Large Volume Liposuction for Obese People

Large volume liposuction addresses the weight woes of obese people. The technology has evolved significantly and is gaining popularity. However, the process has been controversial due to some health risks it involves.


By standard liposuction surgery norms, approximately 5 lbs of fat are extracted in one sitting. In fact, fat is just 50% of the total mass suctioned. The other 50% is IV fluid, plasma, and blood. When the extraction weight exceeds 5 lbs, it is called large volume liposuction. A maximum of 8-10 lbs of liposuction fat can be evacuated from the body at one attempt. More than that can lead to medical complications, such as internal cellular or tissue injury, nerve fiber damage, excessive blood loss, etc.

Obesity and the Affected Body Areas

Obese people often suffer from excessive fat deposits mainly in the abdomen, waist, lower back, upper thigh, and buttocks.

Large Volume Liposuction Procedure

  • Techniques: In the last few years, the excess fat removal procedure has evolved considerably. The mode is now simpler, easier, and less painful with comparatively lower blood loss than the earlier methods. Some of the most often used techniques include:
    • Ultrasonic Assisted Liposuction (UAL): It is considered the most effective method for large volume liposuction. Of the various ultrasonic techniques, VASER liposuction is the best to date. However, the treatment does havepotential risks – such as infections, skin burns, and even death.
    • Tumescent Liposuction: This is a manual method employs a cannula to dislodge fat for suctioning it out of the body. This method is comfortable because it is less painful, heals faster, has better skin retraction than the other modes, and delivers the best possible results, as it targets fat cells.
    • Power Assisted Liposuction (PAL): It employs machine assisted cannula movement instead of manual. The method is not considered too effective in removing large amounts of fat.
    • Superwet: Similar to the tumescent technique, this style employs a high quantity of IV fluid, which proves quite helpful for removing large amounts of fat without incurring much blood loss.
    • Laser Liposuction: It uses the heat of laser rays for dislodging the fat cells, thermal lipolysis. The method is still evolving and finding an expert in this technique is a tactful task.
  • Duration: Usually 1-2 hours
  • Body Areas Operated Simultaneously: Often at least 5
  • Anesthesia: General
  • Observation: Overnight stay in the hospital
  • Frequency: May need to be repeated after defined interval(s)
  • Combination Therapy: Large volume liposuction sometimes results in loose, sagging, and folded skin. The patients may undergo skin firming plastic surgery after lipo. For example, to eliminate the skin sagging – abdominoplasty, or tummy tuck surgery, may follow abdominal liposuction in an overweight patient. The skin firming cosmetic surgeries (not lipo) also help remove stretch marks and scars.

Requisites after Liposuction:

  • Recovery: Depends on the patient’s health, the lipo techniques used, the quantity of fat removed, and the treated body areas. The bruising and swelling may take up to 3 months to go away. The doctor may recommend walking to reduce swelling and the chance of blood clot formation. While you may not be able to resume work before at least a week. Returning to regular physical activity, including bending, lifting, stressing will need a couple of months break after the surgery.
  • Post Surgery Garments: The patient may need to wear compression garments for at least 2-4 weeks after lipo. The clothing helps the lipo fluid drain properly, supports healing, and reduces swelling.
  • Medicines: Your doctor may give you antibiotics to prevent infections.
  • Weight: Check your weight 6-8 weeks after the surgery. Before that retained fluid may affect the measurements. The desired weight will be your last pre-liposuction record minus the volume of fat extracted. If it is more than expected, then you have gained fat and need to go on a diet and exercise.

Risks of Large Volume Liposuction

Thee risks are similar to the standard liposuction risks, except that the probability of occurrence is higher here. The following hazards are especially possible in large volume liposuction:

