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Liposuction has become today’s most popular cosmetic surgery procedure. Intended to refine, shape and harmonize the silhouette in different areas of the body, and to reshape the figure, and to get rid of misplaced curves. It is based on one very simple but very effective principle, the suctioning of fat. Constant progress has been made since the beginning of this technique in the early 80`s, becoming more and more precise while also leaving less and less scarring. Saddle bags, hips, arms, shoulders, and of course the belly … Liposuction has gradually extended its field of application and has become a key intervention in cosmetic surgery. Lite or more extreme liposuction is needed depending on the areas and needs of the patient. In the abdomen, in some cases, simple liposuction may be insufficient and a more extreme intervention is then necessary: the abdominoplasty for men and women.

Liposuction, a fundamental invention!

Liposuction, liposuction of the belly, liposculpture, lipoplasty … all these terms cover the same reality: extraction of fat by suction. Before going further into the description and objectives of this type of intervention, we must pay tribute to its “inventor”, Dr. Yves-Gerard Illouz. He was inspired by the previous work of other surgeons and had the idea in 1977 to remove the localized fat overload through suction.

Thin cannulas and micro-incisions

Liposuction is a “general” intervention because it can be done anywhere the fat is located, anywhere in the body.

What type of fat does liposuction remove? Originally, liposuction focused on fat located deep below the skin, without touching the layer directly under the skin that provides the body with a thermo-protective function. The intervention improved the shape and contours of the body.

Now, it has become possible to suction the subcutaneous fat, which improves the appearance of the skin while promoting retraction. It is this progress that allows us to qualify this type of top layer fat liposuction “liposculpture”. This type of procedure uses a thin cannulas (tube) of 2 or 3 mm. Another very important progression in this field was the appearance of “wet” liposuction (this type was used often for the belly), carried out by injecting products intended to artificially enlarge the fat cells, which optimizes the work of the surgeon, especially in the subcutaneous areas, while limiting bleeding.

One of the great advantages of liposuction is its ability to maintain a number of connections between the subcutaneous and deeper layers of the skin, thus ensuring good vascularization of the subcutaneous planes and promoting internal healing. Before the intervention, a preoperative assessment is carried out. On the day of the procedure, whether it is a lipo of the belly or a tummy tuck for men or women, the surgeon determines, using markers, the location of the fatty deposits to be treated on the patient. In one intervention, different areas can be treated.

The suction is carried out using foam cannula (tube) connected, via a flexible plastic hose, to a kind of surgical vacuum that produces a strong suction. Today, these cannulas are very thin, which allows for both a more precise procedure and a very small, micro-incision (3 to 4 mm), with limited pain. These very fine cannulas now save the skin underlying the treated area. Better still, the appearance of the skin is improved thanks to the skin retraction caused by this superficial liposuction. To treat certain particularly compact fats, rotary cannulas are used which allow us to work with great delicacy while obtaining more even results. Depending on the location and amount of fat to be removed, liposuction is performed under local or general anesthesia. The results are visible very quickly, usually the next day, and continue to improve for two to three months after the procedure.

More than just becoming slim, liposuction aims to sculpt the silhouette – hence the term liposculpture – because it does not just remove unsightly fat.

After liposuction of the abdomen or abdominoplasty, the skin, because of its elasticity, will shrink and adhere naturally to the muscles underneath. It is by taking advantage of this effect, which we call “redrawing”, that we can reshape the silhouette. This possibility gives this intervention full advantage.

The quality of the skin plays a vital role in liposuction operations. A supple and toned skin allows for a more precise remodeling around the underlying muscles. On the other hand, tissues that are less tonic or filled with cellulite are less precise. In this case, we sometimes advise patients to combine the liposuction procedure with a facelift (in the case of double chin, for example) or a resection or removal of cutaneous pieces (with thighs, for example). How much fat is removed? It all depends on the type of intervention. The difference can vary from 1 to 1,000 depending on whether it is a cheek or large thighs. But no matter the intervention, the amount of fat suctioned cannot exceed three and a half liters or 4 liters. This quantity is well tolerated by the body. The resulting loss of water is compensated by replacing it with an equivalent volume to avoid any risk of dehydration.

A cannula is inserted and, by regular movements back and forth, the fat is loosened before the suction begins. The surgeon is careful to respect a balanced suction plan: to remove enough fat, but not too much, uniformly and in harmony with the rest of the body. To achieve this, the surgeon’s experience plays an irreplaceable role as each case requires an intervention specific to the unique needs of the patient.

Once the suction is complete, a compression bandage is made using elastic bands or a compression garment (panty or sheath) intended to promote skin retraction.
To improve the postoperative healing, various strategies are recommended, such as significant hydration, anti-inflammatory treatments, the use of massage, exercise, etc.