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Safety in Large Volume VASER Liposuction

One of the biggest myths about liposuction is that the technique is reserved for slim people looking to improve just a small, isolated area of fat. Fortunately, liposuction has evolved over the last several decades, with the introduction of tumescent and superwet techniques, and ultrasound-assisted liposuction. These advances have made the removal of larger volumes of fat (beyond 4-5 Liters) with less blood loss easier and safer. With large-volume VASER Liposuction a broader range of patients can experience exceptional results, even if they are overweight. Large-volume Hi-Def VASER Liposuction has the advantage of being able to complete the body contouring in one single procedure rather than two or more smaller liposuction surgeries. The versatile apparatus of VASER Liposuction can be utilized more effectively in patients with a higher Body Mass Index (BMI) and for men with gynecomastia. There is no an ideal starting weight for a successful 4D VASER Liposuction procedure and recovery. Nowadays, many full-figured patients who desire flat abs and a fuller, beautifully rounded backside opt for large-volume VASER Liposuction with fat transfer to the hips and buttocks (Brazilian Butt Lift (BBL) and get amazing, long-lasting results.

Large-volume VASER Liposuction with fat transfer to the buttocks performed by Dr. De La Cruz.

Traditional liposuction removes about 2 Liters of fat. The innovative technique of large- volume VASER Liposuction allows up to five or more Liters of fat to be safely eliminated during a single treatment. Many patients find that they are able to drop two to five sizes in clothing after undergoing large-volume VASER Liposuction. This is not only a huge boost to patient’s self-esteem, but it almost instantly improves underlying conditions such as high blood pressure by the removal of a large volume of fat. General anesthesia is typically used when performing large-volume VASER Liposuction procedures. Overall, general anesthesia is very safe for most patients. Under general anesthesia, the anesthesiologist or nurse anesthetist remains with the patient throughout the procedure and carefully checks the patient’s heart rate, electrocardiogram, blood pressure and oxygen delivery (pulse oximetry) at a minimum of five-minute intervals. The maximum liposuction aspirate that can be safely removed depends on the amount of lidocaine in the tumescent fluid (not more than 35mg/kg which is the gold standard of care) that can be infused to perform the procedure (1). It is worth noticing that in states such as Florida and New York, the maximum liposuction aspirate that can be taken out are 4 and 5 Liters, respectively. When the lipoaspirate surpasses the 5 Liters, patients get admitted overnight in the hospital. Furthermore, it is recommended obtaining a medical clearance from a primary care physician (or cardiologist for patients 45 years or older, or if patients are over 40 years old and have co-morbidities such as diabetes, family history of cardiac problems or hypertension) prior to large-volume VASER Liposuction surgery. Deep vein thrombosis (DVT) prophylaxis with an anti-coagulant will likely be needed to prevent a thromboembolic event. Safety is of utmost importance when undergoing large-volume VASER Liposuction.

Patients who undergo large-volume VASER Liposuction should accept the possibility that a later surgery to remove excess skin may be needed. A remarkable amount of skin retraction occurs after VASER Liposuction, especially when it is combined with Renuvion (J-Plasma). Results from clinical studies presented at the 78th Annual American Society of Plastic Surgeons Meeting demonstrated a 53% improvement in skin contraction relative to the standard liposuction procedures (2). Moreover, combining the unique properties of helium plasma and radiofrequency energy, Renuvion (J-Plasma) produces dramatic and immediate effects on the soft tissues and skin when paired with the VASER Liposuction machine. Using Renuvion in conjunction with the 4D guarantees smoother contours and significantly more skin retraction. Renuvion game-changing technology will not only firm up your skin but also it will improve some of the abdominal striae or “stretch marks” that may be present. When fatty tissue beneath the skin is removed, the skin is loose at first because some of its underlying support is gone. Around 6 months after large- volume VASER Liposuction, patients know how much their skin will retract, or shrink, to fit the new contours of the underlying tissue. A small percentage of people who have large-volume VASER Liposuction combined with Renuvion (J-Plasma) and do not have sufficient skin retraction opt to have the extra skin removed surgically.

Large-volume VASER Liposuction with Renuvion (J-Plasma) performed by Dr. De La Cruz.

High volume VASER Liposuction requires more than artistic and surgical skills. This procedure requires very careful monitoring of fluids in the body both during the procedure and through the recovery period. This is to safeguard against complications that can result from overly aggressive fat and fluid volume suctioning. Fortunately, serious complications are rare with large-volume VASER Liposuction. The major concern, which requires postoperative monitoring, relates to fluids and electrolyte imbalances and blood loss. In a review of 631 consecutive cases over 12 years published by the Department of Plastic Surgery of Stanford University Medical Center, no serious complications were experienced. The majority of the complications consisted of minor skin injuries and burns, allergic reactions to garments, and postoperative seromas (3). The results show that large-volume Liposuction can be safe and effective procedure when patients are carefully selected and when anesthetic and surgical techniques are properly performed by highly trained and experienced professionals. Cosmetic benefits are excellent, and overall complication rates are low.


(1) Shiffman, Melvin. “Aesthetic Surgery of the Abdominal Wall”. EPDF.

(2) Lewis, Linda W. “Taking Shape”. MedEsthetics.

(3) Commons GW, Halperin B, Chang CC. “Large-volume liposuction: a review of 631 consecutive cases over 12 years”. National Center for Biotechnology Information, U.S National Library of Medicine.

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