Hi, I’m Dr. Sanjay Parashar; an aesthetic and plastic surgeon with over 25 years’ experience. I have performed over 10,000 surgeries overall, which include over 2,000 liposuction surgeries.
Within the broader category of liposuction, I also specialize in 6-pack surgery, and have developed 2 signature liposuction techniques – “SLIMfit” and “WaistSculpt”.
I am also an author of a book on body contouring: “Art of Abdominal Contouring – Advanced Liposuction”,
Here I will provide you all the information you need to make an informed decision regarding liposuction, and to prepare yourself for it. If after this, you still have more questions, I’d be delighted to answer them in an in-person consultation. Read on…
Liposuction – The quickest, surest way of removing stubborn fat from specific areas
If after all your efforts in exercising and diet control, you still see stubborn fat affecting your body shape, you probably need Liposuction to get a more aesthetic shape.
Liposuction sucks out stubborn fat from specific parts of your body in a controlled manner, thus giving you the look that you desire. This is somewhat like how a vacuum cleaner sucks dirt!
No matter what other surgeons may tell you, liposuction is not a weight loss procedure, rather it is an artistic and precise body contouring technique with the singular purpose of giving you a leaner, slimmer and more aesthetic silhouette – the one you always dreamt about.
Liposuction is the top cosmetic procedure for men in the United States, and the second most popular procedure for women, after breast augmentation.
Here are the 3 stages that will take you towards the shape you desire:
STAGE 1: ABOUT LIPOSUCTION - WHAT YOU NEED TO KNOW BEFORE YOUR INITIAL CONSULTATION
There’s a certain degree of information you should have regarding liposuction even before your initial consultation with me. This information will help you be better prepared and have a more meaningful consultation session.
Liposuction is the surest and quickest way of eliminating stubborn fat from specific areas of the body. In this surgical procedure, body fat is broken down into liquid form and then sucked out with small suction tubes called microcannula. The objective of the surgery is to reshape your body contours to make them more aesthetically appealing.
Under the expertise of a skilled surgeon, the procedure also has an artistic angle to it, so that the excess fat is not just removed, but your body also sculpted for a desirable silhouette (“liposculpturing”).
Liposuction is done under general or local anesthesia based on the treatment area. It takes 2-3 hours, and is usually done as an outpatient procedure, with the patient going back home the same day.
In some people, certain body parts like the waist, love handles and abdomen, chin, buttocks, etc., have stubborn deposits of fat which are difficult to get rid of, and often don’t respond even to exercise. For these people who want to eliminate such fat, liposuction is the best solution to achieve a more desired body shape.
Liposuction is a cosmetic procedure, though in some cases it is done for medical reasons too.
It is a safe and highly popular procedure, has a short recovery time, and can provide you the best results to get a more proportionate figure.
Areas that are typically treated with liposuction are:
For Women: Abdomen, Breasts, Buttocks, Chin, Face, Neck, Thighs, Upper Arms, and Waist
For Men: Abdomen, Chest, and Flanks
You should identify your problem areas, and let me know. If you have multiple problem areas, I will advise you on what areas can be treated, and whether they can be treated together, or will require more than one treatment session.
Often people come asking for liposuction all over the body. Such people fail to understand that Liposuction is to improve the shape of the body in specific areas, and safety guidelines do not allow treatment of all areas in one session.
Liposuction, or other weight loss surgeries such as sleeve gastrectomy or gastric bypass aren’t the only ways of reducing body fat. There are non-surgical options too. Besides exercise and diet control, which is, without doubt, the best way to reduce fat, there are other ways too in which fat cells are broken down under the skin in a non-invasive or minimally invasive manner:
- High intensity focused ultrasound (Liposonix Ultrasound)
- Radiofrequency (Thermage)
- Cryolipolysis (CoolSculpting®/ Zeltiq)
- Carboxytherapy – carbon dioxide injections
- Laser Lipolysis – using laser, infrared (IR) light
- Bi-polar radio frequency (VelaShape®)
You can consider these options too for small problem areas. However, for larger problem areas, or where larger volumes of fat is to be removed, non-surgical techniques do not give the same results as surgical liposuction. Further, while liposuction will generally give you results in a single surgery, for non-surgical fat reduction, you would typically need multiple sessions.
It is very essential for me that you are clear on why you are considering Liposuction. So, even before your initial consultation, you should reflect on some questions:
- Have you tried exercise and diet control?
