General Concepts

Liposuction is a phenomenal operation but realistic expectations are essential. Liposuction removes excess and unwanted fat from defined areas.  The areas treated commonly are the neck, stomach, legs, love handles, and thighs.  Patients love liposuction.  It’s one of the most commonly performed cosmetic operations in America.  It is extremely safe, and the recovery is reasonably easy.  Most patients having liposuction have very high satisfaction and would do it again, given the chance.  But, the single most important concept is what liposuction does not do. It does not tighten loose skin or muscles. The “Real-Reality” is liposuction makes you “a smaller version of you”.  If your stomach jiggles, it will still jiggle after liposuction.  If you have stretch marks, you will still have stretch marks after liposuction. If you have loose muscles, you will still have loose muscles after liposuction. Liposuction removes excess and unwanted fat; it does not tighten loose skin or tighten weak muscles. After liposuction you become “a smaller version of you”. You do not, however, get hanging skin after liposuction. This would be a worse version of you. Realistic expectations of what liposuction will do for you is extremely important and one of the main concepts to understand if you are considering liposuction.

It helps to understand the anatomy. The skin is the part of the body that we see.  The skin may contain stretch marks, dimples, cellulite, and can be loose.  Beneath the skin is the fat.  This is the area treated with liposuction.  Beneath the fat are the muscles of the body.  People who have excess fat might desire liposuction.  However, these other anatomic areas can contribute to the success or failure of the operation.  Loose skin or weak muscles can significantly diminish the benefit of liposuction.  Liposuction addresses the excess fat only; it does not tighten weak muscles or remove loose or damaged skin.  If we consider a particular anatomic area such as the outer thighs or “saddlebag” area, it is common for people to have excess and unwanted fat in this area.  Muscle tone in the legs is usually normal and muscle tightening would never be done.  Poor muscle tone in this area does not contribute to a poor appearance.  However, loose skin and stretch marks can be a problem.  And these skin issues will not be significantly changed with liposuction. Liposuction works on the fat excess only.  The skin does not shrink significantly; the skin will not act like “Saran wrap”.  The skin will not hang however.  People ask, “What will I look like after liposuction?”  I believe the best answer is that you become “a smaller version of you”.  Liposuction only addresses the fat and does not change any inherent skin looseness or weak muscle tone.  You do not get worse hanging skin after liposuction.  You do not become a worse version of you.  If you have liposuction and you have excess and unwanted fat removed, you become a more attractive and “smaller version” of you.  This is not bad news; this is good news.  This is the “Real-Reality” of liposuction.  Understanding this concept is essentially the most important aspect about understanding the operation.  It is an understanding of realistic expectations and realistic results.

Sometimes I will see patients in consultation, who I believe have unrealistic expectations. The person might be hoping for a result that liposuction just can not achieve. Many times I have seen women come in to the office asking for leg liposuction and they show me “The Pull.”  What is “The Pull?”  It is when a woman grabs her legs in the upper thighs   and pulls her leg skin up, lifting and pushing the loose skin into the groin area. When a woman does “The Pull” the skin is dramatically improved.  This maneuver gets rid of excess skin and improves cellulite and stretch marks.  However, this is what liposuction does not do.  This is not “a smaller version of you.”  This is an unrealistic improvement and an unrealistic result that liposuction cannot achieve. When I see a patient like this, extra time is spent, going over the concepts and principles described above. Liposuction addresses excess and unwanted fat.  It does not achieve this unrealistic “Pull” of skin.  It is extremely important to understand what liposuction does and does not do.

If we consider the abdominal area, muscles can be significantly weakened by surgery or having children.  C-sections or other abdominal operations can also contribute to this abdominal weakness. This muscle weakness can substantially contribute to an undesired appearance in the stomach area. In contrast to the leg area described above, weak stomach muscles can be a major factor giving a woman a fat looking stomach.  As described above, liposuction treats only excess and unwanted fat.  It will not treat weak muscles.  Women who have had children typically also have significant loose skin.  Liposuction will not treat this loose skin.  However, treatments are available for loose skin and weak muscles.  Liposuction alone does not address these issues.  This is an important concept that is being reemphasized.  If a patient is 18 years old and has excess and unwanted fat in the stomach area, then liposuction is probably the best option for her.  If she has not had any children or surgery, loose skin and weak muscles are probably not a factor.  However if the patient is 40 years old and has had three children, she might have significant muscle weakness, stretch marks, and loose skin.  Liposuction alternatives or options to this patient would be a tummy tuck or mini tummy tuck.  These operations would address loose skin and weak muscles. (These operations are considered in extensive detail in another chapter.) Liposuction sucks out excess fat and addresses only the fat, not the muscles or skin. This does not mean that liposuction is the wrong operation.  An understanding of options is critical.  A liposuction operation alone would make a significant improvement to the area treated.  The patient would become “a smaller version of what she is”. A tummy tuck however might give more dramatic results and make the patient even smaller or thinner in the abdominal area.  This improved result would be because the tummy tuck addresses the loose skin and weak muscles and gives an enhanced improvement compared to liposuction alone. Tummy tuck cost and liposuction cost differ with liposuction cost being much less usually. Tummy tuck recovery and liposuction recovery differ with liposuction recovery being much easier.

Dr. Saunders is a board certified plastic surgeon who practices exclusively cosmetic surgery. Delaware plastic surgery, West Chester plastic surgery, and Media plastic surgery patients are extremely close to his deluxe state licensed cosmetic surgery center. Please check out the surgical center by visiting it on our web site.

Patients interested in liposuction cost, liposuction recovery, liposuction alternatives, or liposuction side effects are encouraged to make a complimentary consultation by calling the office. Please also look at the liposuction before and after pictures!