Question 1

What is VASER liposuction?

Accepted Answer

VASER liposuction is an FDA-cleared fat-removal procedure. This type of liposuction uses ultrasonic “vibration amplification of sound energy at resonance” (VASER) to break up and remove unwanted fat through a thin, hollow tube called a cannula.

VASER lipo is gentler on the surrounding tissue than traditional tumescent liposuction or suction-assisted lipo (SAL). Plastic surgeons who prefer VASER ultrasound technology to standard lipo say it provides better results, with fewer side effects and less downtime.

“I love the VASER for its ease and versatility,” says Dr. J. Timothy Katzen, a board-certified plastic surgeon in Beverly Hills, California. “I use the VASER on almost all of my liposuction cases and find it especially useful for tough revision liposuction cases,” he notes. Dr. Katzen praises this body contouring procedure for “its reliable and consistent results,” saying that its “faster recovery, minimal swelling and bruising, and overall results cannot be matched.”

Dr. David Sieber, a board-certified plastic surgeon in San Francisco, compares the vibrational action of VASER lipo on fat globules to shaking grapes off a vine. With traditional lipo, “you’re more like ripping the fat cells off the connective tissue,” he says.

“The problem I’ve encountered with the traditional technique is that you can end up overly traumatizing the skin and causing bruising and skin discoloration, which can take up to six months to go away,” says Dr. Sieber. “VASER spares that trauma because you’re not right under the skin with a cannula, beating it up.”

It also tends to be a quicker procedure, with less physical strain for surgeons. The ultrasound energy loosens and melts even stubborn fat, so more can be removed in a shorter period of time.

This technique is commonly used in liposculpture (also called high-definition, or high-def lipo) to sculpt specific body areas, like the rectus abdominis or “six-pack abs.”

Related: High-Tech to High-Def: How Popular Tools and Techniques Are Reshaping Lipo

Question 2

Which body areas can VASER lipo treat?

Accepted Answer

This outpatient procedure can be performed on most areas of the body, including the:

abdomen, back, and flanks, aka the love handles (treating all of these targeted areas in a single procedure is commonly called VASER lipo 360)
thighs, calves, and ankles
buttocks and hips
chest
upper arms
face, neck, and under the chin

It can also be an effective treatment for gynecomastia (commonly called “man boobs”), if the condition is caused by excess fat.

Question 3

VASER lipo pros and cons

Accepted Answer

Pros

This technique offers more uniform fat removal with a smoother result.
The surgical procedure itself is faster and physically easier for surgeons to perform, which may also contribute to a better result.
VASER allows for very precise body sculpting and a modest degree of skin retraction, making it a top choice for abdominal etching and 360 high-definition lipo.
Its ultrasound technology is ideal for breaking apart tough, fibrous fat. Dr. George Marosan, a board-certified plastic surgeon in Bellevue, Washington, prefers VASER liposuction in most situations because “fat comes out more easily with VASER—especially in men, where it’s more fibrous.”
"VASER liposuction is an excellent tool for revision liposuction or for pockets of scar tissue," according to Dr. Katzen.
Many surgeons rely on VASER for treating paradoxical adipose hyperplasia (PAH), a CoolSculpting complication that can cause treatment areas to expand and harden.
It results in less swelling and bruising than traditional liposuction, which requires more forceful manual “jabbing” to break up fatty tissue.
VASER’s ultrasound waves don’t generate as much heat as laser lipo or Smart Lipo, which makes it safer and less traumatic to the surrounding tissues.
Studies have also shown that there is less blood loss and an easier recovery than with traditional liposuction, notes Dr. Katzen. The nerves and tissue around the treatment area are also less likely to be injured, so recovery time is shorter, with less bruising and less pain.

Cons

This specialized technique can be more expensive than traditional liposuction.
If VASER liposuction isn’t performed properly, it’s still possible for the heat to cause burns. Find a board-certified dermatologic or plastic surgeon who has extensive experience performing this procedure and knows how to avoid complications.
Swelling can take three and six months to fully resolve. You’ll still see an immediate difference, but you’ll have to be patient to see your final results.

Question 4

How much does VASER lipo cost?