- Are you thinking of Liposuction as an obesity or weight loss treatment?
- Are you clear on your problem areas for liposuction?
- What are your goals and expectations from the surgery?
I will be asking you these questions in my initial consultation, and your answers will help me to assess whether you are a right candidate for liposuction.
If you are an adult – male or female, are in generally good health, not pregnant, and your current body weight is within 30% of the desired body weight, you are potentially a good candidate for liposuction.
Other factors determining your suitability for liposuction are your body weight fluctuations, the condition and elasticity of your skin, your medical history, and your expectations from the surgery.
Liposuction results are long-lasting. The fat cells that are removed during the surgery do not reappear. However, if you do not maintain your body weight post-surgery, new fat cells will form over time, and can get deposited in the treated areas too.
It is therefore important that you are ready for the post-liposuction phase, to exercise and have a balanced diet, so your new body contours are not affected.
Despite that, changes related to ageing could still alter your body contours.
The recovery period for liposuction can vary from a few days to weeks depending on the treatment area and the technique used.
If your surgery is done as an outpatient procedure, you will be able to go home the same day. Have someone to drive you back.
You will be up and about the next day after surgery. I recommend one to three days of rest at home depending upon the areas treated. After 3 days, most of my patients start going out of the home, attending work, driving, etc. After 6-7 days, I recommend you start mild exercises of other areas. This will improve the metabolism and prevent weight gain in the initial recovery period. Exercises such as jogging, cycling, hand paddling can be started in two to three weeks. Most of my patients return to complete physical activities within 6 -8 weeks. Bottom-line is listen to your body – do what it allows without much discomfort and stop when it hurts or swells.
If you are working, I suggest you apply for one week’s leave.
Strictly following the recommended post-recovery plan will help you recover faster.
Importantly, the skill of your liposuction surgeon also affects your recovery period. When we meet, I will share actual cases of my patients and what enabled their quick recovery.
Every surgery carries some risks, but at this stage of my experience and expertise, I have been successful in eliminating the following risks:
- Life threatening risks such as Thromboembolism, lung complications, etc.
- Infections of any kind
- Excessive Bleeding
- Skin Necrosis (dead skin)
Some of the risks that I have been able to reduce significantly are:
- Scars of the port
- Skin unevenness
- Skin laxity
- Contour deformities
- Over correction
- Under correction
There are some risks that are unpredictable and out of my control:
- Improper skin retraction
- Recurrence of fat
Liposuction cost varies based on the following factors:
- Area/s being treated and extent of fat reduction needed
- Liposuction technique used for the surgery
- Hospital/ Clinic used for the surgery
- Skill & expertise of the liposuction surgeon
Since liposuction is usually done as a cosmetic procedure, and not for medical reasons, insurance does not cover the cost. It is therefore important that you are fully aware of the total costs of the procedure, from initial consultation to follow-ups, so you can make an informed decision.
Another significant aspect to take into consideration, besides just the costs, is your comfort factor with the liposuction surgeon, and your faith in the surgeon’s expertise. Pay a bit more – but be sure, and be comfortable with your surgeon.
To know the cost applicable for your specific case, please book a consultation.
The choice of your liposuction surgeon is a decision to be made with due care. While cost is a relevant consideration, there are other more important factors that should determine your decision:
- Qualifications and certification, specifically plastic surgery related certifications and memberships, such as membership of American Society of Plastic Surgeons (ASPS)
- Years of experience as a plastic surgeon, number of surgeries done
- Number of liposuction surgeries done, and frequency thereof
- Proof of work – before/ after images
- Patient testimonials
- Surgeon reputation
- Your comfort factor with the surgeon, his manners, his patience in answering your questions
- Surgeon’s philosophy regarding patient safety
You are planning a significant surgery, so it’s very important that you decide wisely.
You can read my full profile here.
The clinic or hospital for your liposuction surgery done should be carefully chosen. Ensure that the facility is licensed. A hospital is not necessary for a liposuction surgery, an accredited/ licensed clinic is just fine.
The clinic should have a licensed anesthetist on board, competent nursing and operations staff, and the surgical room should be clean and hygienic.
Ministry of Health (MOH), Dubai regularly conducts inspection of all medical and surgical facilities in Dubai and license is granted or renewed only if the prescribed conditions regarding hygiene, safety, etc. are met.
