With liposuction, the skill and artistry of the surgeon can determine the success of the outcome—more so than the specific technology. The amount of fat to extract, the evenness with which it is removed, and the blending of one area into another are all artistic judgment calls on the surgeon’s part. Dr. Miguel Delgado, a board-certified plastic surgeon and specialist in body sculpting techniques performs liposuction at his San Francisco Bay Area practice.

LIPOSUCTION TECHNIQUE

The tumescent liposuction technique initially involved combining normal saline (sterile water containing the normal concentrations of the various salts found in the body) with epinephrine, a powerful vasoconstrictor (causes blood vessels to contract and thereby reduces or stops blood flow to an area). This innovation effectively controlled blood loss and allowed safe extraction of a much larger amount of fat. This enabled the fat extraction procedure to go from the removal of two to three liters (a liter being slightly larger than a quart) to many times that amount. Today, many physicians consider the tumescent technique to be the gold standard of fat removal methods.

In time, lidocaine (a local anesthetic) was added to the normal saline and epinephrine solution. An adequate level of local anesthesia could be accomplished with this combination, so that general anesthesia is no longer always required. This also opened the door to liposuction being performed by non-surgeon physicians of many different specialties.

BEFORE & AFTER

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Procedure What it does Surgery Recovery Results
Liposuction Removes fat via mechanical suction Yes 7-10 days, no vigorous exercise for 6 weeks Long-lasting
CoolSculpting Reduces fat using a cooling technology that destroys fat cells No None Long-lasting

TYPES OF LIPOSUCTION

PAL

The Power-Assisted Liposuction (PAL) technique placed the cannula into a hand-held power device that moved the cannula back and forth with the push of a button. The design made the process less laborious, facilitated faster extraction of fat, and achieved an overall smoother contour. The PAL System has the rotation of the powered cannula going back and forth and another system rotating side to side. The rotation is over 4000 cycles per minute. MicroAire’s PAL® LipoSculptor™ is a popular device that can be used for more aggressive fat removal. Dr. Delgado has used this system since 2012, which has reduced procedure time and, in most cases, led to smoother results.

UAL

Ultrasonic Assisted Liposuction (UAL) is another advanced fat removal technique. Ultrasonic Liposuction employs soundwaves that have the power to emulsify, or melt, fat. This process also creates heat, which in turn enhances skin contraction. This technique can be especially useful in secondary or revision cases. Approximately 25% of patients seeking liposuction in Dr. Delgado’s practice fall into this category. These are patients who were disappointed with their outcome and wish to undergo a corrective procedure. The VASERlipo™ System is one of the more popular ultrasonic systems, but others are on the market.

LASER LIPO

Laser Liposuction is the newest splash on the scene, and Smartlipo TriPlex® by Cynosure is widely used. This technology uses minimally invasive laser technology, which produces heat to melt fat and create skin contraction. The other stated advantage is that it can be performed under local anesthesia. This laser technology has a history of being extremely expensive with inadequate or questionable documentation of actual better results. To date, there is only anecdotal evidence to support superior results using laser methods. No large, valid studies exist that substantiate these claims. If Laser Liposuction does prove it can deliver higher patient satisfaction and better quality outcomes—and not fall by the wayside as another overrated marketing gimmick—it will earn a place at Marin Cosmetic Surgery Center. Dr. Delgado has seen many of his colleagues abandon this technology and sell their Smart Liposuction machines. For the time being, however, Dr. Delgado opts to offer only those procedures he knows to be of sound value for his patients.

WHO IS A CANDIDATE?

Liposuction can be effective on people of varying weights and sizes. Results can be impressive, but actual outcomes will vary from patient to patient. Skin with good elasticity is more likely to adjust to the body’s new contours. Although age is not always a consideration, older patients tend to have less elasticity in their skin and, for this reason, will not achieve quite the same results as younger patients.

The most commonly treated areas in women are the inner and outer thighs, knees, hips (post iliac crests and flanks), abdomen, and arms, while men most often opt for treatment of their chin, waist, and stomach. Most of Dr. Delgado’s patients are looking for the treatment of multiple areas and, generally, these can be done in a single procedure.

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HOW IS LIPOSUCTION PERFORMED?

Liposuction is performed at Marin Cosmetic Surgery Center, located at Sutter Marin County Community Hospital. The operating room’s proximity to the hospital enables Dr. Delgado to offer exceptional surgical care while optimizing patient safety and privacy. 

Before your procedure, Dr. Delgado will first utilize a special felt-tip pen to precisely map out the targeted treatment areas while you are in an upright position. These markings allow him to make accurate adjustments during surgery to accommodate any gravity-related changes in fat displacement when the body is moved to a horizontal position. Once the surgical map is complete, anesthesia can be administered, and the actual treatment can begin.

Liposuction is typically performed under general anesthesia, ensuring that you will be comfortable throughout the procedure and that Dr. Delgado can give you the best results possible. At Marin Cosmetic Surgery Center, anesthesia is administered by an experienced anesthesiologist. 