Accepted Answer

VASER liposuction costs type: embedded-entry-inline id: 6aTOuvi443nRPfQzwP6tIP, on average, but the price can range as high as type: embedded-entry-inline id: 3TqRgTEUtEO0futq5cEvbi for a full-body treatment or one that also involves skin tightening.

Your VASER lipo price could be higher or lower than the average, depending on:

How many parts of the body you’re having treated, the amount of fat that needs to be removed, and how long it takes to remove it
Your surgeon’s level of experience
Their practice location
Whether you have local or general anesthesia (which is more expensive)

Insurance doesn't cover the cost of VASER liposuction or any other cosmetic surgery, but most plastic surgeons offer payment plans or accept third-party financing options, such as CareCredit.

All forms of surgical liposuction are more expensive than minimally invasive procedures like CoolSculpting, but Dr. Katzen points out that VASER lipo permanently removes far more fat, and results are much more immediate. It's also worth noting that RealSelf reviewers give VASER a type: embedded-entry-inline id: Ks6V6ARYAktTMUTOEu3el Worth It Rating, much higher than any noninvasive body contouring treatment.

Question 5

VASER liposuction before and after pictures

Accepted Answer

The VASER liposuction photos in our gallery have been shared by the provider who performed the procedure, with the patient's consent.

Question 6

Who makes a good candidate for VASER liposuction?

Accepted Answer

Healthy adults who are close to their ideal body weight, with a BMI (body mass index) of 30 or below and specific areas of unwanted fat, are typically good candidates for VASER lipo.

Like all liposuction techniques, this isn’t a weight-loss treatment: it’s a body sculpting procedure, intended to target pockets of excess fat that haven’t responded to diet and exercise.

If you’ve recently lost a lot of weight, it’s a good idea to maintain a consistent weight for six to 12 months prior to any cosmetic surgery. This helps ensure long-lasting results.

It’s also important to have good skin elasticity and tone, to avoid sagging once the underlying fat is removed. “I love VASER, but the technology doesn’t allow for miracles,” says Dr. Armando Soto, a plastic surgeon in Orlando, Florida. “If you have loose, stretchy skin and a loose belly from pregnancy, you will likely need a tummy tuck,” which removes excess skin and tightens the abdominal muscles.

During a consultation, your surgeon will assess your skin elasticity. If they have any concerns about loose skin, they may recommend pairing VASER lipo with a skin tightening procedure.

Patients with underlying medical conditions, like diabetes or heart disease, aren’t good candidates.

If you’re a smoker, you’ll need to stop for at least two weeks prior to your surgery and avoid smoking during recovery.

Question 7

How VASER lipo works

Accepted Answer

VASER lipo can be performed under general anesthesia, so you’re fully asleep, under or local anesthesia with IV sedation, so you’re very relaxed and sleepy, but still technically awake. The type of anesthesia you have will come down to the extent of your procedure, your surgeon's recommendation, and your own preference and budget (general anesthesia can be much more expensive).

Here’s what to expect:

First, your surgeon will inject a saline-anesthetic-epinephrine mixture, or tumescent solution, directly into the treatment areas.
This saline solution causes the blood vessels to shrink (reducing bleeding and swelling) and the fat to expand, making it easier to remove. It also acts as a “heat sink” to prevent the fat from overheating and helps control pain.
Then your provider will make a small incision in the treatment area and insert a skin protector (a little rubber stopper) before inserting the ultrasound probe into the fatty tissue. Additionally, a wet towel is applied to prevent any contact between the vibrating probe and the skin.
With an easy, violin-playing type of hand movement, the fat deposits are broken up with ultrasound energy, and the fat is sucked out via a cannula (a thin tube).

Once you’ve recovered from the anesthesia, you’ll be able to go home. Make sure you have someone you trust there to get you home safely.

Question 8

Does VASER lipo tighten skin?

Accepted Answer

VASER lipo isn’t a skin tightening treatment, but the heat from the vibration can offer some mild firming.

“There have been mixed studies on whether it actually causes any skin tightening,” says Dr. Sieber.

A case series published in Aesthetic Plastic Surgery in 2022 looked at 261 patients treated with VASER between 2005 and 2020. The authors concluded that “VASER liposuction allows surgeons to address [the] superficial fat plane and [achieve] enhanced skin tightening.”

