How much Lipo is too much Lipo?

Northern Virginia LipoAs liposuction technique has evolved, plastic surgeons have been able to safely remove more and more fat. In the early days of liposuction, the limiting factor wasn’t the amount of fat, it was blood loss. While it is standard of practice nowadays to first inject a solution into the fat to minimize bleeding, this wasn’t known to surgeons even 30 years ago. This fluid, known as tumescent, allows plastic surgeons to remove fat in a near bloodless manner, making the procedure safer, but begging the next question: how much is too much?

The American Society of Plastic Surgeons recommends a maximum fat removal of 5,000 mL, which weighs over 10 lbs, but this number has been questioned by some authorities on the matter. Other variables come into play. One to recently gain news coverage is BMI (body mass index). If a patient weighs 200 lbs, the logic follows that person may be able to tolerate more fat removal than someone who weighs half as much. Another factor is the amount of solution injected before liposuction. While most of this fluid stays locally near the fat cells until suctioned back out, some of the fluid is absorbed by the body. In small amounts, there is little effect, but in larger amounts, the excess fluid can cause strain on the heart. Also the medications placed into this fluid prior to injection can lead to toxically high levels if too much fluid is used.  A final factor is also operative time. The longer someone is under anesthesia, the higher the risk, so the surgery needs to be completed in a reasonable amount of time, typically 5-6 hours maximum for outpatient procedures. So, while there is no simple answer to how much is too much, there is surgeon experience to rely on.

My person philosophy is that every patient is different in regard to their needs and goals. I aim to remove as much fat as I safely can to meet the patient’s wishes, but with the understanding that if there is any indicator during surgery that not as much fat can be removed as was hoped, the liposuction can always be done in multiple stages. Sometimes it is better and necessary to have 2 shorter surgeries as opposed to one marathon procedure. Safety in the operating room is number one priority, and this is how Austin-Weston, The Center for Cosmetic Surgery, maintains 5 separate operative suites accredited by the American Association for Ambulatory Health Care. We pride ourselves on a culture of safety and results, and our happy patients, positive online reviews and before-and-after results speak for themselves.

At Austin-Weston, all of the plastic surgeons are board certified by the American Board of Plastic Surgery, the organization responsible for making sure surgeons are well-educated and safe. This means extensive training in understanding fluid dynamics of liposuction and the limitations of the human body.

Christopher D. Knotts, MD


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