During the liposuction procedure, Dr. Delgado will inject the tumescent fluid consisting of saline (sterile water with body-identical salt content), lidocaine (local anesthetic), and epinephrine (a vasoconstricting agent that controls bleeding)—a process that distends the fat layer.

Next, Dr. Delgado proceeds to make tiny incisions in inconspicuous areas, such as the navel and the buttock crease, depending on the location of the excess fat. A thin cannula is then inserted into the tiny incisions. Dr. Delgado may use Power-Assisted Liposuction (PAL) or Ultrasonic Assisted Liposuction (UAL), depending on the customized plan for the patient. The device is attached to tubing extending to a machine that provides a vacuum.

The cannula is pushed back and forth through the fat layer. This breaks up the fat cells so they can be vacuumed out through the tubing to a canister on the machine. Once the desired contour is achieved, incisions are then closed with sutures, and a compression garment is placed over the treated area(s).

Dr. Miguel Office background
Dr. Miguel Delgado

YOUR CONSULTATION

The first step towards body sculpting surgery is a consultation with Dr. Delgado. This can be scheduled at either his San Francisco office or his Marin County office. At this appointment, you and Dr. Delgado will discuss your areas of concern and the look you wish to achieve in those areas.

Dr. Delgado often uses digital photography and computer imaging to illustrate results that can realistically be attained with fat removal via liposuction. The impact of variables such as asymmetries and the degree of skin elasticity, and adverse events like cellulitis, bleeding, and blood clots are also discussed.

Dr. Delgado will also provide a detailed preoperative instruction booklet intended to guide you through various preparations that should be made before surgery.

Dr. Delgado is nothing short of phenomenal. When I tell you that this doctor saved my life, I truly believe, that he has the gifted hands of God himself!

— Kamala Duplessis

LIPOSUCTION RECOVERY

Immediately following liposuction surgery, you will be taken to a recovery room to spend a few hours under the care and supervision of our team. When fully alert and oriented, you can go home or to a local hotel. A responsible adult is required to drive and assist you for the first 24 hours. If you do not have such a person available, the Marin Cosmetic Surgery Center patient coordinator can arrange for a specially trained medical assistant to drive you to your destination and stay with you during this period. Some patients will spend the night in the recovery room at Marin Cosmetic Surgery Center, especially if a large volume of liposuction is performed.

Sutures are removed seven to ten days after surgery. Patients usually return to work within a few days following the procedure, depending on their type of work. A compression garment is worn over the treated areas for four to six weeks. The purpose of this garment is to control swelling and promote skin contraction. For the majority of patients, discomfort after surgery is generally limited to soreness rather than pain. Pain medications are prescribed to lessen any discomfort felt during the first few days. Most patients often find that the discomfort is too minimal to merit the use of narcotics.

Comfortable chairs

Liposuction FAQS

Are there potential risks and complications?

What areas can be treated?

Will there be scars?

How old should I be?

Can other procedures be performed at the same time?

How much does liposuction cost?

Are there potential risks and complications?

Like all surgeries, liposuction procedures carry the risks of bleeding, infection, blood clots, and adverse events related to anesthesia. However, these risks are minimized by the combination of Dr. Delgado’s team of licensed and credentialed professionals and his accredited, state-of-the-art facility located contiguous to Novato Community Hospital, a Sutter Health Facility.

What areas can be treated?

Liposuction can treat any part of the body that contains fat. Men usually opt to treat the abdomen, flanks, and underneath the neck. Women generally choose areas like the neck, arms, abdomen, flanks, back, inner and outer thighs, and knees.

Will there be scars?

Scars are very minimal. Dr. Delgado will place the small incisions in the most inconspicuous locations possible, including areas that would normally be covered by clothing. He will discuss the placement of these incisions with you prior to your procedure.

How old should I be?

Though there is some controversy regarding this, Dr. Delgado believes that a person should be at least 18 years old and have the maturity and motivation to lose weight by exercise and diet.

Can other procedures be performed at the same time?

Yes, this is quite commonly performed. For example, liposuction is often combined with a tummy tuck or other body contouring procedures as part of a Mommy Makeover.

How much does liposuction cost?

The cost can vary greatly depending on the number of areas treated and how much fat is removed. At the time of your consultation, you will be given a detailed estimate of all your surgery fees.

San Francisco has been home to many historic landmarks and thriving marketplaces for centuries. One such is the Ferry Building Marketplace at the base of Market Street, located only one and a half miles from the office of Dr. Miguel Delgado and 28 miles from Dr. Delgado’s Novato, Marin County location. Historically, the Ferry Building was a transportation hub made obsolete by the opening of the Bay Bridge and Golden Gate Bridge. Now, it has been turned into a thriving market for food, local produce, and local culture.

Frequently Asked Questions

Are you put to sleep for liposuction?

General anesthesia, which puts the patient to sleep, is used for most liposuction procedures.

Does fat come back after lipo?

Liposuction permanently destroys fat cells. However, if you do not stick to a proper diet and exercise routine, you can gain back the weight.