  • Dermal Damage: Excessive dermal damage results in skin sagging, dimpling, and lumps. Bruising, swelling, scarring, and numbness are the other side effects of large volume liposuction. The numbness is mostly temporary. If the nerve damage is intense, the numbness or varied sensitivity may persist.
  • Anesthesia Quantity: The amount of anesthesia required in a surgery varies in proportion with the patient’s BMI. Accordingly, a fat individual requires a large quantity of anesthesia, thereby enhancing the chances of the complications linked with it.
  • Death: Due to a high degree of physiological and anatomical damage, large volume liposuction may even lead to death.
  • Fluid Imbalance: In liposuction extractions, 50%-60% is fat and the rest is blood, tissue fluid, etc. The risk of dehydration and electrolyte imbalance escalates in large volume liposuction when over 5lbs of the complex is removed from the body.
  • Obesity Related Risks: An overweight person is quite prone to heart trouble and excessive bleeding during the treatment.
  • Hematoma: It is the accumulation of excess blood under the skin. The condition turns the affected area blue.
  • Seroma: This is the deposition of tissue fluid under the skin. It is pale yellow or transparent.
  • Blood Clots
  • Allergic reaction to the medication or anesthesia 
  • Infection: If the liposuction fluid is not drained properly, the risk of infection increases.
  • Rework Requirement: Sometimes the results do not shape up close to expectations. A reworking may be required, which means again going through the complete procedure, discomfort, risks, and recuperation.
  • Fat Relapse: In natural weight loss methods, the fat cells only shrink in size, but are present. The moment excess fat is available they can accommodate it and expand. Therefore, during liposuction, especially large volume, the fat cells are removed to decrease any more accumulation. The fat may not redeposit in the treated areas, but will settle in the untreated ones, especially upper abdomen, collarbones, and neck, with many adipocytes.

Patient Checklist

The safeguards for large volume liposuction are nearly the same as for standard liposuction. Here is a quick list:

  1. Patient’s eligibility: People ranging between or below 50-75 lbs. over their ideal weight are the best lipo candidates. Health, age, weight, weight patterns, diet, exercise, smoking & drinking habits, skin elasticity, and motivation are important considerations for the people crossing the 75-100 lbs overweight range. Those with fat concentration in a body area (such as the buttocks, abdomen, thigh) are usually eligible. People over 150 lbs of excessive weight are simply not qualified. A candidate over 100 lbs will need to slim down through exercising & dieting and can then be considered for liposuction, if he/she fits in the eligibility matrix otherwise.
  2. Surgeon Selection: Select a board certified, experienced surgeon with a record of competence in large volume liposuction. You may even check your doctor’s credentials. Please note that ‘any’ surgeon can perform lipo after just a short training. Therefore, selecting a large volume liposuction specialist gets trickier.
  3. Anesthesiologist: The success rate of handling large volume liposuction cases is important. The expert should be adept at the administering and removing fluids from the body.
  4. Supporting Surgeons: well-qualified surgeons should assist your doctor.
  5. Before-After Images: Liposuction experts keep albums of before-after images of the cases they have handled. Do see them.
  6. Patient References: Speaking to the ex-patients of your doctor is helpful. You will get first hand information about their experience. Your doctor’s clinic can supply the contact details of these patients.
  7. Surgical Facility Selection: Select a recognized and certified facility with emergency handling ability. The paramedical staff should be adept at the support required.
  8. Thorough Health Check Up of the Patient: Inform your doctor about your complete medical details, including the medicines you have been or are taking. You need to be physically, emotionally, and mentally sound. Your doctor will also want you to undergo some medical tests before resorting to liposuction. These include blood tests, electrocardiogram (ECG), tests for diabetes, thyroid, asthma, and blood pressure (hypertension). People with low immunity, diabetes, heart trouble, problems of blood clotting or disturbed blood flow, and the excessively overweight may not be eligible.
  9. Realistic Expectations: Liposuction is simply a body contouring process and not a weight loss tool. In addition, the results are less likely to be perfect. Therefore, your doctor should present a clear picture of the probable changes.

10. Complete procedure discussion: Discuss the procedure, its types, the technique applicable to you, anesthesia, recovery, pre- and post-surgery precautions, medicines, side effects, etc. with your doctor.

Liposuction Costs: The calculation of liposuction costs are similar to standard procedurse. The price of large volume fat extraction is higher as the surgery may involve more than one body area, a combination of techniques and equipment, different types of anesthesia, more than one expert, long duration, and the frequency of the surgery.  You may ask if your doctor provides a  financing option. Also, get clarity on the ‘corrective’ process if the results require. Confirm if you will be charged again for it and if yes, then how much.