Maximum Amount of Fat Removal Per Surgery? Will I Need Lipo Twice?

Im a size 14(36-36-52). Im dieting & exercising to become a size 10. Desired measurment (36-29-55). My butt is sagging,so I'm considering a BBL. I want a smaller waist & abdomen; for my back fat/love handles to disappear; & a rounder, fuller butt. I was told that by law, that only 4L of fat can be removed per surgery! Is this true? Will I need 2 lipo surgeries to reach my desired outcome? Also what medical test are required before the procedure (physical, bloodwork, cardio?) Miami/Ft.Laud, FL

Doctor Answers 9

Large Volume Liposuction. Is it Safe?

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In 2001 Bruce Halperin and I reported on 631 cases of Large volume Liposuction in the Journal of Plastic and Reconstructive Surgery.  We are soon to add 426 cases to this number.  These have been done successfully and with great care in patient selection.  There is no actual limit in California but every case has a limit based on good judgement and common sense based on experience.  In a 70 year old one liter may be large volume and in a 20 year old that is healthy and a good candidate , 13 or 14 liters may be safe.   Our largest volume was 27 lbs at one setting.  We certainly do not roiutinely recommend this unless surgeon experience is attained over many years with gradually increasing  volume.  There are actually few candidates for volumes over 25 lbs.  We have done 41 cases over 20 lbs and this has worked fine in well chosen candidates.  The  best volume and plan is defined after careful examination of the patient by a doctor well versed in large volume liposuction.   Over the past 10 years it is of interest that we have reduced our volumes in the Stanford program and have put more emphasis on a combined approach of weight loss and liposuction.  There are many reasonable candidtaes who can benefit by volumes up to 15 lbs.   This is a very complex subject .   It is always a good idea to consider serial procedures at different settings.  Safety first always.  Always seek consultation by a large volume experienced surgeon certified by the American aBoard of Plastic Surgery. And remember, the very best suggestion is getting to your ideal weight and then consider liposuction for residual annoying areas.  Good luck.  Dr Commons.

Large volume liposuction and safety

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There is no blanket mandate on the limit of how much fat can be removed during liposuction.  Each state either has a limit or the surgeon should use sound judgement in choosing the appropriate candidates for larger volume liposuction.  The American Society of Plastic Surgeons has recommended a 5 liter limit on liposuctions done as an outpatient, but some states supercede this with lower limits.  You should check with your surgeon in Florida as to what the restrictions are there.  Remember, the most important issue is your safety.  If that means 2 separate surgeries, separated by several months to allow you full recovery, then that is what you should do.

Liposuction and limitations

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I am not exaclty sure of the law in Florida, but that does ring a bell. Large volume liposuction is discouraged because of the increased risks. It is better to get down to your desired weight with diet and exercise first.

Steven Wallach, MD
New York Plastic Surgeon
4.2 out of 5 stars 30 reviews

Liposuction Safety FIRST Priority

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When performing liposuction, safety should be everyone’s first priority.For this reason, we never exceed a volume of more than 5,000 cc's of fatty aspirate when this procedure is performed on an outpatient basis.

When this number is exceeded, the complication rate rises dramatically.Under these circumstances, massive fluid shifts can occur, which increase the potential for cardiac and pulmonary complications.

When patients desire Brazilian Butt Lift Surgery, this fat can be processed and grafted into the buttock region. A secondary procedure may be necessary if the patient isn’t totally happy with the results of their liposuction or Brazilian Butt Lift procedures.

If you’re considering Brazilian Butt Lift surgery, it’s important that you consult a Board-Certified plastic surgeon with experience in this area.This surgeon should be able to formulate a treatment plan that addresses your anatomic findings and achieves your aesthetic goals.

4000 cc limit in Florida

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Here in Florida, in office-based surgery practices, there is a 4 litre = 4000 cc fat limit with liposuction.  (This limit does not apply in a hospital setting.)  With combined procedures, say tummy tuck and liposuction, the limit is moved down to one litre of liposuction.

So, yes, you might need two procedures...

Do as much as you can with pre-operative weight loss.  Remember, 4 litres of fat is equal to about 10 pounds of weight.

Large Volume Fat Removal May Be Best Done By A Two-Stage Liposuction Approach

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The most important thing in any surgery, particularly in liposuction, is your safety. There is no question that the larger amount of fat removed and time spent doing so does increase the risk and potential complications to some degree due to the internal trauma posed on one's body. Because of complications that have occurred throughout the country, some states have imposed restrictions on how much fat can be removed in a single setting including where the procedure is performed and dependent on what other procedures are being simultaneously done. These are on a state by state basis and are not a federal regulation or mandate. While large volume liposuction (defined as greater than 5 liters) can be safely done without complications, it is much harder on one's recovery than most patients would think...not to mention the increased risks. For these reasons, even though you may see it as inconvenient and not as economically efficient, it may wise for you to consider a two-stage approach separated by 6 months in between the surgeries.

Liposuction done safely has limits of removal

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Different surgical societies agree that mega liposuction has more risk, some serious, and there is a limit of 4 liters. In New York, there is a restriction that any office liposuction removing more than 1/2 liter must be done in an accrerdited office (accreditation by the Joint Commission, the AAAHC or the AAAASF.

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

Liposuction and volume of fat removed

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I practice in Texas and am currently unaware of any law that mandate or limits the amount of liposuction you can have at once.  That said, however, there are some practical limits to having safe and effective liposuction in an outpatient setting.  I often use a number like 5% of the body weight, for example, a person weigh 212# or 100kilos would get up to 5L of liposuction.  This amount provides me with enough fat removal to significantly change someones contour while not endangering them.  There are many surgeons who will perform what is called large volume liposuction (>8L) however, many of these often require hospitalization and have a higher rate of needed blood transfusion and other complications.

So to answer your question whether you will need more than one session, yes you may.

I hope this helps.

How much fat is taken out during liposuction?

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hi Suga,

It is entirely possible that liposuction alone will give your buttocks a better shape. You may not even need a Brazilian Butt Lift.  The B'more Butt Lift is based  on using only Liposculpting to enhance the shape of your buttocks. 

I practice in Baltimore, therefore I do not know Florida regulations for liposuction. However, if you would like to learn more about how much fat is typically extracted from each area of your body, please see the link below.


Ricardo L Rodriguez, MD

Baltimore, Maryland


Ricardo L. Rodriguez, MD
Baltimore Plastic Surgeon
4.5 out of 5 stars 98 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.