Others characterize the effects as enhanced skin retraction, an ability to adhere to its new contours following fat removal—not true tissue tightening or shrinkage.

Miami-based plastic surgeon Dr. Onelia Garcia says patients should temper their expectations for skin tightening results. “In patients with some moderate skin laxity, VASER may allow for better contouring and removal of more fat without making the skin any looser, but it certainly will not tighten [loose skin] beyond its original condition before surgery.”

When skin laxity is a concern, plastic surgeons typically combine lipo with a tightening procedure, like BodyTite or Renuvion.

Question 9

VASER liposuction recovery time

Accepted Answer

Most people need one to two weeks of downtime after VASER lipo due to swelling, bruising, and soreness.

Your recovery time will depend on the extent of your plastic surgery procedure.

If you had just your arms or double chin done, your recovery period may only be three to five days.
For VASER 360 lipo of the entire torso, recovery can take up to two weeks.

Most surgeons recommend wearing a surgical compression garment to control swelling and help shape the treated areas. It can be uncomfortable (imagine the tightest shapewear you've ever tried), but it’s easily concealed under clothing.

According to newly published VASER consensus guidelines, the “use of full-day compression garments is preferred for approximately 1.5 months after VASER UAL [ultrasound-assisted liposuction], the length of which is determined by [your] degree of edema [swelling]”

The authors note that “compression may minimize the risk of seromas [pockets of fluid under the skin]; serial drainage is recommended for follow-up treatment of seromas.”

Some surgeons, including Dr. Marosan, routinely insert small surgical drains after VASER liposuction procedures to minimize complications like seromas.

“The more energy one uses during lipo—whether it’s the ultrasound of VASER or the radiofrequency of BodyTite—the more likely it is that one will need a drain, because more fluid is produced from all that energy,” notes Dr. Christian Subbio, a board-certified plastic surgeon in Newtown Square, Pennsylvania.

Still, surgeons have varying protocols: Some never use drains, and others use them selectively.

The new VASER consensus guidelines also recommend manual lymphatic massage after VASER liposuction, ideally performed on a daily or weekly basis, for six to 15 sessions or until drainage has resolved.

Related: How Important Are Lymphatic Drainage Massages Post-Lipo? Experts Weigh In

Question 10

Does VASER liposuction hurt?

Accepted Answer

A VASER lipo procedure should never hurt, but if you’ve been given only local anesthesia with sedation, you may feel some initial pinching and pressure.

Most surgeons prefer patients to be asleep for the cosmetic procedure, particularly for large-volume procedures, so that the patient is still and comfortable throughout.

The initial recovery can be very uncomfortable, and sometimes painful. “Most people are sore for 7 to 10 days and then turn a corner,” says Dr. Subbio. “A lot of the discomfort associated with lipo has to do with nerve pain.”

Most surgeons prescribe narcotic pain medication for the first few days of recovery. Talk with your surgeon about the best over-the-counter pain relievers to keep you comfortable after that.

Question 11

Is VASER lipo permanent?

Accepted Answer

VASER liposuction results are permanent, with one caveat: you’ll need to maintain a stable weight.

Gaining muscle mass will enhance your results, but weight gain from fat could expand the remaining fat cells in and around the treatment area. This can reverse some of your results and lead to contour irregularities.

To ensure the longevity of your results, be prepared to stick to healthy habits post-surgery.

Question 12

Is VASER liposuction safe? What are the risks?

Accepted Answer

Is VASER liposuction safe?

When it’s performed by an experienced, board-certified plastic surgeon, VASER lipo is considered one of safest and most reliably effective liposuction techniques available.

However, like any surgical procedure, it’s not risk-free.

Potential complications of VASER liposuction include:

seroma (fluid accumulation under the skin)
skin discoloration in the treated area
burns from the ultrasound probe (rare but possible)
infection from the incisions (very rare)

Cosmetic issues, like contour irregularities or asymmetry, are also possible.

To help avoid complications and poor results, find a board-certified plastic surgeon who has years of experience performing VASER lipo, with a track record of positive patient reviews and an impressive before and after photo gallery.

Question 13

VASER lipo vs. power-assisted or laser lipo: what’s the difference?