My medical center – Cocoona Center for Aesthetic Transformation, Dubai is an MOH-licensed clinic, and we are permitted to perform surgeries under local anesthesia. We also have competent anesthesiolgists on board, and a full team of caring and professional nurses, patient counselors, and other support staff.
Now that you have all the base information regarding liposuction, you should take the next step of booking the initial consultation.
STAGE 2: INITIAL CONSULTATION – MY QUESTIONS TO YOU
During our initial consultation, I will first ask you certain questions, then explain the liposuction procedure to you, and then answer all your remaining doubts and concerns.
At the end of the consultation session, my goal is to have clarified to you fully and clearly what you can realistically expect from your liposuction, assessed your eligibility for liposuction, satisfied all your concerns and doubts, and assured you of my capability to provide you the best results. Having done that, I will connect you with my patient counselor, who will handle the routine aspects of preparing you for your prospective surgery.
- What areas are bothering you most?
This will help me understand your main concern areas, so I can focus on that and achieve the desired result. This is called targeted Liposuction.
- Why do you think you need liposuction?
I will be happy if you say “Doc, I have tried hard to exercise and manage my diet and have reduced some weight, but a certain area fails to respond well”.
If you say you want it because you don’t want to try by exercise and diet management, I will have to sadly refuse the procedure.
- What is your maximum and minimum weight?
This will allow me to understand your weight fluctuation pattern, possibly reasons for fluctuation and the condition of your skin. If there is not much fluctuation, I can expect a better and long-lasting result. A significant fluctuation will tell me that your skin may not retract well after liposuction, and we may have to look at other options.
- What is your medical history?
I will inquire about your past surgeries, pregnancies, medical illnesses, allergies, ongoing medications, etc., to gauge your suitability for surgery, and which technique of surgery will be best for you.
- What are your expectations?
This will help me understand your desire and expectations. I will than analyze if they are realistic or unrealistic. I will explain to you what to expect, and whether I will be able to meet your expectations.
The basic Liposuction process involves converting the fat in the body into a liquid and then draining it out with a suction. I have done thousands of Liposuction surgeries to improve my patients’ body contours. The surgery will be done either at an accredited day care surgical facility such as Cocoona, or a hospital, depending upon your choice, and anesthesia considerations.
Understanding the process involves knowing about anesthesia, melting of the fat, removal of the fat, post-procedure recovery, return to normalcy, risks involved, and expected results.
- What anesthesia is used?
The procedure involves some form of anesthesia. Mostly it can be done under local anesthesia with IV sedation. After IV sedation, I inject local anesthesia at few sites using smallest possible needle. Then I make a small hole to insert a blunt fine cannula. This will allow me to perform “tumescent liposuction”.
During this part of anesthesia, you will feel mild pressure, and it can take about 10-20 minutes to complete the anesthesia. In some patients who do not prefer to feel anything at all we can administer general anesthesia.
Then, small incisions (3 – 4 mm) are made in hidden areas such as belly button, bikini line, under the breast, etc. If incisions are required in a visible area, they are made very small and staggered to prevent a surgical look. There are no sutures placed to prevent stitch marks.
- How is the fat melted / liquefied?
The tumescent technique for local anesthesia swells up the fat, and allows me to perform “tumescent liposuction”. This is considered the most preferable method of liposuction, as it eliminates the need for general anesthesia, results in minimal bleeding, and aids faster recovery.
Sometimes, based on need, I may prefer other processes:
Laser Lipolysis – For selected patients, where there is small pocket of fat in areas such as chin, arms, flanks, thighs, knees, ankles, etc., I use Laser Lipolysis. I do not recommend laser Lipo for large areas where more than 2 liters of fat need to be removed or where we need more skin tightening.
Ultrasonic Lipo – Z Lipo – Ultrasonic energy is used to liquefy large volume of fat. It is particularly useful for secondary/correction liposuction, tough areas such as abdomen, back, chest. And particularly in Men, Z Lipo helps more skin retraction than laser Lipo. It is also very useful for High Definition Liposculpturing in both, men and women. “Six –pack” and “Chiseled Chest” in Men, and “Turtle Tummy” in women can be achieved using Ultrasonic assisted liposuction.
VASER Liposuction – Vibration Amplification of Sound Energy at Resonance, is performed using a high energy ultrasonic device. It is much more powerful than the previous Z Lipo. So it is useful in selected individuals looking for athletic and toned looks. It does carry some risks of burns, and excessive internal scarring (???) – hence it is used with caution.
