The first step a patient should take when considering liposuction is to consult a liposculptor. Nothing can replace experience in this field, and no degree guarantees competence in liposuction.
The first question a patient should ask is: “How many procedures has this liposculptor performed to date, and how many does he do per week?” Indeed, liposuction has become so popular in recent years that many surgeons have decided to add this technique to their long list of practices, performing it here and there between facelifts, rhinoplasties, lipectomies, and others. Therefore, I recommend a professional who specializes in liposuction, who performs it almost daily, who has concentrated all his energy and skills in this area, surrounded by a team and state-of-the-art equipment. Liposculpture can be compared to hair transplantation: some doctors have specialized in this field and have thus become the best in their domain, true experts.
The meeting with the practitioner will be decisive for liposuction. It is important that the patient clearly expresses which parts of their anatomy they dislike and why. It is essential that expectations are well communicated to avoid any disappointment.
The various bumps or lumps found on the body are not 100% fat; there are muscles and bones that will not change after liposuction. This must be well explained and, above all, well understood, because a disappointed patient will loudly share their misadventure, while a satisfied patient will keep their secret, not wanting their perfect figure or “Jennifer Lopez” curves to be attributed to artificial means.
One area that must be clearly explained, and I repeat this willingly, is the abdomen, which consists of three layers or levels: first, the fat located between the skin and the muscle, then the muscle itself, and finally the fat located behind the muscle, at the level of the intestines, called the omentum.
The patient must understand that liposuction only accesses the first layer or level, and if the muscle is weak, their stomach will not become as flat as they desire, especially if it is “infested” with fatty tissue around the intestines, as is often the case with a large belly, particularly a beer belly, which, by the way, is not always related to beer, far from it.
An honest surgeon must be very clear on this point, otherwise, they will be responsible for a great disappointment in their patient. Additionally, many patients need reassurance during the consultation, as they have heard all sorts of far-fetched interpretations, mostly false, about liposuction.
TV shows that talk about complications, horror stories, deaths, which are extremely rare and often unrelated to liposuction, but neglect to mention the “stunt surgeon” who performed it, and especially the type of anesthesia used. The fragmentation of information here is crucial to understanding the causes and explaining them to the public afterward.
For example, our practice is limited in the amount of medication used to anesthetize the fat. This dosage is calculated based on the patient’s weight. The amount of fat removed, as well as the body surface area to be liposculpted, are also subject to rules that must be followed. Of course, if the permitted limits of 30, 40, or even 50% are exceeded, the complications will not be due to the technique but to the user, i.e., the surgeon who commits a wrongful act.
A complete medical history must be taken at the first visit. Thus, if the patient heals poorly, the incisions could leave a mark. Similarly, bleeding problems, diabetes, or complications from previous surgeries must be taken into account.
The second criterion that seems crucial to me is to choose a practitioner who works with the tumescent method, i.e., local anesthesia and small-caliber cannulas depending on the areas to be liposculpted. I personally believe that general anesthesia exposes patients to absolutely unnecessary risks, especially for a purely aesthetic procedure like liposuction. Klein states in his book “Tumescent Technique” that the risks of complications are 1000 to 10,000 times greater when general anesthesia is used.
Tumescent outpatient liposuction, i.e., under local anesthesia, is the safest and most comfortable method when performed in a specialized medical clinic (CMS). The hospital offers no additional safety for this type of procedure, quite the contrary, think of nosocomial infections.
The best recommendation you can get to choose a competent and experienced professional is from a patient who has undergone liposuction, was satisfied with the results, and can even show you the results. Unfortunately, most patients do not want it known that their figure or flat stomach is the result of liposuction.
If you were in Europe, during the first consultation, the doctor would have you undress completely to examine you from all angles. In Quebec and America, this way of doing things is not really in our customs. And a doctor, even with the best intentions, who acted in this way, would be poorly judged. Patients have difficulty lifting their sweater or lowering their pants to show their excess fat. However, when the patient returns for a postoperative visit, about three months after the procedure, their body, which they are now much prouder of, and the confidence they have in their surgeon, make them happy to show the results without false modesty.
Another reason to consult an experienced practitioner is to plan a treatment plan, i.e., to plan the areas to be sculpted during the same procedure, especially if the patient does not have the financial means to undergo more than one. However, lack of financial means should never justify an excessive quantitative intervention that would pose a health risk.
In aesthetics, any risk is inherently an inadmissible decision.
Here is a list of questions to ask during a liposuction consultation:
Does the surgeon work under local anesthesia?
How many procedures does he perform each week?
How long has he been practicing liposuction?
Is it possible to speak to patients who have already undergone the procedure?
Is it possible to see before and after photos of patients?
Does the surgeon sometimes teach other surgeons his liposuction technique?
What results can be expected?
What kind of complications can occur after liposuction?
How soon can you return to work?
How soon will you see results?
Another important observation to make yourself: What kind of welcome did I receive from the doctor and his staff? Can I trust them completely?
During the exploratory visit, were you comfortable asking all your questions, and did the doctor answer you in a satisfactory manner? Because it is extremely important that you feel good and confident with the professional before, during, and after the procedure. Some patients have told me that after the procedure, it was almost impossible to reach their surgeon. Be sure to ask: “Doctor, after the operation, how can I reach you if needed?“
If he tells you to call the office, this is not a very good sign, as offices are closed evenings and weekends; or you call the hospital… this is not very good either, you know the routine: “Press 1, 2, 3, 9,” and in the end, you end up with the same message, going in circles.
The consultation is, of course, crucial, as it will determine what can and cannot be done. Patients do not always realize the limitations of liposuction, and it is important not to disappoint them by encouraging unrealistic ideas and expectations, which would be a questionable, if not dishonest, approach.
Also, be wary of a surgeon who criticizes the work of his colleagues without having seen the patient’s photos before liposuction. Some anatomical features cannot be corrected by liposuction, which does not call into question the competence of the one who will give you the correct information.
During this first consultation, you will be asked about your medical and surgical history, any potential surgical contraindications will be sought, and information will be gathered about the type of medication you take regularly or have taken recently, as they could cause bleeding or conflict at the liver level with those that need to be infiltrated into your fat.
It is also very important to specify how the procedure will take place, the type of anesthesia, postoperative pain, return to work, the appearance of aesthetic results, which are visible within the first few weeks and will continue to improve over the following months.
Note that patients referred to us by friends or relatives satisfied with their liposuction are more confident and better informed about the reality of this decision. They come openly to learn about the conditions and date of their operation. Without references other than advertising, people are more fearful, not knowing if they are dealing with an experienced, specialized professional or a beginner. They then evaluate the answers given and precise explanations much more carefully, which is very normal. Again, the respectful liposculptor will understand this apprehension of the “new” patient and will show great listening, allowing all the time necessary to demystify this procedure.
An informed decision will always remain the best path to follow.