Accepted Answer

All liposuction surgeries begin with the injection of a tumescent fluid or wetting solution into the treatment area, to control blood loss and help reduce pain following the procedure. Prior to removing the fat, many surgeons use some type of technology to separate it from the surrounding tissue.

Power-assisted liposuction (or PAL) uses rapid vibrations (courtesy of an oscillating handpiece) to break up fat cells without heat, while VASER relies on ultrasonic energy waves to get the job done (and generates some heat in the process).

“Both PAL and VASER are great modalities for breaking up fat with ease,” explains New York City plastic surgeon Dr. Umbareen Mahmood. She notes that VASER’s heat often makes it preferable for melting stubborn fibrotic fat, but it may require a somewhat longer incision. “If I’m doing PAL, my incision is two to three millimeters—whatever size my cannula is. But the incision site for VASER needs to be slightly larger, to fit a rubber stopper in there to protect the skin from the heat of the cannula.”

Compared to laser liposuction, Dr. Sieber says that “VASER is able to emulsify fat much more rapidly. With a laser, you might be able to treat an area that’s the size of a deck of cards in three to eight minutes. With VASER, you can treat the entire abdominal area in 20 to 30 minutes.”

Another upside of VASER lipo: the extracted fat remains viable for transfer to anywhere you want more fullness, including the face, breasts, or buttocks. Fat that’s been liquefied via laser liposuction isn’t usable elsewhere.

Laser lipo can heat the fat to upwards of 900ºF, and some doctors also worry about the risk of third-degree burns. Says Dr. Mahmood, “I see it frequently, especially in medical tourism patients—people come back with a great shape but permanent scars.”

Question 14

Sources & studies

Accepted Answer

Ruff PG 4th, Garcia O Jr, Nykiel MJ, Galanis CJ. Consensus-based Recommendations for Vibration Amplification of Sound Energy at Resonance Ultrasound-assisted Liposuction. Plast Reconstr Surg Glob Open. 2023 Jul 11.

Tran, B.N.N., Didzbalis, C.J., Chen, T. et al. Safety and Efficacy of Third-Generation Ultrasound-Assisted Liposuction: A Series of 261 Cases. Aesth Plast Surg 46, 2310–2318 (2022). https://doi.org/10.1007/s00266-022-02992-7

Nagy MW, Vanek PF Jr. A multicenter, prospective, randomized, single-blind, controlled clinical trial comparing VASER-assisted Lipoplasty and suction-assisted Lipoplasty. Plast Reconstr Surg. 2012 Apr;129(4):681e-689e. doi: 10.1097/PRS.0b013e3182442274. PMID: 22456382.

Schafer ME, Hicok KC, Mills DC, Cohen SR, Chao JJ. Acute adipocyte viability after third-generation ultrasound-assisted liposuction. Aesthet Surg J. 2013 Jul;33(5):698-704. doi: 10.1177/1090820X13485239. Epub 2013 May 29. PMID: 23718978.

Swanson, Eric M.D.. Improved Skin Contraction after VASER-Assisted Lipoplasty: Is It a Change We Can Believe In?. Plastic and Reconstructive Surgery 130(5):p 754e-756e, November 2012. | DOI: 10.1097/PRS.0b013e318267d96a

Hoyos AE, Millard JA. VASER-assisted high-definition liposculpture. Aesthet Surg J. 2007 Nov-Dec;27(6):594-604. doi: 10.1016/j.asj.2007.08.007. PMID: 19341688.

VASER LIPOSUCTION

Dr. J. Timothy Katzen, MD, FACS

Jolene Edgar

BEFORE & AFTER PHOTOS

Dr. J. Timothy Katzen, MD, FACS

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	Vaser Liposuction surgical	Power-Assisted Liposuction (PAL) surgical	Laser Liposuction nonsurgical
Worth It Rating	93%	Not yet available	93%
Average Cost	$10553	Not yet available	$7019
Downtime	Up to 2 weeks of downtime	Varies by procedure	3–5 days of downtime
Anesthesia	Local or general anesthesia	IV sedation or general anesthesia	Local or general anesthesia

Dr. J. Timothy Katzen, MD, FACS

Jolene Edgar

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21months after vaser lipo is it possible to have fluid trapped under the skin? Can this be fixed? (Photos)

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