Liposuction / Lipocontouring

Liposuction is truly a transformational procedure with lifelong benefits. Done well, it is beyond liposuction, it is a contouring procedure, creating a refined, new shape.

— Haideh Hirmand / MD

Liposuction is the most requested aesthetic surgical procedure for both men and women who are looking to lose unwanted fat in specific areas of their body. Liposuction refers to the removal of excess fat between the skin and the muscle, significantly improving contour and creating a more flattering shape. It has enjoyed over 25 years of worldwide popularity with more predictable results than ever before. Liposuction is not a weight loss strategy. The best candidates are those of normal weight with isolated fatty areas that are resistant to diet and exercise. Stubborn pockets of fat can be due to pregnancy, aging, hormonal changes, menopause or genetic predisposition.

Typically requested for the abdomen and hips, liposuction is also routinely done on “saddle bags,” thighs, and back. It can also be performed on the breasts, neck, and ankles when indicated. It is not a treatment for cellulite. Liposuction can be done alone or in conjunction with other procedures for both shape and contour improvement.

It is a misconception that once liposuction is done, “the fat goes somewhere else.” The fact is, that if weight remains stable, no increase in size of any other fatty area should be realized. However if there is weight gain, the fat can be stored in the same location or in another next-in-line location. There may be some fat redistribution that happens with age and with hormonal changes, but in the absence of real weight gain, it should not result in bulging in a different area.


It is important to first determine whether you are a good candidate for liposuction. A comprehensive consultation will take into account not only the physical exam but your lifestyle, weight history and goals. Those within 30 percent of their ideal weight with good overall health and elastic skin tone have the best results.

The main aesthetic priority is to consider which areas are to be addressed for the most proportionate result. Safety is another key priority. Liposuction is very safe when performed on the right person, under the right circumstances, in an appropriate clinical setting.

The average amount of fat removed in a typical liposuction procedure is 1-4 liters which can be done in an outpatient setting. Large volume liposuction of fat (5 liters or more) indicates a different type of liposuction. Though possible, it requires careful post-operative monitoring and an in-patient stay for 24-48 hours. Most times it is wiser to consider two sessions for a quicker recovery and overall safety.

Hirmand Technique

There are several types of liposuction techniques available. Liposuction, while common, is very technique dependent and requires not only surgical precision but a keen aesthetic vision. My philosophy is comprised of two important points:

  • Rather than focusing on suctioning fat, my approach is one characterized by “shaping” while contouring.
  • Since body contouring is often more than liposuction, sometimes fat grafting in certain areas enhances the final contour. Again, it is not just about removing fat. In some places, it is useful to add fat for best contour.

My preferred technique is power assisted liposuction combined with tumescent techniques using small cannulas and micro cannulas as needed. The power assisted technique is more efficient and faster (the tip of the cannula oscillates at high rates as the cannula is moved.) Incisions are 3-4 mms and are often hidden.

A widely held belief is that complications from poorly done liposuction cannot be fixed. Revisional liposuction can be performed with great success. The unevenness, divots, and scars can indeed be corrected. My technique for revisional liposuction includes scar release, fat injections, fat redistribution, or a combination of all.

Non-invasive technologies have emerged that can be effective in conjunction with or in lieu of liposuction for certain localized areas. CoolSculpting® where fat is frozen and eliminated over a period of of three months has shown to be particularly effective for fat reduction in the back/bra fat area, love handles and belly bulge. Men are great candidates for non-invasive localized fat reduction.

CONTOUR FOR LIFE, a body contouring program for life:

Our signature CONTOUR FOR LIFE PROGRAM is unique. Traditionally liposuction is not offered nor is it effective in those who struggle with their weight. Our program helps those who are not traditionally a candidate for liposuction because of their weight. Since the success of liposuction is predicated upon a commitment to a healthy lifestyle and stable weight, this program is easily integrated and quite effective targeting those for whom this is an issue. Contour for Life integrates 5 principles:

  • Medical evaluation and weight control
  • Liposuction
  • Behavioral Modification
  • Exercise physiology
  • Nutritional Counseling

Individuals in our program are closely followed on a monthly basis. Once 10% of the weight loss goal is lost with medical supervision, a first stage liposuction is performed. The procedure often facilitates further weight loss. A second stage liposuction is performed, as needed, once the weight loss goal is achieved. The program has proven success, with great long term results.

Surgical note

Anesthesia: local, sedation or general depending upon the extent
Length of surgery: varies
Outpatient/inpatient: outpatient*
Adjunct procedures: Fat grafting
Recovery: 1-7 days depending upon the extent of the procedure. Bruising takes a week to ten days to subside. Results take 3-6 months to completely manifest as the swelling diminishes.

*if 4 liters or under