Most of what you read regarding Liposuction says that the ideal candidate is within 10-15 pounds of their ideal weight. This may be true for the “ideal candidate,” but what does that mean for those that are not their ideal weight and in fact may even be obese? Large volume liposuction is a somewhat controversial subject. Some believe that the limit of fat that can safely be removed should be no more than 5 liters per procedure. Unfortunately, this means that there will be many obese patients excluded from liposuction. Others believe that there is no limit of fat you can remove, but rather a limit of the medication that you can use to get these areas numb.
Those that are against large volume liposuction believe that there is a “fluid shift” that occurs when you remove such large amounts of fat. So essentially, you will be dehydrated from the removal of fat and could possibly go into cardiac arrest. Those that feel large volume liposuction is acceptable say that the amount of fluids used to get the areas numbed, adequately replace the fat that was removed. In other words the amount of fat removed is replaced with the fluids infiltrated. In most cases the fluids used during a liposuction procedure using the tumescent technique are about a 1:1 ratio. So if 7 liters of fat are removed approximately 7 liters of fluid is injected to get the area numb.
From my experience of 1000’s of procedures, my ratio is roughly 1:1 with fluids and I have personally never had any issues with large volume liposuction patients. They walk out feeling fine just like any other patient of lesser weight. Further, they have had normal recoveries and have not had any serious complications in the post op period. In fact, I have removed upwards of 8-10 liters of fat, which equates to 18-22 pounds of pure fat on over 200 patients. These patients do very well in general and are very happy with their results.
Larger patients must have slightly different expectations. There is no magic to liposuction that can undo some of the damage that obesity has inflicted on your body. Removing the fat will simply reduce the volume in the treated area and decrease your size. The body is an amazing machine that is able to adjust to many different situations. The skin will retract quite nicely, but there are limits. If your skin is severely stretched out then it may not retract to an acceptable tightness. Most of my obese patients simply expect to be smaller and look much better in their clothes. This is a very realistic and attainable view of large volume liposuction procedure. If you are obese and have tried to lose the weight with diet and exercise but have not had success, then Large Volume Liposuction may be the answer for you.
By: Trevor Schmidt PA-C