Road to wellness: Patients with higher BMI can benefit from liposuction coupled with a healthy lifestyle

Did you know that liposuction is the number one plastic surgery procedure in the United States? Patients seek this popular procedure to remove excess fat from targeted areas, including the neck, back, buttocks, hips, abdomen and thighs. This sculpting procedure contours the body to create a more proportionate appearance.

Liposuction can benefit people of all shapes and sizes, including those with a high body mass index (BMI), but it's not a quick fix for losing weight. Yes, liposuction removes fat, but not enough for significant weight loss. Why? Because there's a limit to how much a surgeon can safely remove at once.

How much fat is removed?

ASPS Member Surgeon Michael Hakimi, MD, explains that the ASPS recommendation is five liters of total lipoaspirate – a combination of fat and fluid – in a single liposuction procedure. One liter of fat weighs approximately two pounds.

"That five liters includes fat, lidocaine (a local anesthetic), blood, whatever comes out," said Hakimi. "It can only total five liters in one sitting."

Hakimi explained that if a surgeon uses a lot of tumescent solution, a local anesthetic, it can account for a significant amount of the lipoaspirate that's removed.

"Out of the five liters, you might end up with two liters of fat and three liters of tumescent solution," said Hakimi. "It varies depending on how much fat they have and also what technique the surgeon uses."

Patient safety comes first

For safety reasons, ASPS recommends the removal of no more than five liters of tumescent solution in one liposuction procedure. Removing more than this can dangerously tip a person's electrolyte balance, leading to cardiac arrhythmia (irregular heartbeat) and low blood pressure that requires patient resuscitation. Plastic surgeons are careful to follow the liposuction guidelines so that patients have the best outcome.

Additionally, liposuction may not be an option for some high-BMI patients. Obesity is linked to many health concerns that may involve additional risks during surgery, which are not appropriate for an elective procedure like liposuction.

Safety is paramount during a liposuction procedure, and the best way to ensure yours is to work with a board-certified plastic surgeon who is an ASPS Member Surgeon.

Liposuction for plus-sized patients

If only five liters can be liposuctioned in one surgery, is that enough to make a meaningful difference for a patient, especially one who is plus-sized? Yes, according to ASPS Member Surgeon Kimberly Singh, MD, who specializes in working with high-BMI patients who are otherwise healthy and can pass a series of preoperative tests and lab work.

"In a larger person, taking five liters out from just one focal area, like the tummy, for example, can make a big improvement in how they look and feel and how they move," said Singh. "Functionally, it can have a lot of positive effects."

According to Singh, many of her high-BMI patients tell her that exercise becomes easier for them after abdominal liposuction. This leads to other positive outcomes.

"The vast majority of my patients, when I see them six to nine months out from surgery, they've lost considerable weight on their own just because they can move and they feel better about themselves," said Singh.

The limitations of liposuction

While liposuction is not a weight loss solution, it can kickstart a healthy lifestyle when combined with a good exercise routine and nutritious food consumption.

High-BMI patients can undergo several liposuction procedures over time to address multiple areas of their body. Yet even if a patient undergoes various liposuction procedures, the scales will not show much weight loss because the process is limited in its ability to make a person lighter on the scale.

Five liters of total lipoaspirate is the maximum that a surgeon can remove in one procedure, which translates to just a few pounds of fat. Instead of weight loss, the power of liposuction lies in its ability to sculpt bodies of all shapes and sizes, including those that are plus-sized.

To find a qualified plastic surgeon for any cosmetic or reconstructive procedure, consult a member of the American Society of Plastic Surgeons. All ASPS members are board certified by the American Board of Plastic Surgery, have completed an accredited plastic surgery training program, practice in accredited facilities and follow strict standards of safety and ethics. Find an ASPS member in your area.