Removing 5L with liposuction - is that too much volume?

Question

I have a lot of anxiety about my upcoming procedure- lipo 360, arms, chin, inner & outer thigh, body tite to inner thigh, arms & chin. It will be over 5L and I will be staying overnight, but I’m worried about complications. It seems most everything I’ve read says you should not do over 5L in one sitting even if you’re staying overnight bc it’s too risky… I am 32, 5’4, 175lbs. Can someone please advise if this is too many areas and too much volume?

Geuris Cruz Quiroz, MD · Answer

This is a really good question dear Gorgeous772848. As a plastics surgeons we have a limit of fat remove during liposuction procedure by Association of plastic surgery. Your areas are common for an 360 liposculpture and does not mean you will be having 5L or more remove. In my practice I have this type of surgeries all the time and I can tell my patient can be have at least 3-4L in total, but if you are still concern just talk with your surgeon and remove area, you need to be going under anesthesia felling safe and secure with your procedure and your doctor. Your safety is always first! The best of luck!

Stephen T. Greenberg, MD, FACS · Answer

Thank you for your question.  It is safe to remove up to 5L of fat at one sitting.  It is extremely important to make sure you are rehydrating yourself post surgery.  Your Surgeon will keep an IV running to help hydrate and along with you drinking fluids and being up and moving around you should be ok.  I would suggest speaking with your Surgeon of choice to discuss any questions and concerns.  Best of luck to you.

Krishna Vyas, MD, PhD, MHS · Answer

Guidelines recommend no more than 5 liters of fat to be removed during the procedure to be considered safe if done in a controlled and monitored setting, with proper hydration and post-operative care. Since you will be staying overnight and receiving IV fluids, this will help mitigate potential risks like dehydration and electrolyte derangements that can impact your recovery.
The amount of fat removed should align with your overall health and the areas being treated. 5 liters is the upper limit of what's typically considered safe, and it can increase the risk of complications such as fluid shifts, bleeding, or infections, especially when multiple areas are involved.
If you remain concerned, you can always discuss splitting the procedure into two sessions, spaced at least two weeks apart. Your plastic surgeon is the best person to assess your situation and provide a safe plan that aligns with your goals. Ultimately, ensure you feel comfortable and informed about your surgeon's approach to managing these risks.
Krishna Vyas, MD, PhD, MHSHarvard, Hopkins, & Mayo Clinic Trained Aesthetic Plastic SurgeonNew York, New York

Connie Hiers, MD, FACS · Answer

Since you will be spending the night and receiving IV fluids, removing this volume of fat should be safer. I would suggest discussing your concerns with your surgeon. You could change to two surgeries, both as outpatient with at least 2 weeks apart.

Douglas Taranow, DO, FACOS · Answer

Our maximum allowed fat volume removal is 5000cc's (5 liters).  The safety of removing higher volumes is a condition of the patients general health (are they otherwise health, young etc.) and the surface areas being treated (the more surface area, the more risk...The more areas liposuctioned the higher the risk of bleeding, fluid shifts or infections, and the longer the procedure and anesthesia).

Mats Hagstrom, MD (license on probation) · Answer

I think there are a few things to be concerned about. The volume and itself is not really so much an issue because the volume is a Large part related to the size of the patient.
The question I would be asking is why do you need 5 L of fat removed. Typically people were looking at high-volume liposuction have obesity as their primary problem. Liposuction does not cheat obesity, and without first, addressing the underlying cause of obesity, most people will simply regain the weight in the new fat distribution. 
Individuals who lost control of your eating habits need to address that first and foremost. The truth is all people who need 5 L of fat, removed or more, are obese, and should lose weight first and foremost. If these volumes, the problem is not fat distribution, but rather obesity.
Secondly, regardless of the volumes removed, you need to get a clear understanding of your candidacy for the procedure. Some people have the potential of getting excellent liposuction results regardless of their size or weight, while others are not good candidates, and no matter who does the procedure they don’t have the potential to get to great Liposuction outcomes.
Understanding your own candidacy, for the procedure is fundamental and understanding what the procedure can, and cannot accomplish. This is best done by having multiple in person consultation at which time you should be allowed to see numerous before and after pictures of previous patients who had very similar body characteristics to your own. This is true for every area being treated. You should’ve seen at least 20 sets of before and after pictures preferably 50 or more by sufficiently experience provider to get a clear understanding of what average before and after pictures, look like on patience of your cans of the sea in the hands of your provider.
The third area of concern is choosing the correct provider for the procedure. Liposuction results vary drastically, depending on who does the procedure. Simply being board-certified and plastic surgery with an overall good reputation and years of experience does not mean somebody has mastered liposuction. Doing the procedure well on a consistent basis, including the ability to make accurate assessments and deliver predictable outcomes is far more difficult than most people believe. For this reason, I recommend patients have at least five in person, consultations before committing to surgery and consider having a many more if needed. During each consultation, ask providers to show you their entire collection of before, and after pictures of previous patients, who have similar body characteristics to your older. Ask providers to show you examples of excellent outcomes, average outcomes, and outcomes that did not turn out, as well as they had hoped. Being shown a handful of preselected images, representing the best results of a provider’s career is completely insufficient to get a clear understanding of what average results look like or how many procedures like this any one surgeon has actually done. 
Surgeons need to be vetted for quality outcomes in every area being treated. This is especially true for complicated areas like lower extremities. Lower extremity liposuction is technically challenging, and without sufficient skill and experience results are often not what patients had hoped for and can lead to disfigurement.
In reality, anybody who needs more than 5 L of fat should be lotta weight loss plan, and not getting Liposuction.
Typically successful, massive weight, loss leads, patience to develop skills, laxity, and with successful weight loss. Patient generally lose their kid with a seat for Liposuction.
It’s important to have a clear understanding of what the primary underlying problem is. If the problem is obesity, and the treatment is not Liposuction. Not everybody is a great candidate for Liposuction and the number of plastic surgeons to do Liposuction really well on a consistent basis is relatively few.
Plastic surgeons often think they’re much better at Liposuction than they actually are. A substantial number of plastic surgeons think of liposuction as an answer for instigated procedure with a low learning curve. This attitude confirms the number of poor outcomes better seen on a regular basis from Liposuction in cases where patients were not careful in selecting the right provider. The time to be critical and selective it’s before your scheduled surgery.
Choosing the right provider, can I have dramatic consequences in regards to outcome when it comes to Liposuction. Liposuction results very more in outcome based on who does the surgery and any other plastic surgery procedure.
You may or may not be a good candidate for Liposuction. You may or may not be in good physiological health to tolerate the procedure. Liposuction, in general is a safe procedure and taking up more than 5 L of fat in a large, healthy physiologically fit person should not represent a significant risk. Those statements are in parts based on working with providers who use good technique and have sufficient skill and experience to do the procedure well. I don’t want to go into technical aspects of how the procedure should be done, but the proper use of tumescent solution and giving the solution sufficient time do its function is critical in minimizing blood loss, which can potentially be significant in high-volume Liposuction. 
Hopefully at this point you had sufficient time to vet multiple plastic surgeons. See sufficient numbers before and after pictures of patients with similar body characteristics to get a clear understanding of what average results look like in the hands of your provider for each and every area being treated.
I typically tell patients that when, in doubt, slow down and schedule more consultations. If you’re already scheduled for surgery, then you’ve made a commitment to have the procedure and you need to put your faith and forward questions to your provider.
The time to review questions and concerns should be before you have your surgical procedure.
Best,
Mats Hagstrom, MD

Removing 5L with liposuction - is that too much volume?

Answers (6)

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