Background: Liposuction, both by number of procedures performed and body surface area, is the most common aesthetic body contouring procedure. While a large number of different face and body parts can be treated by liposuction, the treatment of abdominal and waistline fat accumulations is the most popular requested area. While initially intended to treat smaller abdominal amounts of fat, abdominal liposuction has evolved to become a larger surface area treatment wrapping around the sides in the back.
Extending abdominal liposuction into the back has been shown to be very safe in properly trained and experienced hands. With fat removed in a near circumferential manner around the lower torso, it is no surprise that major body shape improvements can be seen. How much abdominal flattening and back roll reduction can be achieved is highly influenced by the amount and quality of the overlying skin. Back skin always has a greater amount of contractile ability due to its greater dermal thickness. Abdominal skin often has less ability to shrink down smoothly due to loss of elasticity from pregnancies and weight loss.
As liposuction has evolved over the past 35 years in the U.S., numerous types of technologies have been applied to how liposuction has been performed. All of these technologies are largely about how the fat is broken up so that it can be suctioned out. While it is easy to get caught up as a potential patient in the different energies and marketing names of these liposuction types, nothing is more important than the skill and experience of the surgeon performing the procedure.
Case Study: This 46 year-old African-American female desired to liposuction to further what she has been able to achieve by diet, exercise and weight loss on her own. She had hit the proverbial wall in any further body shrinkage of her stomach, waistline and back.
Under general anesthesia and using pre-liposuction tumescent infiltration, power-assisted liposuction of the entire abdomen, pubis, flanks and back rolls was performed. Using a 4mm cannula, a total of 3,800cc of fat aspirate was obtained. Essentially lipsuction as performed until the aspirate became more red than yellow.
Her postoperative swelling was considerable, as expected, and it really took her a full three months to have a complete recovery. Until the treated areas are no longer tender, feel soft and the sensation in the overlying skin is back to normal, all swelling has not resolved and the skin maximally contracted back down.
Interestingly at her three month postoperative evaluation, she felt she had no significant change in the fullness of her abdomen or a reduction in her back rolls. Comparing her before and after surgery pictures showed that her perception was not accurate.
Also of interest was the apparent change in the appearance of her buttocks. While no fat injections were done into her buttocks, the significant reduction in the waistline above her buttock made it seem that she had.
- Liposuction of the torso (abdomen, waistline and back) is the most commonly performed body contouring procedure.
- When liposuction is done in a near circumferential manner around the waist, a dramatic reduction can be achieved in the shape of the torso.
3. Liposuction does not always eliminate all stomach or back rolls if too much excessive skin exists.
Dr. Barry Eppley