What is the largest amount of fat that can be extracted during liposuction?

   Usually 5 liters is considered the upper limit in outpatient settings.Kenneth Hughes, MDLos Angeles, CA

Dear naomiloveThank you for your question!  The recommended maximum volume removal with liposuction is 5 litres of fat. A good candidate for liposuction generally does not need more than this volume removed.  There are many techniques for liposuction and the actual volume of FLUID plus FAT removed can vary widely with each technique.With Warm RegardsTrevor M Born MD

The safe limit for a single session of liposuction is considered 5,000 cc's of fat. This is a significant amount of fat and the typical "good candidate" for liposuction needs far less than 5,000 cc's of fat removal. After having performed in excess of 6500 liposuction sessions, I've rarely removed that amount of fat at one time. It's important to discuss your goals with a physician who does a lot of liposuction and determine after a thorough consultation what would be appropriate for you to have a safe and rewarding liposuction procedure.

I tell patients that the goal is to improve contour not to worry about the exact weight of fat removed. It varies so much from person to person.  There are also safety issues to address as well, and this can limit the actual amount of fat removed during any single liposuction procedure.

Liposuction has been advanced by use of tumescent solution that both thins the fat but also has a vasoconstrictor (epinephrine) that reduces bleeding during, and bruising after liposuction. As a result more volume of fat can safely be removed than without use of this tumescent fluid. There is still a limit however to that amount that can be safely removed as an outpatient due to a physiological response known as "third-spacing". This is where your body replaces fat that has been removed with your own intra-vascular fluid (blood and serum). In order to ensure that you can drink enough fluids at home to maintain your intra-vascular volume (hence, blood pressure) the limit that I adhere to is 3000-5000cc depending upon body habitus. If more needs to be removed it is safest to do it in a series of procedures treating a different area each time. Have a full discussion with your board-certified plastic surgeon if this potentially is an issue.Best, Scott A. Brenman, M.D., F.A.C.S.Plastic & Reconstructive Surgery

Most surgeons consider five liters (just over five quarts) to be the maximum that should be removed during any one procedure. Some surgeons will remove more than that but usually only if the patient is under direct medical observation for a couple of days after the procedure. After high-volume liposuction, the body can produce enormous amounts of swelling. That swelling can cause people to lose a lot of fluid (third spacing). On top of that, we sometimes use large amounts of fluid during the procedure. These changes can be serious. They can lead to a drop in blood pressure and difficulty in breathing depending on if the body has too little or too much fluid. The majority of patients do not need that much fat removed to obtain optimal results, but some do.  It's better to be safe and have two procedures.  When I split up liposuction into more than one procedure, I try to finish one area completely and start on a separate area during procedure number two. That way I'm not liposuctioning through an area that is in the midst of early healing with all the inflammation that happens after liposuction. You don't necessarily have to wait a long time between the procedures but definitely more than a couple of days. Surgeons vary on this issue.Some surgeons believe the total of five liters should be all fat, some fat and fluid that is removed during the procedure.  I hope that helps.Best of luck,Mats Hagstrom, M.D.

Dear naomilove,

That’s an excellent question and thank you for your
post. In general, in plastic surgery, we
strive to get excellent aesthetic results and contour improvements, but also to
maintain surgery that is the safest possible.
The amount of liposuction that can be removed is usually a function of
the jurisdiction that the surgeon practices in, as well as the body mass index,
or size of the patient. In Ontario, the
general consensus for the College of Physicians and Surgeons and the plastic
surgery community is that 5,000cc of combined aspirate; that is, both the fat
and non-fat components of what is removed.


5,000cc of combined aspirate is usually enough to achieve any
excellent body contour result, even multi-zone liposuction in even the most
challenging patients. If more fat is
required to be removed than that, then often weight loss is an adjunctive
strategy or it is done in a series of sessions.


When doing relatively large-volume lipo aspirate and
contouring, management of deep venous thrombosis and pulmonary embolism is
important. In general, good hydration
with intravenous fluid resuscitation, blood thinners and keeping the patients
overnight and monitored with sequential compression garments is an important
part of careful and safe management. In
addition, the use of high-technology, modern liposuction techniques where
thermal coagulation will minimize trauma to the blood vessels and lymphatic
structures, using procedures such as SmartLipo™, BodyTite™ and VASER® Lipo,
have shown to decrease the amount of blood loss during lipocontouring
procedures and also enhance skin contraction, which is often one of the major
obstacles to a good result in large-volume reduction.

I have been doing high-tech liposuction for the past 10 years
and liposuction in general for 20 years and have found that use of combination
technologies, such as BodyTite™ and SmartLipo™ will enhance soft tissue
contraction by 30%, minimize bruising, swelling and edema, and usually optimize
evenness of contour results.

For more information, please review the link below.

I hope this information has been of some assistance and best
of luck.



Sincerely,

R. Stephen Mulholland, M.D.

Certified Plastic Surgeon

Yorkville, Toronto