The amount of fat you might wish to remove through liposuction is likely to be different to someone else. Maybe you’re considering liposuction to sculpt your waistline, while someone else may be wanting to transform their body shape entirely.
There is a general guideline that states the maximum amount of fat that can be safely removed is 5 litres per procedure. This limit is regardless of your weight, your percentage of body fat or your desired result.
However, a 2015 study suggests that this guide should be replaced with a sliding scale based on the patient’s Body Mass Index (BMI).
“The number is just picked out of a hat,” said plastic surgeon Dr Gutowksi
Many surgeons questioned this guideline as there was no scientific data to support this absolute threshold. For years there was debate over the way the volume limit is calculated.
“The problem is that this guideline seems like it was picked out of a hat”, said Dr Karol Gutowski a clinical associate professor at the University of Illinois at Chicago and a board-certified plastic surgeon, “…there’s no data behind it. No science.”
So, Dr Gutowski and his colleagues established a database to record the outcomes of liposuction procedures performed by board-certified plastic surgeons over the previous fifteen years. The aim was to evaluate the correlation between liposuction volume and any complication risk, taking into account the patient’s BMI.
The findings, published in the September issue of Plastic and Reconstructive Surgery, revealed that those with a higher BMI could have more fat safely removed by liposuction.
During the study, the investigators tracked over 4,500 liposuction patients. Most of those patients were women. However, a rise in men undergoing the cosmetic surgery was seen. A large majority of the patients were treated as outpatients and were able to go home the same day following the procedure.
Did Risk Of Complication Rise When More Fat Was Removed?
The researchers did find a correlation between complication risk and increased fat removal. Patients who experienced complications had large liposuction volumes, on average 3.4 Litres and higher BMIs.
Those who had more than 5 Litres of fat removed, increased their complication rate to 3.7 per cent.
After analysing the information gathered, Dr Scot Glasberg, president of the American Society of Plastic Surgeons said, “the reality is liposuction is incredibly safe”. In fact, the total complication rate was less than 1.5 per cent, with most of the complications not deemed serious and no deaths occurring.
The Risks Of Complication From Removing Too Much Fat
What are the risks? The body’s normal response to the trauma of the surgery is to swell, and excess fluid can build-up in the cavities where the fat has been removed. Most of the fluid will clear within six to eight weeks, however, sometimes seroma will form.
Generally, seroma is not considered a serious complication, and usually, it will resolve slowly on its own. However, depending on the severity, the surgeon might remove it by draining the excess fluid to speed up recovery.
Possible complications of removing excessive amounts of fat include the following;
- Unattractive lumpiness or hallow dimpling of the skin where areas have been “over-suctioned”.
- Increased health risks such as anaesthesia-related reactions, infections and oedema.
- Longer surgical procedures can increase the likelihood of blood clots forming, seromas, drop in blood pressure and toxicity.
- Fluid build-up, also known as seroma which can require drainage (the complications that occurred were almost all due to an increase in seromas).
BMI Can Help Determine Liposuction Treatment
Dr Gutowski said that through their research they identified the key factor in the liposuction complication risk to be the patient’s BMI. Those with the higher BMI were better able to tolerate large-scale fat removal during the procedure than those with a lower BMI.
This prompted the authors to introduce the concept of a “relative liposuction volume threshold” which is based on BMI. This tool enables surgeons to have a sliding scale to assess complication risk and see where this would increase for each individual patient.
Which makes sense considering that for a patient weighing 50 kg, removing 1 litre of fat may be excessive, whereas removing 4 litres of fat during one liposuction procedure in a patient of 100 kg might not be excessive.
Each Patient’s Individual Risks Must Be Considered
In addition to the BMI sliding scale approach, each patient’s own individual risk factors must also be considered. Considerations such as the length of the surgery, adjunct cosmetic procedures and the patient’s overall health before surgery should all be taken into account when evaluating the liposuction risk.
Liposuction for Removing Different Amounts of Fat Based On BMI, Individual Risks & Desired Results
Cosmos Clinic surgeons use this tool and consider the patient’s desired results to determine the safety and most effective treatment for the patient.
“Our risk assessment tool can further aid shared decision-making between the surgeon and patient by linking BMI and liposuction volumes,” adds Dr Mitchell Kim of Cosmos Clinic Gold Coast.
This is your typical liposuction used to remove stubborn fat from problem areas such as the tummy, love handles, arms, back, flanks, legs and even the chin. Here is an example of a Cosmos Clinic patient’s results from Vaser liposuction performed in the abdominal area.
Some patients who are overweight may be suitable candidates for Mega Liposuction. Cosmos Clinic performs Mega Liposuction procedures using Vaser (ultrasound) liposuction if it’s deemed the best option for the patient. This procedure can achieve significant results for patients and Cosmos Clinic surgeon Dr Joseph Ajaka reveals that mega liposuction patients notice a big drop in appetite too. Mega liposuction can remove up to 10 litres of fat, to give you an idea of what’s possible, check out some mega liposuction before and after photos, here is an example;
Vaser Hi-Definition Liposuction is for patients who already have a relatively athletic physique and want to achieve a more defined look.
To learn more about the different types of liposuction check out our post on Australia’s most popular type of liposuction.
Liposuction May Not Be The Answer
It is important to note here that liposuction is actually not a weight loss procedure. You will lose some weight, yes, but think of liposuction more like a body sculpting procedure to help remove stubborn fat that is resistant to a healthy diet and exercise.
A benefit of Vaser liposuction is that it does cause the skin to tighten but if an excessive amount of fat is removed patients can be left with sagging skin.
Dr Ajaka, explains that patients requiring greater amounts of fat removed may be better candidates for procedures such as a tummy tuck or thigh lift if they have excessive skin.
Those who are overweight and want to undergo liposuction may see better results by beginning with making some lifestyle changes and committing to losing some of the additional weight through exercise and diet before the treatment.
To get a better idea of how much fat can be removed through liposuction, it’s often better to see some results than talk about litres of fat. Check out more before and after photos and learn about Vaser Liposuction here, also see our article about life after lipo which gives tips on how to optimise liposuction results and maintain your post-liposuction physique long term.