What is considered high volume Liposuction?

Good morning Chrissy,You're absolutely right, there are some great results out there after high volume liposuction. Outcomes that patients and surgeons can be very proud of.High volume liposuction is generally considered to be any amount of liposuction greater than 5 liters. In the right circumstances; good general health, proper monitoring and fluid management this can be done safely. The issue really comes down to the amount of surgery, rather than the area being worked on.At 5 liters and more of liposuction the body starts to respond like it has gone through a major surgery. This can result in changes in blood pressure, fluid shifts and impacts on the kidneys that need to be closely monitored and managed acutely to keep patients safe. There may also be higher rates of other complications such as fat or blood clot embolism.All this is despite the fact the surgery may have been quick and performed through tiny incisions.If you think you might be a candidate for large volume liposuction, take time to meet with a board certified Plastic Surgeon. Inquire about the facility they use, ask how long you should expect to be admitted after surgery and what type safety and monitoring equipment will be available to help keep you safe.Remember, even though you might want it all done at once, sometimes it is better to stage multiple treatments in order to keep risks at an acceptable level.Take care. All the best.Dr Nodwell

It really depends on the surgeon, but in Canada we would generally consider anything above 5L of fat being removed to be high volume requiring an overnight stay and IV fluids after the procedure. Anything below 5L can safely be done in an outpatient setting and allow you to go home the same day. All areas of the body have their unique challenges and potential complications, so there really isn't an area that is safer than another. The only way to know if you are a good candidate is to book a consultation with a royal college certified plastic surgeon near you. Best of luck!

The definition of this term is determined by the amount of fat removed at one operation. It can vary form surgeon to surgeon, but in general, 5 liters of aspirate can be considered high volume. If one is removing more than this amount, it is recommended (and mandatory in some states) that the patient be monitored overnight in a 23 hour facility. Some surgeons have removed up to 10-20 liters of fat. This can become very risky, especially patients with other medical problems, because there are large shifts of fluids and electrolytes in the body that can cause harm if not kept in balance. It can be a very cafe procedure if prepared for properly. However, if one is to remove that much fat, perhaps weight loss prior to surgery would be best. It is safer, has no cost, and no recovery.

While high volume liposuction is traditionally defined as 5 liters of fat aspirate, that number actually varies based on the height and weight of the patient. The key question about the definition of high volume liposuction is when does it cause major fluid shifts in the body and induce enough trauma that one needs to be better monitored and medically managed after the procedure. That definition revolves around patient safety.

It is exactly what the words are.  The volume is higher than the average lipo. This was commonly done to treat multiple areas on larger patients. Many places recommend not doing this including some states forbidding high volume, because the potential for fluid shifts and over hydration of patients leading to potentially higher risks.

Most plastic surgeons do not remove more than 5 L of fat during a single procedure if done as an outpatient procedure.Certain states have more restrictive limitations though 5 L is a general standard for most plastic surgeons.this morning I took off 5 L from a patient's upper lower abdomen only.My estimate is at least 80% of her subcutaneous fat was removed. She'll come back in a few months to have her hips and waist treated to finish the job.Her improvement will be striking.High-volume liposuction is indicated in people who have thick layers of subcutaneous fat in multiple areas.when patient selection is done correctly this procedure usually results in very hi patient satisfaction.I cannot emphasize enough the importance of patient selection when making proper assessments and giving expectations of what type of results someone can achieve.other cofounding factors such as skin laxity or potential muscle separation from previous pregnancies can drastically limit what can be achieved with liposuction.Best,Mats Hagstrom M.D.

Dear Chrissy McD,

Thank you for your clinical post and
an important question. State by state
and province by province there is some variation what is considered safe
outpatient liposuction and what is considered high volume liposuction. In Canada, the consensus by the Canadian
Society of Aesthetic Plastic Surgery is that 5 litres of combined aspirate that
is aspirate of both fat and non-fat fluid would be 5 litres. Most plastic surgeons in Canada will not
remove more than 5 litres combined aspirate and certainly when 5 litres has
been reached most plastic surgeons would insist on the patient staying
overnight for 24 hours in monitored care.

The more fat that is taken from the
body the more soft tissue trauma that occurs and there is certain physiologic
fluid shifts that occur that can leave your body in a volume depleted
shock-like state. Proper monitoring
during liposuction with fluid replacement, post-operative compression garments
and deep venous thrombosis (blood clot) prophylaxis is critical. At my facility removal of 2 litres of pure
fat or less can be done as an outpatient.
Any time there is 2 litres or more pure fat or 5 litres combined
aspirate patients are kept overnight and monitored for 24 hours with adequate
intravenous fluid resuscitation, mobilization and blood thinning treatments.

When liposuction is performed
judiciously and appropriate interim post-operative care is taken the morbidity
and mortality from liposuction is extremely low.

I would definitely seek the
consultation and advice of a plastic surgeon with significant experience in the
art and science of liposuction and you should anticipate excellent results if
you have good soft tissue elasticity and tone and reasonable expectations.

When you read the sections on
liposuction you’ll see that there are new and more modern techniques to treat
the fat, which I term energy-assisted liposuction. The use of energy such as an internal laser,
radio frequency energy or ultrasound energy can more gently coagulate and
liquefy fat, seal blood vessels and tighten skin. The liquefied and coagulated fat still needs
to be aspirated, but there is generally less bruising, swelling and pain and
it’s certainly better skin contraction with energy-assisted devices.

I hope this information is of some
assistance and best of luck.

To find out more or schedule a consultation,
please visit the link below.

R. Stephen Mulholland, M.D.

Certified Plastic Surgeon

Yorkville, Toronto