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Liposuction as body shaping, not weight loss




A deeper look at the latest in Liposuction

When people look at ways to change their body’s look, they often consider liposuction. It typically takes as little as an hour, sometimes less, and can be the perfect procedure to shape and contour a body. But if you’re looking for a way to lose weight, liposuction is simply not the way to go.

Liposuction is at once one of the mostly widely used, and possibly among the most misunderstood, tools in the toolbox of cosmetic procedures. It can be the ideal solution for people seeking to “shape” their body, but it’s important to understand what it is, how it works and, in this case, what it is not.


Liposuction commonly targets the abdomen, hips, thighs, chin or knees, removing fat cells from particular regions of the body. While it can be a path to a better shaped body, there is one thing it is not.


“It’s not for weight loss,” Dr. Robert Jacobs of Cosmetic Surgery of New York said. “It’s to remove localized fat. On your hips. To contour specifically to that area. Tiny incisions. Big results. It’s very small incisions with big results.”


The doctors at Cosmetic Surgery of New York have been doing liposuction since the beginning in the 1980s and it has become a common and widely and often well-used option. In fact, liposuction was the most common cosmetic surgical procedure in 2021, according to the International Society of Aesthetic Plastic Surgery More than 1.9 million procedures were done, and, overtaking breast augmentation. The top five most popular surgical procedures according to that group were liposuction, breast augmentation, eyelid surgery, rhinoplasty, and abdominoplasty.


The top five non-surgical procedures were botulinum toxin, hyaluronic acid, hair removal, skin tightening and fat reduction, according to the group. But liposuction not only is retaining its place, but rising up the roster.


“There have been a lot of refinements,” Dr. Hillard Warm, of Cosmetic Surgery of New York, said. “But it’s been good for years. It’s more refined.”


What liposuction does

Liposuction lets you target any area where a person has a problem. A lot of people have fat under the chin or the neck. Liposuction can help with that. Superficial fat on the hips and love handles also can be targets for liposuction.


“It’s whatever the person has,” Dr. Jacobs said. “Wherever the problem is.”

As with anything, those who have done it longer often have developed greater expertise. “Experience helps,” said Dr. Warm. “If somebody has done lots of liposuctions, they’re much more likely to give you a better result.”


Myths

While there are many uses for liposuction, there are also myths. Liposuction is not a weight loss program, even if it accomplishes shaping by removal of fat. It helps you shape or contour your body, but it is not designed to takeoff weight as much as alter shape. In other words, we change where the fat is stored, possibly in a few areas, but not the whole body. That allows you to reconfigure where fat is stored. It is about a different type of staying “in shape.”


“We remove some fat cells from a portion of the body, changing its shape,” Dr. Warm added.


“When a person eats, the fat has to go someplace else.  A calory looking for a place to park has to go someplace else.”


Doctors may take away many, but not all, the fat cells in the hips. Some calories will go back to the hips, but most will go elsewhere. The idea is the excess will be distributed all over your body and you’re not going to see it. The person may eat, exercise and expend energy. Liposuction is not a weight loss program, but rather a shaping program.


Ideal candidates

Liposuction is more often used by women, but it is as affective with men. And it’s becoming more popular with men, although not by leaps and bounds.  So gender is not a factor in whether someone is a good candidate. Age, however, can impact whether someone is an ideal candidate. While older people may want liposuction, younger people typically make even better candidates.

“Young people today want it to be gentle and on an outpatient basis with quick recovery,” Dr. Jacobs said. “And choices of anesthesia. A lot of people want it fast and quick.”


Once doctors remove the fat, the skin has to shrink to cover up the new areas. If the skin is lax, taking out the fat won’t make it less saggy. Elasticity is good, which is one reason younger people tend to do better. People who are much older may not have enough elasticity, so the skin hangs rather than recontours to the correct shape.


Latest in liposuction

While liposuction has been around for decades, there are variations on this theme. Tumescent liposuction, with injected saline or salt water, further reduces bleeding and provides other improvements. Ultrasonic liposuction added ultrasound to zap some fat cells, making the process even more effective. And smart liposuction added lasers that zap fat cells, which some say is more gentle and helps the skin tighten.


“Many places don’t have smart, assist, or ultrasonic and traditional,” Dr. Warm said. “We have all three of them here.”


Power assisted liposuction is another option. Like power steering, it makes the procedure easier and quicker and can work better for the patient.


Safety and skill

Liposuction is as safe as the doctor doing it. The reason some people get into problems is they try to do too much, which can be dangerous. When we do procedures, we never get close to a dangerous amount of fat removed. We are board certified by the American Board of Plastic Surgery, but any licensed doctor can do liposuction.


There is no limitation although in hospitals, there can be limitations. In a private facility any doctor is allowed to do these procedures.  Our office is also accredited by what used to be known as the American Association of Accreditation of Aesthetic Surgery Facilities, now known as Quad A.


As part of recovery, patients typically wear a compression garment for a few weeks. There may be some soreness, but patients usually are not very uncomfortable. It remains an effective way to help shape your body and one that can be a very standard part of a plastic surgeon’s practice.

“Experience helps,” Dr. Jacobs said. “If somebody has done lots of liposuctions, they’re much more likely to give you a better result.”

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