Who is a good candidate for VASER liposuction? Guidelines to avoid overexpecting skin shrinkage

VASER liposuction is suitable for people whose chronic conditions are well-controlled and who have a clear target area for fat removal. It is liposuction using ultrasound, and slightly better results in skin shrinkage and bleeding have been reported compared to standard liposuction, but the difference is small. It is not recommended for people with severe obesity or heart or lung disease, or those with unrealistic expectations.

How does it differ from standard liposuction?

The differences are modest. In a trial comparing VASER and standard liposuction on the left and right sides of the same person, skin shrinkage per liter at 6 months was 17.0% versus 11.1%, and the bleeding rate was 9.6% versus 13.0%.[1].

A specialized review summarizes this difference as approximately 6% in skin shrinkage and approximately 3 cc per 100 cc of aspirate volume in bleeding.[2]. Since all subjects were female nonsmokers, the same difference may not occur in everyone.[1].

Who is it suitable for?

People whose chronic conditions are stable and who want to refine localized fat bulges. Severe obesity is listed as a condition that disqualifies candidacy for liposuction.[3]Higher BMI is also reported to increase perioperative complications.[4].

Expert consensus summarizes that VASER causes less bruising and pain compared to conventional liposuction and has a shorter recovery period.[5]It is also noted that the suction intensity is adjusted by body area—face, neck, chest, abdomen, flanks, and so on.[5].

Who cannot undergo the procedure, or should approach it with caution?

Textbooks list severe obesity, painful fat disease (adiposis dolorosa), strong preoccupation with appearance (body dysmorphic disorder), and untreated psychiatric illness as conditions that disqualify candidacy. Strong scarring in the treatment area, hernia, and allergy to the anesthetic lidocaine are likewise disqualifying.[3][3].

Textbooks indicate that people with heart or lung disease, poor wound healing, or unrealistic expectations should be excluded from liposuction candidates.[6]Guidelines on submental liposuction likewise recommend verifying age, preexisting conditions, blood-thinning medications, and psychological readiness beforehand.[7].

Where are gaps between expectations and outcomes most likely to occur?

They most often arise regarding skin retraction expectations. The additional skin tightening benefit from VASER is approximately 6%.[2]Data showing whether this can compensate in cases where the skin has significant excess were not found in the range of information reviewed.

Over-removed areas may become indented, and fat injection is sometimes performed later to correct this.[2]Underlying conditions such as autoimmune diseases, smoking, and excessive suctioning of tissues close to the skin have been noted as potential causes of pigmentation or skin necrosis.[2].

What aftercare is needed after surgery?

Massage to drain swelling is recommended. Expert consensus recommends performing lymphatic massage after VASER daily or weekly, approximately 6–15 times, or until fluid seepage stops.[5].

Although rare, life-threatening complications are known, such as pulmonary embolism (blood clots in lung blood vessels) and severe infection.[2]You should also consider the schedule of follow-up visits and aftercare that will continue after surgery before making your decision.

What to confirm before undergoing the procedure

There are three benchmarks for making your decision. The first is your medical history, any medications you are taking, and your weight status.[3][4][7]The second is the degree of skin sagging (skin laxity) and what you expect to achieve with treatment.[2][6]The third is whether you can continue with post-operative massage and follow-up visits.[5].

How much the skin will tighten and how much fat can be safely removed cannot be determined without physically examining your body. Please confirm with your doctor during your consultation whether VASER is suitable for your body.