What are some of my liposuction options?

I'm interested in liposuction, but there are so many options, which is best?

By Dr. Killeen, published on March 7, 2022

liposuction options header

One of the most popular plastic surgery procedures in the United States is liposuction. Using small incisions and a long metal cannula, we can remove fatty tissue from areas that are stubborn and difficult to reduce by diet and exercise.

Ideal candidates should be at a healthy weight with a stubborn area of fatty tissue out of proportion to the rest of their body. Patients often come to their consultations with a list of different types of liposuction and ask what the differences are and which one is best for them. In simple terms, the best liposuction option is the one the surgeon is most comfortable with. Let me explain some of the more common terms.

Tumescent Liposuction

Tumescent liposuction is advertised by many practices. During every liposuction procedure, tumescent is always used as a diluted numbing solution. In general, when practices advertise this, they mean that the patient is awake and only receives this type of anesthesia.

There is a risk that practitioners advertising this are not surgeons and/or do not have privileges at accredited surgery centers or hospitals. For many patients, awake liposuction is a great option. However, this should not be the only procedure offered by a practitioner. You can see one of my awake patients here and the video below.

A Dr. 90210 Patient Is Determined to Get Rid of Her Hip Dips

Liposuction with the Addition of a Heat Source

There are several heat sources that are available prior to the fat removal process. Examples include radiofrequency, laser, high frequency focused ultrasound, etc. You will see all kinds of cutesy names. Essentially, they all do the same thing. Skin is heated to create a controlled burn that tightens skin, coagulates blood vessels, and liquefies fat. The result will be some skin tightening, less bruising (in theory), and more even fat removal.

Is this something you need? Possibly. Gynecomastia (male chest) and buffalo humps (upper back fat deposits) are often firm and fibrous. VASER is especially effective in this area. These devices are all good options for people with poor skin quality that I worry won’t contract well. With the addition of heat, submental liposuction (turkey neck) works very well. I almost always recommend it for this area. The downside is the added expense, time under anesthesia, and potential burns. If your surgeon recommends these for every patient, he or she is trying to sell you something instead of giving you a thoughtful, individualized plan.

Lymphatic Massage

A practitioner uses this technique to move swelling-causing fluid out of an injured or operated-on area into a healthy, non-operated area. By doing so, swelling is reduced more quickly. This is a great addition I wish all patients would do. Along with reducing swelling, the therapists also break up scar tissue to help you achieve the best results.

High Definition or 3D Liposuction

These are terms (there are also some others) that describe doing liposuction in a way to fake a muscular body. The majority of the time, you’ll see them done on men, but sometimes you’ll see them on women as well. For the average patient, plastic surgeons don’t recommend this procedure. The type of patient who looks good long-term with this procedure is someone at their ideal body weight (even better if lean) who lacks the anatomy to achieve muscle definition with appropriate exercise.”

Unfortunately, faking a six pack doesn’t work. People who try to just end up looking weird, don’t do it. Often, these procedures don’t hold up over time, or even with slight weight gain. If you look at the social media of your local “gurus” who do this, you will never see long-term results, which is very telling. The one-size-fits-all approach is never the best method for surgery, as you are probably noticing.

What type of doctor should do my surgery?

It is unfortunate that there are many poorly trained individuals performing liposuction. See a board-certified plastic surgeon for the best possible results and a safe experience. The surgeon should be affiliated with an accredited surgery center and have admitting privileges at a nearby hospital to perform the same procedure. If complications occur, you want a surgeon who is well trained to handle them. Liposuction can be performed in office procedure rooms, but your surgeon should also have privileges at the above facilities. This is a huge red flag if he/she does not.

The minimum training in plastic surgery is 6 years; in my case it was 8 years, as I was trained in general surgery as well. We perform thousands of operations during our residency/fellowship all over the body. We have seen nearly every complication you can imagine, and can handle them personally. You deserve the best, don’t cut corners with your health. Being a good surgeon means more than having pretty cosmetic results. We have the skills to identify and manage complications.

Liposuction is an amazing procedure that usually has an easy recovery. Getting a consultation is definitely worth it if you have a stubborn area that has been bothering you for years!