Any healthy person aged 18 to 78, with body shape issues and realistic expectations. For my part, my youngest patient was 16 years old (parental consent is then required) and the oldest was only 83 years old…
The person consulting must have adipose issues, therefore caused by fatty tissue. If it’s a bony ridge for example or large muscles causing the problem, obviously liposuction won’t help.
The best example is in the abdominal region. Some men who present with a large belly will be very surprised to learn that liposuction cannot help them. Indeed, this roundness is not caused by fat located between the skin and the muscle. It could be due to weak abdominal muscles, causing the intestines to protrude, creating this bulge, or the fat could be located behind the muscle, around the intestines (at the level of the omentum) and causing this large belly. To know if liposuction will solve your problem, you need to do what is called the pinch test, which involves pinching the skin in its full thickness between the thumb and index finger: here it would be at the level of the abdomen. If the thickness is barely 1 cm, you cannot benefit from liposuction, but if it is much larger, say 1-2-3-4 cm or more, liposuction can be very useful to you.
Some patients insist on removing all the fat. It is important to understand that we cannot remove 100% of the fat. We must leave a layer that corresponds, when pinching the skin between the thumb and index finger, to about one centimeter in thickness. Otherwise, we would have a disastrous result, as the skin would stick in some places to the deep layers, giving an impression of repelled leather. Moreover, the skin could no longer glide over the underlying muscle and would lose its flexibility.
For example, place your index finger on the back of your hand and gently slide the skin over the deep layer, you will understand that this flexibility of the skin is very important.
It’s not only at the abdominal level where excess volume is not necessarily caused by fat, take for example the buttocks, it is possible to have sagging buttocks, caused by muscle weakness in that area. It is important here again to make a good diagnosis, to pinch the skin (pinch test), to check if the roundness comes from excess fat, muscle weakness, or both. If the skin fold that can be pinched is very thin, it is then a case of muscle weakness in which case the solution would not be liposuction, but rather exercising these muscles to achieve a good result. When we talk about realistic expectations, we mean among other things that liposuction only addresses fatty tissue. Relaxed muscles as well as a wide bone structure will remain unchanged after liposuction: it is very important to know this. Moreover, liposuction cannot change a person’s build, and we cannot transform a robust person into a slender being. We cannot make a “Claudia Schiffer” out of a “Whoopi Goldberg”.
By realistic expectations, we also ensure that the expectations must be proportional to the amount of excess fat. One liter of fat removed will obviously give less results than four liters. One liter, especially if distributed over two or three sites, will not change the size of the clothes the patient wore before, while 3 or 4 liters will make a noticeable change in clothing.
To be even more explicit, I would say that liposuction will give you the body you would have had, without this excess fat. Thus, if you have large muscles in your thighs, you will have beautiful muscular thighs once the fat is removed, and not the thin thighs of your 110-pound (50 kg) neighbor. Liposculpture will give you back your thighs, before the fat had padded or masked them, as well as your abdomen, your flanks, your very own chin. One day, a patient told me during her post-operative visit: Doctor, you gave me a magnificent belly, but I find my thighs a bit large. I replied: Madam, all I did was give you back your belly and your thighs. If you find your thighs a bit large, it’s because nature made them that way, underneath the excess fat I aspirated!
But is there a thickness limit that would justify liposuction?
I would answer that if the “pinch test” gives a thickness of an inch or even a little less, it would be justified to perform liposuction, sometimes less in some people seeking the perfect size.
