How Much Fat Can Be Removed During a Single Day Liposuction Surgery?

Liposuction is the most common plastic surgery procedure performed in the United States.

The lipo procedure removes fat from the face and/or body.

After adequate oral, intravenous, or inhaled anesthesia, the surgery begins. All techniques place a wetting solution (referred to as tumescent solution) of salt water (lactated ringers or normal saline) placed into the treated body sites, which contains lidocaine (numbing medication), epinephrine (minimizes bleeding) and bicarbonate (prevents burning).

There are many adjuvant liposuction devices that either facilitate fat removal and/or facilitate  skin tightening:

1. Suction alone
2. Ultrasound (VASER) – Skin tightening has been shown to be the best with ultrasound (53% better than suction alone) compared to laser (28%). Ultrasound also yields 26% less bruising and bleeding compared to suction alone.
3. Lasers (Smartlipo, SlimLipo, etc.)
4. Radiofrequency {RF} (Thermi)
5. RF combined with Helium gas- Renuvion or J-Plasma

The amount of fat that can be safely removed is often a question of surgeons and patients alike. This is one of the highest risk factors in liposuction and also one of controversy with no universally recognized value. Different states of the union have different recommendations of safe quantities. Although the recommendation is over twenty years old, California recommends a maximum is 4 liters of fat or 5 liters of total fluid removed as an outpatient.

More fat can be removed safely as long as other concerns are met.

Judicious intravenous fluid administration minimizes the risk of delivering too much fluid, since both the IV fluid and liposuction fluid are absorbed into the blood stream. Less body areas treated with the same amount of fat removal is safer than more body areas liposuctioned. In general, the more fat removed in a heavier (higher body mass index) patient yields the highest risk. The percentage of fat removed compared to patients overall weight is a factor, where more fat can be removed in a heavier patient. Shorter surgical and anesthesia time is safer than longer cases. Refer to “What type of Anesthesia Should I Do for Liposuction?”

From my experience using judicious anesthesia, limiting intravenous fluid administration  in a healthy patient, 4 to 6 liters of fat can be safely removed. However, the key is the fat that remains which creates a sexy, slender, and athletic body contour and not the total fat removal.

Healthier and younger patients weighing less and not on medications affecting lidocaine metabolism make the procedure safer and may enable more fat to be removed. In most cases, artistic sculpting of a slender body yields better cosmetic outcomes than the mere amount of fat removal. A smooth skin contour and athletic body shape is the desired goal most patients and surgeons are trying to create. There is no substitute for an experienced, well-trained, compulsive surgeon who can minimize skin contour irregularities and transforming you to an aesthetically pleasing man or women.