Liposuction is an amazing tool to sculpt the body and eliminate unwanted areas of fat in the trunk, flanks, and stomach, but while it is possible to load a pound or two during the procedure, liposuction, or liposculpture, is not actually a weight loss tool. And, it can be dangerous if performed on a patient who is too overweight.

I performed liposuction on the patient whose before and after images are to the right, and removed approximately 300-400cc from the stomach, another liter from her flanks and lower back combined. This patient was a great candidate for liposuction, because you can see, she had a stubborn pad of fat especially in the lower abdomen pre-operatively that she was unable to get rid of through diet and exercise. Liposuction is a great tool for sculpting and removing that unwanted fat.

AAAASF, the governing body for medical safety of operating rooms, guidelines are that no more than five liters of fat should be removed at any one time. Therefore, the proper advice to anyone especially overweight is that weight loss is required before undergoing liposuction. If enough weight is lost, the patient may want to consider the more dramatic effects of an abdominoplasty, or tummy tuck, surgery. The guidelines for a maximum of five liters removed are as they are, because of the tumescent technique used in liposuction. This technique requires inserting almost the same volume of saline solution into the patient’s abdomen as the volume of fat being removed. The saline solution does two things: 1) reduces friction internally to allow the liposuction cannula to slide more easily and 2) makes little blood vessels constrict reducing bleeding intraoperatively.

This is the best in class technique, and it works really, really well. However, all that saline solution is absorbed by the body and changes the patient’s blood pressure. Too much fat removed means too much saline solution needed, which can put the patient into heart failure. I have seen on social media at least one practitioner, not a board-certified plastic surgeon, performing overly large volume liposuction to the point that his patients would have been better served by not being operated on and being asked to lose weight first.

Be careful who you trust to perform this and any other cosmetic surgery as it is real surgery. In liposuction in particular, your surgeon is acting as your sculptor. Choose a good one! The most common pitfall of liposuction is the lack of creation of smooth lines and contours: leaving irregularities, bumps or divots. It takes a fair amount of experience to create a natural smooth result in all liposuction candidates.