Maximum amount of fat that can be removed safely during a tummy tuck and liposuction? (photo)

There is not a correct answer that is applicable to all patents.  Every patient is different and procedure really needs to be customized to each patient based on their anatomy, their BMI and their health status.  There are some underlying principles which other doctors have already mentioned such as liposuction should not be viewed as a weight loss substitute and this is very true.  Liposuction is used for contouring.  Tummy Tuck is used to remove skin, to tighten the underlying muscles and the remove some excess fat and contour the body.  To achieve the best result, you really need to work on achieving a realistic weight balance prior to surgery.  Additionally, all procedures do not need to be performed at once.  For instance.  A tummy tuck tuck can be performed followed later by a buttocks lift and liposuction.  Patient safety should always be the #1 priority.

When it comes to your safety, I agree that this should be paramount.  I think you have to trust the judgment of your surgeon.  I limit body procedures to about 4 hours, and I think that there is such a thing as too much at one time.Find a board certified plastic surgeon who performs hundreds of tummy tuck 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

Plastic
surgeons in the U.S. tend to be more conservative than those in many
other countries, you are right about that. Limits we observe are for
patient safety, first and foremost. For instance, doing more than one
procedure at a time is generally quite safe, but as the other doctors
have noted, when you go beyond 4-5 hours "on the table," the risk of
complications increases. There's just no reason to do that when it
comes to elective surgery.

We
also limit how aggressive we are to ensure great results and patient
comfort. If a cosmetic surgeon suctions vast quantities of fat at a
time, the prospect of irregular hills and valleys--not to mention saggy
skin--is a real possibility. That's one reason liposuction is viewed as
a body contouring procedure rather than a weight loss solution. And
many of us prefer not to do cosmetic surgery on too many areas at once
even if everything can all be accomplished withinabout a 5-hour window--after all, if areas of your front and back
sides are healing at the same time, how will you rest easily after
surgery?
It
can be tempting to travel to another country when you are hoping for a
big impact. But reputable, board certified plastic surgeons in the U.S.
really do have
ALL your best interests at heart.Elliot Jacobs, M.D.New York Plastic Surgeon

Thank you for the question and the pictures.In my own opinion I believe a patient should never have more than 5 lts. removed at one stage. The pictures show a dramatic transformation with a tummy tuck and liposuction, it was probably done in two stages and after the patient lost weight.

Each State in the US has different amounts of fat to be removed during a liposuction. In Florida; If only doing liposuction in an office surgery setting the maximum amount of fat is 4L. If in combination of a TT + lipo than the total amount is 1L. While if being done in hospital larger amounts of fat removal are allowed whether in combination or alone but the expense of the use of the hospital is the real question. In DR or Columbia their fees in hospital are much less<<<<<. So compare apples to apples US Hospital vs out of country hospitals.

If you are obese like the person in the pictures, then you are better off losing weight first. Depending upon the technique used, you may or may not combine liposuction of the abdomen with a tummy tuck.

In the countries you mentioned, there is minimal, if any, malpractice liability, no national specialty boards, etc. so some physicians take risks that we cannot or should not assume.  The maximum volume which can be safely liposuctioned is 5000 ccs, which is five liters.  Liposuction is not, unfortunately, a substitute for weight loss.  I am more conservative than many plastic surgeons in terms of multiple procedures.  There is a lot of hype about it on television shows (and those patients aren't paying for surgery, either).  Frankly, if I perform two operations in one sitting: 1/you don't have the option to go elsewhere if you aren't thrilled with one result and 2/I get paid for two procedures, not one.  I personally think that a degree of greed and salesmanship has inspired multiple procedures.  In terms of safety, no cosmetic operation should last more than 5-5.5 hours as, thereafter, the morbidity and risks escalate geometrically.  I also believe that the media has created an inappropriate demand.  There can absolutely be too much surgery at once!  If you are unhappy with the state of your abdomen, then you could consider a tummy tuck.  Ideally, you should be at your best weight prior to surgery.  Hope this is informative.  Happy New Year!  Dr K

Ask 10 plastic surgeons these questions and you will get 10 answers. There is much 'I do this because of X and it works for me' but there isn't a lot of literature on the topic. The last recommendations from the board are 10 years old. The definition of 'large volume' was defined as >5000cc of total aspirate. From this executive summary, any patient having more suction than that should remain in an overnight surgical center or hospital. That being said, there are plenty of respectable plastic surgeons that routinely go beyond the 5L mark. You need to meet with a plastic surgeon in person to see if you're even a candidate. Regarding the aggressiveness in different areas of the world, there are some states that limit liposuction volume (Florida for example), but most do not. There are some very aggressive surgeons in the USA and abroad as well. Regarding multiple procedures, in general, the more you have done in one setting, the more risk you are assuming. This probably has more to do with time under anesthesia and blood loss than actual numbers of procedures, but no one has definitively proved what is 'safe.' Your best bet is to go to a respected plastic surgeon you are comfortable with and who can show you before/after photos of his/her work. Hope that helps,CDK

The goal of plastic surgery is to remove excess skin and some fat -- we don't take fat people and make them skinny. That is what diet and exercise are for. Before a tummy tuck your BMI should be below 30. Out side of the USA doctors don't worry about malpractice and complications as much as we do here. Thus they may take greater risks - if you have a problem here, we deal with it -- if you have surgery abroad and you have a problem -- then who will take care of it? We believe surgery is safer in the USA and the results are better - get an opinion from a board certified plastic surgeon.

Good question! But there isn't a good cookbook answer as it depends on the patient, the surgeon, and the number of other procedures being performed at the same time.In general, the maximum for liposuction alone is ~4500ccs as an outpatient in a surgicenter.The amount that can be removed after a TT depends on the patient and surgeon. The surgeon must be careful not to do excessive liposuction and jeopardize the blood supply to the abdominal tissue. The maximum amount of surgery that I will perform on a healthy patient is a 4 hour procedure. A TT with a little lipo and a Breast Aug/lift  would qualify as a 4 hour procedure.Consult a Board Certified Plastic Surgeon. Best wishes