October 2023

Avoiding Trendy Lipo:
Why Elegant Lipo Is Better

Elegant Lipo

Not a day goes by when my Social Media feed isn’t overrun with the latest liposuction craze. Most plastic surgeons focus on devices that promise superior results. Examples are Air Jet, Water Lipo, SLIM Lipo, Smart Lipo, and Tickle Lipo, to name only a few. Equally concerning are the trending liposuction concepts such as abdominal etching or fat grafting into the muscles. These trends promise otherworldly results, but are they really what you need? Are they really that effective?

Plastic surgery should be a way to enhance natural beauty offering improvement while respecting normal anatomy. Beautiful liposuction is designed to target fat below the skin called subcutaneous fat, in discrete problem areas like the neck, arms, back or bra fat, axilla or armpit, abdomen, flanks, and thighs. Good liposuction candidates will have good skin quality, mild to moderate fat deposits, and be in good overall health. Liposuction in moderation is much more effective than trying to use liposuction as a weight loss solution. For this reason, guidelines are widely accepted limiting the amount of fat removed at one setting to no more than 5 liters.

Basic Lipo Involves A Couple of Steps

  • Adding wetting or tumescent solution to the fat, and
  • suctioning out the fat with a cannula.

These steps are done using small access points located in discrete areas that are easily hidden, and if done correctly, leave almost no scarring. In most cases, this approach yields excellent results.

Modern Day Liposuction Technology

Technology innovators discovered that adding an energy source to lipo devices would serve lipo patients with additional benefits. Modern-day technologies include ultrasound and laser. Innovative liposuction devices like Slim Lipo, or Smart Lipo, and VASER® utilize these technologies to provide more cosmetically elegant results than traditional lipo devices.

Laser and Ultrasound-Assisted Liposculpting

VASER lipo is the most sought-after by body sculpting patients and is the most frequently used lipo device by board-certified plastic surgeons on the market today. The mode of operation is similar: tumescent fluid prepares the fat for smooth extraction while a smaller cannula is inserted to remove fat. The laser or ultrasound energy targets liquefy the fat cells, making for smoother and more even removal of fat.

The energy component also addresses what older lipo methods could not address quite so elegantly. Areas where fat is more fibrous or dense like the back fat and bra bulge area, and a man's chest are now able to be treated more thoroughly and evenly thanks to the energy component. The energy component is also enormously successful in revision lipo patients where either:

  • The final result was uneven and lumpy,
  • scar tissue formation was apparent, and/or
  • not enough fat was removed to contour the area beautifully.
  • Tighter Skin with Newer Technology

    Laser and ultrasound liposuction provide an additional benefit that its older counterparts do not: the benefit of skin retraction and contraction. The heat generated by the energy source stimulates collagen and elastin to create a firmer and more taut result once healed. And because there is more delicate movement and less force in extracting emulsified fat, swelling and bruising are also significantly less for liposuction patients.

    Advanced Abdominal and Chest Etching

    Etching refers to a common practice where liposuction is performed superficially to highlight the underlying muscles. In the abdomen, this is typically done to define the 6-pack muscles. The washboard look can be achieved by micro-sculpting vertical and horizontal lines in the superficial fat to outline and define a chiseled look for men and women.

    Avoid over-etching

    While many patients desire an over-the-top etched appearance, care should be taken as these changes might not age well. For example, vertical etching ages well while horizontal etching does not. Creating subtle highlights in the midline and sides creates an athletic abdomen. Horizontal etching over time will “accordion” or become mismatched to the underlying muscles. The horizontal lines will sag over time leaving them closer together like a collapsed ladder.

    Don't Use Fat to Enhance Muscle

    Some surgeons are taking an additional step by adding fat to muscles to make the muscles more evident. Again, this is likely a short-lived enhancement that does not age well. One of the fundamental principles of plastic surgery is to replace “like with like” and adding fat to enhance a muscle certainly won’t age well. Muscles are also encased in fibrous tissue making them susceptible to increased pressure. Injecting fat into muscles increases pressure in this closed space and likely damages the muscles long term.

Pay Attention To What Your Plastic Surgeon Is Saying

When evaluating liposuction technology make sure you understand what is being offered and the advantages of using that technology. You will likely pay more for the technology which may or may not be necessary or effective.

Would Your Future Self Thank You?

More importantly, take your long-term results into consideration when going into procedures like aggressive lipo body contouring. Most of my patients steer away from having surgeries that appear unnatural or violate normal anatomy.

In my opinion, the best liposuction result is natural and highlights your natural curves and assets. Good liposuction, and good plastic surgery for that matter, leaves no marks of having had any work done. You should look revitalized, fit, healthier, and refreshed. No extensive, visible scarring, no lumpiness or asymmetry.

Before and After Liposuction by Dallas Plastic Surgeon, Dr. John Burns

female lipo before and after  abs and flanks by Dr. John Burns in Dallas, Texas
dallas male lipo before and after to chest, abs, and love handles by Dr. John Burns
before and after female arm lipo by Dr. John Burns
dallas male lipo before and after to chest, abs, and love handles by Dr. John Burns

Here Are A Few Rules of Liposuction That I Always Follow:

Less is more

Knowing when to stop is more important than pushing the envelope. There should always be a layer of fat below the skin so that the skin is not in direct contact with the underlying muscle. This prevents contour irregularity.

Use the smallest cannula possible to do the job. Large caliper cannulas take our fat rapidly and often leave unevenness. Smaller cannulas extract fat slowly leaving ample time for correction.

Stay deep

Never liposuction near the surface of the skin. By staying deep there is a much less chance to develop an over-liposuctioned area or affect the skin surface negatively.Remove fat in 3 vectors.

NEVER remove fat in a single vector which will look artificial. By using multiple vectors, the underlying fat is cross-hatched, and fat is more evenly removed

Use an energy source when necessary

An energy source such as laser or ultrasound can penetrate through scar tissue and fibrous fat making extraction less traumatic and more even. This is ideal for male fat, chest or back fat, or secondary liposuction where there is scar tissue from a previous procedure.

1:1 ratio

Try and get at least a 1:1 ratio of tumescent fluid introduced to liposuction aspirate removed. This creates a more uniform fat extraction environment with less trauma, bruising, and swelling.

Safe And Long-lasting Results

If you've got questions about how to get beautiful and safe results, we welcome you to schedule your complimentary consult with Dr. Burns. Our team offers both in-office and virtual consults for women and men across Texas, the U.S., and the world.


Optimize Your Liposuction Results


Before and After Liposuction by Dallas Plastic Surgeon, Dr. John Burns

female lipo before and after  abs and flanks by Dr. John Burns in Dallas, Texas
dallas male lipo before and after to chest, abs, and love handles by Dr. John Burns
before and after female chin lipo by dallas plastic surgeon, Dr. John Burns
dallas male lipo before and after to chest, abs, and love handles by Dr. John Burns

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