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ROCKVILLE, MD  •  MCLEAN, VA
 301-656-6398  |  703-442-4919
AT Cosmetics

Liposuction

Dr. Tattelbaum is an experienced, board-certified plastic surgeon offering liposuction in Maryland and nearby areas.

A word from the Doctor

Liposuction is one of the most popular surgeries that I perform. 

In fact, it is one of the most popular surgeries in the country with more than 400,000 performed annually. Despite its appeal and popularity, paradoxically I think it is one of the least understood cosmetic operations. 

So, on this page, I will try to provide some clarity. I’ll explain the different types of liposuction, including laser options, and shed some light on the procedure.

I’ll begin with the concept that the key to a good result is all about the skin, and not about the fat.

Written by Dr Adam Tattelbaum M.D.

Dr. Adam Tattelbaum M.D. in scrubs

Why choose Dr Tattelbaum?

  • Double board-certified Maryland plastic surgeon
  • Member of the American Society of Plastic Surgeons
  • Member of the American Society for Aesthetic Plastic Surgery
  • Listed in “America’s Top Surgeons” by the Consumer Research Council of America

What is liposuction?

Liposuction procedures remove excess fat from the body using a suction device. It is most commonly used to reduce localized fat deposits in the thighs, hips, buttocks, arms, and abdomen. Though liposuction is not a weight-loss procedure, it can help slim and contour problem areas for a more aesthetically pleasing appearance.

In its most simple and original form, the procedure involves a small metal tube (called a “cannula”) that is placed under the skin. The cannula is connected to a vacuum suction device, and as it passes back and forth, the vacuum sucks the fat out from underneath the skin. There are many styles of cannula – some that are larger, some that are smaller, and some that remove fat more or less aggressively.

Despite this, liposuction is about the skin. The fat removal is the easy part and there is almost no area we cannot remove fat from, but the skin is a different story.

If a patient has good, tight skin and fat is removed from underneath, then the skin will shrink up nicely and the patient will be happy. But if the skin is loose and fat is removed, the patient may be skinnier, but the skin will look dimpled wavy and irregular.

We discuss this more further down, but if you don’t have good skin elasticity, you may require liposuction with a tummy tuck to achieve the best results.

In short, liposuction can:

  • Remove fat from areas of the body resistant to diet and exercise
  • Achieve a more sculpted appearance
  • Deliver long-lasting results
  • Improve certain medical conditions such as Lymphedema

For more information about liposuction in Maryland, get in touch today to organize an initial consultation with Dr Tattelbaum.

What about tumescent liposuction?

Tumescent liposuction involves adding fluid under the skin before proceeding with liposuction. This fluid, called tumescent fluid, has a number of benefits:

  • It contains a local anesthetic to minimize pain
  • It contains epinephrine to cause blood vessel constriction, which minimizes bruising
  • It helps to hydrate patients, making recovery easier
  • It makes the target for liposuction larger, making it easier for surgeons to achieve a more even result

The composition of tumescent fluid has been well studied for safety. Some doctors use more or less fluid, depending on their preference. But the use of tumescent liposuction is the mainstay of all liposuction regardless of the device that is used to remove the fat.

Types of liposuction

There are four main types of liposuction:

Standard

Standard liposuction involves a small metal tube (known as a cannula) that is placed under the skin. The tube is connected to a vacuum suction device, and as the tube is passed back and forth the vacuum literally sucks the fat out from underneath the skin. It’s our job to pick the correct cannula for the job. A larger and more aggressive cannula may be used for bigger areas such as the abdomen or flanks, while a smaller cannula may be used for areas such as the chin or face. The energy to move the cannula is powered by the surgeon’s hand. We use this method mainly for small liposuctions.

Power-assisted

Power-assisted liposuction uses the same method as standard liposuction, but the metal cannula is connected to a device that makes it reciprocate (go in and out) very quickly. This reciprocating motion makes it easier to move the cannula through the tissues and remove fat quicker. We use power-assisted liposuction frequently due to the way it feels and the uniform results it generates.

Energy-source

Energy-source liposuction refers to technologies that send energy into the fat to help break it up. For example, ultrasonic liposuction uses high-frequency sound waves, while laser liposuction uses light energy. These are very different technologies, but the end result is similar. Initially, these technologies promised to not only remove the fat but cause the skin to shrink too. We believe they remove fat well when performed correctly, but there’s little evidence of skin tightening. In addition, because they use increased energy, there can be a higher risk of seroma (fluid collections under the skin) and burns to the skin.

External

By definition, anything ‘external’ is not truly liposuction, but there are a few methods that attempt to remove fat in a non-invasive way. Some use ultrasound waves, and some use freezing. They might be appropriate for patients that do not want a surgical procedure, but the results are not as strong and it is important to modify expectations.

How much does liposuction cost in Maryland?

The cost of liposuction can vary depending on the number of treatment sites. One site is an area of the body to receive liposuction. This will be clearly explained in your consultation with Dr. Tattelbaum so 1) you understand exactly where fat will be removed and 2) you know the exact cost of treatment.

Our liposuction treatment is priced as follows:

Under general Anesthesia:

  • $5,500 for the first site
  • Additional sites priced by size

Preparation

It’s crucial to understand that liposuction is not a weight-loss tool. It is intended to shape the body and remove fat from areas that are resistant to diet and exercise. 

