Liposuction is one of the most common plastic surgery procedures in the United States. In this procedure, we use tiny incisions and a long metal cannula to remove fatty tissue in areas that are stubborn and difficult to reduce with diet and exercise.
The ideal person is 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, asking what the difference is and which one is better. The simple answer is that the best one is what the surgeon is comfortable using. I’ll go over some of the common terms and what they mean.
Many practices advertise tumescent liposuction. Tumescent is the dilute numbing solution that is always used in every single liposuction procedure. Typically when practices advertise this, they mean that this is the only form of anesthesia the patient receives during the procedure, meaning, you will be awake.
This can be a warning sign as practitioners advertising this often are not surgeons and/or do not have privileges at an accredited surgery center or hospital. Awake liposuction is a great option for many patients, but it is important this is not the only thing the practitioner offers. You can see one of my awake patients here and the video below.
Liposuction with the Addition of a Heat Source
There are several different heat sources that are offered prior to the actual fat removal. Radiofrequency, laser, high frequency focused ultrasound, etc. You will see all kinds of cutesy names. They all do essentially the same thing. They heat the skin up to create a controlled burn that tightens skin, coagulate blood vessels, and liquifies the fat. This will lead to some skin tightening, less bruising (in theory), and more even fat removal.
Do you need this? The answer is maybe. Buffalo humps (upper back fat deposits) and gynecomastia (male chest) are often firm and fibrous. VASER is amazing in this area in particular. All of these devices are a great option for poor skin quality that I am worried will not contract well. Submental liposuction (turkey neck) works beautifully with the addition of heat, I almost always recommend it for this area. The downside is added expense, time under anesthesia, and potential burns. Any surgeon who recommends these for every patient is trying to sell you something, not giving you a thoughtful, individualized plan.
This is a special type of massage where the practitioner pushes fluid causing swelling out of the injured/operated on area into a healthy, non-operated on area. This helps rid your body of swelling faster. This is an awesome addition I wish every patient would do. In addition to swelling, the therapists do a beautiful job of breaking up scar tissue and helping you get the best results possible.
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. You will see them done most often in men, but women sometimes as well. Most plastic surgeons are not fans of this procedure for the average patient. The type of patient that looks good long term with this procedure is someone at their ideal body weight (even better if lean) that lacks the anatomy to achieve muscle definition with appropriate exercise.
You cannot fake a six pack without the work unfortunately. People who try to just end up looking weird, don’t do it. These procedures often do not hold up with time, or with even slight weight gain. If you check out the social media of your local “gurus” that do this, you will never see long term results, that is very telling. I am sure you are seeing a theme here, one size fits all is never the right formula for surgery.
What type of doctor should do my surgery?
Unfortunately there are many poorly trained people performing liposuction out there. To assure you have a safe experience with the best possible results, see a board certified plastic surgeon. Your surgeon should work at an accredited surgery center, and have admitting privileges at a nearby hospital for the same procedure. If you do have complications, you want your well trained surgeon to be able to take care of you. It is acceptable to do liposuction in office procedure rooms, but your surgeon should also have privileges at the above. If he/she does not, this is a huge red flag.
Plastic surgery training is minimum 6 years, often more (mine was eight as I am trained in general surgery as well). We perform thousands of operations during our residency/fellowship all over the body. We have seen every complication out there and can personally manage them. You deserve the best, don’t cut corners with your health. Being a good surgeon is more than a pretty cosmetic result. We have the skill and training to identify and manage complications.
Liposuction is an amazing procedure that typically has an easy recovery. If you have a stubborn area that has been bugging you for years, it’s definitely worth a consultation!
After receiving her medical degree from Loma Linda University School of Medicine in Loma Linda, California, Dr. Killeen completed her residency in plastic surgery at the Oregon Health & Science University Hospital in Portland, OR, where she served as Chief Resident.
While completing her residency in general surgery at the world famous Cedars-Sinai Medical Center in Los Angeles, CA, she was recognized for her outstanding academic achievement in surgery, leadership, and clinical performance.
Dr. Killeen specializes in complex breast revisions, breast reconstruction, and breast & body aesthetic surgery. She has a special passion for non-invasive skin rejuvenation and medical skin care.
She resides in Beverly Hills, CA with her husband, two kids, two dogs, and two show cats.