Surgeon

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.