Can I get liposuction if I am overweight?

Yes, you can get liposuction if you are overweight but treatment is often recommended for people within 30 pounds of their weight goal.

Does liposuction get rid of cellulite?

Liposuction is not a recommended treatment for cellulite.

Can visceral fat be removed?

Since visceral fat is found deeper in the body, it can only be removed through exercise and diet, not liposuction or other cosmetic surgeries.

Does liposuction really work?

Yes! Liposuction is known to be an effective treatment that permanently removes pockets of stubborn fat for many patients.

Does a tummy tuck remove fat?

Yes; a tummy tuck removes excess skin and fat from the abdomen for a more contoured appearance.

How can I avoid weight gain after surgery?

After surgery, avoid sugary and fatty foods and drink lots of water. As you heal, you can gradually become more physically active and eventually resume your exercise routine.

How can I lose tummy fat fast?

Eat a high protein, low-fat diet and cut back on carbs, alcohol, and sugary foods. You should also incorporate cardio into your exercise routine and try to reduce stress levels.

How do you shower after liposuction?

After liposuction, you should wait 48 hours for your incisions to close. You can then carefully shower but avoid taking baths for two weeks and do not remove your compression wraps when you shower. Carefully pat dry your incisions and try not to soak the bandages.

How can I reduce my stomach fat?

You can reduce stomach fat by incorporating exercise into your daily routine and stick to a healthy, portioned diet without sugary or fatty foods and drinks.

How does fat transfer work?

During a fat transfer, liposuction will be used to remove fat from areas of the body that are undesirable (abdomen, thighs, hips) and move it to the face, breasts, lips, or buttocks.

How dangerous is liposuction?

Like any surgery, bleeding, infection, blood clots, and anesthesia reactions are all risks of liposuction so it is important to receive treatment from a licensed, experienced doctor.

How does Lipo work?

During your liposuction procedure, a few small incisions will be made in places that are easy to conceal. A thin tube called a cannula will be inserted through the incisions and into the fat layer to break up and suck out fat.

How do I prepare for liposuction?

Before your liposuction procedure, you may need to get lab tested to check for underlying health conditions. You may also have to adjust your current medications and will have to stop smoking and avoid taking aspirin and other anti-inflammatory drugs that can increase bleeding.

How long do you drain after lipo?

Drainage should stop within three days after your liposuction procedure.

How long do you need off work after liposuction?

You should be able to return to work after a few days, but this depends on how large of an area was treated.

How painful is liposuction recovery?

Liposuction recovery is often described as a feeling of soreness rather than pain. This moderate discomfort will be treated with prescription pain medication for the first few days. After this time, the pain and discomfort should be minimal.

How much does it cost to get liposuction on your stomach?

Since prices can vary depending on the type of liposuction being used and the size of the area being treated, please speak to your provider to determine the cost of your liposuction procedure.

Is it easier to lose weight after liposuction?

Although liposuction is not a weight loss surgery, the confidence boost that comes from liposuction can make it easier for patients to motivate themselves and lose weight.

How much does liposuction cost without insurance?

Prices can vary significantly depending on the location of your doctor and the area being treated so please call your providers office for pricing.

Is Lipo permanent?

Yes! Fat is permanently destroyed during liposuction so results should not change as long as you stick to a healthy diet and exercise routine.

How much fat can lipo remove?

Liposuction removes an average of 6-8 pounds of fat but you can lose a maximum of eleven pounds during one treatment.

Is liposuction an outpatient procedure?

Liposuction is typically an outpatient procedure unless a large area has been treated and your doctor wants you to be more carefully observed.

Is there a weight requirement for liposuction?

Liposuction can treat people of any weight, but it is recommended you be within 30 pounds of your weight goal.

What is Lipo Laser?

Laser liposuction is a nonsurgical approach to liposuction that uses a laser to melt fat from under the skin. These fat deposits are then naturally filtered out by your bodys metabolic processes.

What can you eat after lipo surgery?

Stick to a diet of leafy green vegetables, lean meat, nuts, seeds, and whole grains.

What is the best type of liposuction?

The most popular type of liposuction uses a cannula to suck out fat. Although it is the most popular treatment, therefore effective for many people, every person responds differently to different types of procedures.

What do they do with liposuction fat?

After liposuction, the fat can be injected back into other areas of the body or medically discarded.

What is ultrasonic liposuction?

Ultrasonic liposuction uses ultrasonic waves to break up and liquefy fat with sonic vibrations. After the fat is liquefied, it will be sucked out with a cannula.

What is AirSculpt Lipo?

AirSculpt Lipo uses a laser to soften fat and then a cannula is used to gently pull out the fat, rather than suck it out like traditional liposuction.

What types of liposuction are there?

Tumescent liposuction is the most popular form of liposuction, but your doctor might also offer laser liposuction, ultrasound liposuction, AirSculpt liposuction, or power-assisted liposuction.

Who is good candidate for liposuction?

Liposuction is effective for a variety of people, but younger patients who are not obese are often the ideal candidates.

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