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Liposuction remains one of the most frequently performed cosmetic plastic surgery procedures in the San Francisco Bay Area, California and the US in general. It is an effective method of selectively removing fat from problem areas.

Liposuction (SAL) of Gynecomastia Abdomen

Before (Left) shows localized fat of the chest (gynecomastia) and abdomen. After (right) reveals improved contours and better muscle definition with tumescent liposuction.

How Much Fat Can be Removed With Liposuction?

To improve patient safety, the American Society of Plastic Surgeons and the American Society for Aesthetic Plastic Surgery released a joint statement recommending an upper limit on the volume of fat removed of 5 liters. This is not to say that more fat cannot be removed safely. This recommendation was made for patients undergoing elective outpatient liposuction, on a come-and-go basis. In others words, if you are having liposuction and going home that same day.

Five liters is about 10 pounds, so you can see that liposuction is not a good method of weight control. Liposuction is best if you are near your ideal weight, and have localized, disproportionate accumulations of fat. Unlike weight loss, liposuction can remove fat from the areas you choose, this makes it ideal for stubborn areas that won’t leave. The selective nature of liposuction has lead some to use the term liposculpture.

Over the last few years, as the demand for liposuction increased, a large number of different liposuction techniques sprung up like weeds. All claim to better than every other technique, and most have no or an insignificant amount of proof to back their claims. The best technique remains the tumescent technique, under the guidance of a well trained professional. Ultrasound Liposuction (VASER, Liposelect) and Laser Liposuction (SmartLipo) both piggy back onto Tumescent Liposuction. As a result they get the same benefits of Tumescent Liposuction, but with increased cost and the chance of getting burned.

Liposuction (SAL) of the Thighs

Before (left) localized fat collections of the inner and out thighs. After (right) tumescent liposuction provides smoothed contours, improved appearance and enhanced fit of clothes.

Can Liposuction Tighten My Loose Skin?

Loose skin is a contraindication for liposuction. While all techniques claim to shrink skin, none can significantly tighten loose skin. Studies comparing tumescent liposuction and other liposuction techniques have been done. In a well controlled study, in which tumescent liposuction was performed on one side of a patient, and laser liposuction was done on the other side, neither patients, nor surgeons, could not tell which side was which. Significant skin tightening remains a problem from all liposuction. You will find examples where the skin seems to dramatically tighten, but these lucky people would tighten with any modern technique. Unfortunately, they are the exception rather than the rule.

Liposuction Safety

The most important aspect of any elective cosmetic surgery is safety. It is surgery, and should be performed by a qualified surgeon in an accredited facility, with proper monitors, excellent anesthesia, meticulous sterile technique and with proper equipment.

How to Choose a Liposuction Specialist

As a Board Certified Plastic Surgeon trained in a program well known for cosmetic plastic surgery, I am biased, and with good reason. As a group, plastic surgeons receive the best surgical training available specific to plastic surgery. The San Francisco Bay Area has been home to three world class training programs, and as a result, you have many excellent professionals from which to choose. While there are some unique individuals, trained in other disciplines, who can get good results, if you are considering Cosmetic Plastic Surgery, considering seeing a Board Certified Plastic Surgeon.

At a minimum, your surgeon should be a member of the American Society of Plastic Surgeons (ASPS), and even better, a member of the American Society for Aesthetic Plastic Surgery (ASAPS). ASAPS members are plastic surgeons who specialize in cosmetic plastic surgery. ASAPS members are required to be Board Certified Plastic Surgeons, members in good standing of their local societies, operate only in certified facilities and allow periodic review of their results. More about these organizations can be found by clicking on their names.

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