RFAL (Radiofrequency assisted Liposculpturing) – I use this device if I feel your skin needs a lot of tightening. Bipolar radiofrequency helps in breaking down the fat and in heating the dermis/ skin to a controlled temperature that allows good skin retraction.
Power assisted Lipo / Vibro Lipo – When I need mechanical advantage in breaking down the fat, I turn towards this device. This is mainly to improve my efficiency and reduce tiredness. The effect for the patient in my view is nothing different than Ultrasonic Lipo or even conventional Liposuction.
Water Jet Liposuction – I will use only in very select cases, if I am confident it is safe, and will give us more advantages than all other equipment that we are already using.
- How is fat removed?
Once the fat is liquefied, it is then removed by a vacuum device with small diameter cannulae. This process is called “Liposuction”. You will now understand that “suction” is an integral part of the procedure and that it means removal of fat.
- What is Liposculpturing?
It is the artistic part of Liposuction where fat is removed gradually and differentially, like chiseling a sculpture. Hence it is also called as Body Sculpting.
- How much fat can be removed?
Enough fat should be removed to achieve the desired result, yet prevent excessive removal. There are various guidelines for fat removal.
I follow the below stated rules, which are best practices in the industry:
- Less than 8% of total body weight – Average ranges from 5-10 %. Anything more can alter the hemodynamics of the body requiring IV fluid therapy, blood transfusion, or in worst cases ICU support.
- Less than 25% of the total body surface area – I limit number of areas as well. Multiple areas of liposuction can cause more discomfort and delays the recovery period. More importantly as an artist, I believe “I cannot build a masterpiece in one day”
- Achieving the contours– It is never about volume. It is about achieving a desired outcome. Once the shape is achieved I stop the liposuction.
- Respect the Skin– One more important guideline is skin laxity, I stop when I feel the skin will not contract any more. This way I can prevent skin wrinkling, skin folds and irregularity.
- What is done with the fat that is removed?
If needed, the fat that is removed from your body can be used to augment or enhance other areas of your body, such as your buttock (Brazilian Butt Lift), breasts, or other body parts.
At this stage, you are likely to have some more questions for me to clarify. Some such questions are covered herein. I will be glad to answer these and any other concerns you have.
- What is the recovery phase immediately after the procedure?
After completing the procedure, the wounds are left open without stitches. This allows complete drainage of fluid from inside the body. Because of following this best practice, none of my Liposuction patients have had any Seroma (liquid under the skin) symptoms.
The areas are covered with gauze padding and bandage. The drainage stops within 12-18 hours. You can than remove the dressing, have a quick shower, and wear the recommended pressure garment.
If there is any oozing from any of the sites, please apply small pads until it dries. I do not recommend covering the wounds completely as moisture retention can cause redness and discoloration of the scars.
- What should be done post-surgery to improve the results?
Pressure garment is the key to best results. A properly fitting garment needs to be worn for approximately one month. During this time, I recommend ‘foam paddings’ to achieve a better result. Subsequently in the next stage, wearing tight cotton outfits for a few weeks will help support the skin while it is retracting.
Starting early controlled exercises improve drainage, muscle toning and better skin retraction. Watching your diet will help you achieve better result for long period of time.
- When will the results be visible?
In many cases, you will see some improvement the day you remove the bandage. After that there will be some swelling, which may fluctuate during the first week, and then it gradually starts going down.
If the skin is elastic, the results start showing within a month, then on it continues to show improvement every month.
If the skin is flaccid, it may take 4-6 months to see the result. Interestingly, some areas like waist-line, arms, and ankles, show results much earlier than others.
STAGE 3: THE NEXT STEPS …
After our detailed initial discussion, almost all matters would have been clarified. You will then get a handbook that explains the details of before and after care, medications to avoid, risks and complications, financial agreement, consent and permission forms, medical history form, etc. Please spend some time reading the booklet completely.
My patient coordinator will get back to you with cost details applicable to your surgery, and the booking protocol, and will also answer any questions you may have in the run-up to the surgery.
Then a pre-operative appointment will be arranged wherein we will do a complete medical checkup, measurements, surgical planning, photographic documentation, and other necessary paperwork.
Finally, on the appointed day, I will perform the Liposuction, transforming your body shape to the desired one.
It is advisable to have a family member or friend to drive you back home after the surgery.
Liposuction sucks out stubborn fat from specific parts of your body in a controlled manner, thus giving you the look that you desire. This is somewhat like how a vacuum cleaner sucks dirt!