Liposuction is the commonest term that one comes across during any cosmetic surgery related search. Liposuction is no doubt the most commonly performed cosmetic procedure. When the name of a surgical procedure is known by so many, the number of misconceptions about the same can also be as many. This blog is to give a fair idea about the right candidacy for liposuction surgery.

Liposuction is a surgical procedure by which excess unwanted fat present immediately underneath the skin is sucked out with the help of specifically designed cannula. This doesn’t mean that liposuction can be done on anybody who wants to remove some fat from their body. There are certain indications and contraindications too.

Liposuction is not a procedure for losing weight as wrongly understood by many. It is essentially a body contouring procedure.

Let us go through a few clinical scenarios to understand how liposuction will/will not help an individual.

• Clinical Scenario #1:

  21-year-old model, 172 cms tall, weighing 54 kgs is on strict diet and regular workouts. She has a near perfect figure but she wants to get liposuction done, as her fashion photographer is not happy with a little extra flab in her hips. Is her problem too big for a surgery? Is she the right candidate for a surgery?

  Yes! She is infact the ideal candidate for liposuction as liposuction is primarily a body contouring procedure. That little flab in her hips is resistant to regular workouts and diet (resistant fat). Liposuction of such localized areas will give the best results. Also this can also be done under local anesthesia with out the risks involved with general anesthesia.

• Clinical Scenario #2:

  21-year-old, unmarried medical postgraduate student, 167 cms tall, weighing 69 kgs has lost significant weight following a successful diet regimen. But still she is a not comfortable wearing sleeveless top during parties because of bulky arms.

  She will require a detailed consultation and counseling with a qualified cosmetic surgeon. There are several points to be considered. She has lost weight but has bulky arms. Arms, thighs, hips and back are notorious for being resistant to exercise and diet. Also she may have excess skin in the form of folds as she has lost weight. A thorough assessment has to be made. She is a candidate for surgery for sure but we need to decide if it can be done alone or needs to be done with an accessory procedure.

  1. Liposuction alone
  2. Liposuction with arm lift

  Will she be happy with excess skin folds after liposuction in order to avoid a scar or will she accept a scar in a concealed area to regain perfect arm shape? A consensus will have to be arrived at with proper counselling sessions assessing the pros and cons of each procedure.

• Clinical Scenario #3:

  31-year-old male software engineer, 174 cms tall, weighing 79 kgs doesn’t like his tummy and flanks and want “6 packs”.
  He is again an ideal candidate with normal BMI who would like to lose fat in his tummy alone. 6-packs in his abdomen can be created with liposuction by a procedure called as “Abdominal Etching”, the advantage being that he doesn’t have to undergo a staunch diet regimen, which will affect the quality of his life to achieve a six-pack. Also for six packs to be evident total fat mass should be <9%. when that level is reached, fat in face, especially, under eye and cheek regions lost leading to loss of youthful look. hence he will be benefited by liposuction.

• Clinical Scenario #4:

  31-year-old male working in a govt. office, unmarried, 170 cms tall, weighing 156 kgs, borderline hypertensive wants to reduce weight by liposuction.
  He is not an ideal candidate for liposuction. He has to reduce weight by diet plans and / or exercuse. He needs to come to a near normal BMI and maintain it for a period of 6 months before a surgical body contouring procedure. Once his weight reduces there is a very good chance for reversal of his hypertensive status.

• Clinical Scenario #5:

  45-year-old male, 186 cms tall, weighing 94 kgs had liposuction done previously for his tummy and flanks. He is not happy with results and wants re-surgery. On examination his skin thickness is less than 1 inch during a pinch test.

  Following liposuction it is not very uncommon to have minor contour abnormalities. In such situations, mild touch up procedures can be done to correct them. Such a procedure can even be done under local anesthesia.

  But in this case, the clinching factor is skin fold thickness. 1-inch skin fold thickness is generally considered as endpoint in a liposuction procedure for tummy. Hence in this person further liposuction will not help. Probably he has put on weight intra abdominally following surgery. Diet and exercise will help him. Surgery will not be a good option. Following liposuction when a person puts on weight it usually tends to accumulate in other areas.

Liposuction as an additional procedure

There are certain indications where liposuction can be used as an adjunct procedure and not as a primary body contouring procedure. This will improve the aesthetic results when used in combination. Some of these conditions are

• Lipomas – Liposuction is used to reduce the number and size of incisions for removing lipomas.
• Gynecomastia – Liposuction helps improve contour especially by the sides
• Abdominoplasty – Liposuction facilitates procedure and better contour of upper abdomen
• Lipodystrophy
• Lympoedema
• Fat transfer – Liposuction can be used as a technique to harvest the fat for fat fill procedures.
• Under eyes fat fill
• Breast augmentation
• Scar treatment