This should guide your pre-operation preparation for liposuction.

Most importantly, it means that you should be within touching distance of your ideal weight before liposuction.

In addition, you should:

  • Note down your objectives, concerns, and questions for Dr. Tattelbaum ahead of the consultation

  • Stop smoking, reduce alcohol intake, and maintain a healthy diet in the weeks leading up to surgery

  • Exercise regularly and get plenty of rest, this proactive approach will aid recovery

  • Organize for someone to take you home after surgery

Recovery

The recovery from any type of liposuction is a long-term process.

It may take several months for your skin to return to normal, though most patients can return to normal activities within a couple of weeks. 

In the short term, you should take several days to recover from the procedure. Most of our patients report feeling tired, swollen, and sore. These effects are part of the body’s natural response to surgery and will dissipate over the first few days. 

The swelling will take longer and you may be given a compression garment to aid the recovery process. Whilst the majority of swelling will reduce within a few weeks of liposuction, it can take a few months for the final result to be visible. 

We will discuss individualized recovery options in your initial consultation. We will create a plan for recovery that allows you to return to full activity as soon as is medically possible.

We also recommend:

  • Take the medication and painkillers prescribed by Dr. Tattelbaum to combat soreness

  • Avoid physical activity and strenuous work until approved by Dr. Tattelbaum

  • Eat a healthy, balanced diet

Am I a suitable candidate for liposuction?

The most suitable candidates for liposuction are in good health and, most importantly, have good skin elasticity.

So, we assess potential liposuction patients using the following grading system:

  • Good skin tone — patients have a low likelihood of irregularities
  • Moderate skin tone – patients can proceed to liposuction but must be more tolerant of the possibility of dimpling
  • Poor skin tone – patients may wish to consider a skin tightening procedure in addition to liposuction because the skin is too loose, such as a tummy tuck, thigh lift, or back excision

The paradox of abdominoplasty is that the results are best in younger patients with the best skin elasticity. These are the patients who should need it the least! Even in the best situations, patients will always pinch something. Liposuction does not remove all the fat (it wouldn’t look normal), and liposuction, by definition, removes no skin.

I have an overhanging belly, do I need liposuction or a tummy tuck?

Many post-partum and weight-loss patients wish to remove the over-hanging belly from their lower abdomen. Unfortunately, liposuction by itself may not solve the problem.

As liposuction can only remove fat, this would leave the over-hanging skin which may droop even further.

So, for such patients, the removal of excess skin must be part of the equation. And to remove excess skin, you will need a tummy tuck procedure.

Dr Tattelbaum’s Perspective

“No one really wants a tummy tuck, and yet, despite that, it is one of the most popular surgeries that I perform.

Most post-partum patients and many patients wanting weight loss will come in, grab the overhanging roll on their lower belly and ask me to liposuction it away. I see their eyes glaze over as I explain that liposuction in this situation will make the loose skin looser, that the hanging skin will hang more.

I go on to explain how the removal of extra skin must come into the equation—like making a bed and tightening the top sheet. For many, the education is invaluable whether they go on to get a tummy tuck or not.

What breaks my heart is the small group of patients who don’t believe. These patients will get liposuction elsewhere and end up disappointed. I see many of these patients back when the reality of skin tightening finally sets in. Unfortunately, these become more difficult tummy tucks. When there has been prior liposuction, the skin is less elastic, and dimples and waves cannot always be completely removed.”

How much fat can you remove in liposuction?

Liposuction is a great procedure for adding the final touches to a person’s body, especially in problem areas where they’re struggling to remove residual fat through diet and exercise.

It cannot, and should not, be used to remove large stores of fat from the body. Doing so is dangerous and could lead to very serious complications.

The general guideline is that only 6-8 pounds of fat should be removed during liposuction.

How long do the results last after liposuction?

The results from liposuction are permanent as long as the patient maintains their weight afterwards.

A healthy, balanced diet and regular exercise will help. Importantly, both your diet and exercise should include things that you enjoy, or you’ll find it difficult to sustain them long-term.

What about laser liposuction?

Each time a new liposuction device comes out, the manufacturers have a vested interest in selling as many machines as possible. This leads to marketing hype that often exceeds reality and devices in the hands of non-plastic surgeons.

Because these machines are expensive and must be paid for, it has also led to poor results in poor candidates. Be sure you know the credentials of your surgeon, and be sure you are a good candidate.

This is true of laser liposuction and other new technology. While laser liposuction is a great option for body contouring, it is not a brand-new day in the world of abdominoplasty. It can help remove fat, but it will not reshape the skin.

“Dr. Tattelbaum and his staff were fantastic from start to finish. He made me feel completely comfortable throughout the process, spent the time to answer all my questions, guided me well and made the decision so easy for me. I am 5 months out and beyond thrilled with my results. I could not have had a better experience. My only regret is not doing it sooner.”

Schedule your liposuction consultation

Please get in touch today to schedule a no-obligation consultation for liposuction in Maryland.

The consultation lasts for roughly one hour. In the consultation, Dr. Tattelbaum will evaluate your health and starting situation. He will answer any questions you may have and cover the risks, benefits, and alternatives.

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