How Much Size Reduction Can You Expect After Liposuction?

How Much Size Reduction Can You Expect After Liposuction?

How much will the circumference of the thighs actually decrease after thigh liposuction? We are sometimes asked this question during consultations. The reduction is roughly 4–8 cm, but in reality the amount of fat removed differs depending on height and weight and on individual body type, such as a muscular or a fatty build, so the size reduction varies. That is why this is a question we cannot answer in advance before surgery.

 

However, once the amount of fat removed during liposuction has been confirmed, it seems to have a certain correlation with the eventual size reduction. Also, because there is usually swelling after liposuction, the reduction cannot be felt for several weeks. So for patients who become anxious about their size reduction, I came to think that rather than simply telling them to wait a little longer, it would be better to calculate the numbers first and present them with the expected reduction.

 

The patient in this case was a middle-aged woman, 166 cm tall and weighing 70.6 kg, from whom 2,400 ml of fat was aspirated during liposuction of the thighs and buttocks. To patients who ask before surgery, "Please take out as much fat as possible," I show the aspirated fat directly after the operation and tell them that liposuction does not lie, and that their size should decrease by as much fat as they see in front of them. Well then, shall we put this to the test?

 

 

Using before-and-after photos taken at the same scale, we obtained a diameter of 18 cm before surgery and 16 cm after surgery. Using the formula for the circumference of a circle, C = 2πr, the circumference of the upper thigh was calculated as 56.5 cm before surgery and 50.3 cm after surgery.

Since the thigh is shaped like a cylinder, if h is the length from the groin to the knee, the volume of the thigh can be calculated with the formula V = πr²h. The thigh is not a perfect cylinder, and since this operation included both the thighs and the buttocks, we assumed a cylinder for convenience of calculation, taking these increases and decreases into account.

Accordingly, the volume of the thighs and buttocks before surgery is calculated as about 11,196.6 ml, and the volume after liposuction as 8,846.7 ml. Subtracting the postoperative volume from the preoperative volume gives a volume reduction of 2,349.9 ml, which, surprisingly, is very close to the 2,400 ml of pure fat removed by liposuction. By roughly assuming the thigh to be a cylinder whose length runs from the groin to the knee and calculating its volume before and after surgery, the amount of fat actually aspirated during thigh and buttock liposuction and the calculated volume reduction happened to match.

Conversely, this would mean that if we measure the thigh circumference and thigh length before surgery and know the amount of fat aspirated and removed after surgery, we can work backward with the formula V = πr²h to predict the reduction in thigh circumference.

 

As the table above shows, we calculate the preoperative volume of the thighs and buttocks from the thigh circumference and length measured before surgery, and by subtracting the 2,400 ml of aspirated fat from the preoperative volume we obtain the remaining postoperative thigh volume of 8,785.3 ml. From this, we can work backward with the formula V = πr²h to estimate the postoperative circumference. In addition, by dividing the amount of aspirated fat by the preoperative volume, we find that the volume decreased by about 20%.

Because surgical technique and the extent of surgery differ from surgeon to surgeon and clinic to clinic, it would be a stretch to apply this generally. However, it does suggest that when patients have thigh and buttock surgery at Venus Clinic, we can estimate to some degree, based on the amount of fat aspirated, how much the thigh circumference will eventually decrease.

 

 

Looked at another way, what the photos above objectively show is a liposuction before-and-after in which the diameter of the upper thigh decreased by about 2 cm, its circumference by about 6.3 cm, and its three-dimensional volume by about 20%. In the photos it looks like a subtle reduction, but converted to volume, a reduction of about 20% compared with before surgery is quite surprising. Beyond the size reduction, however, you should also note that only the buttocks and thighs have been reduced naturally, while the waist and calves remain unchanged, so the figure has changed into a more balanced and stable shape.

In conclusion, there are limits to showing the size reduction from liposuction in photographs, and this is why, among the liposuction before-and-after photos found online, you can quite often see photos that have been excessively shrunk to exaggerate the results.

Meanwhile, breast reduction using liposuction reduces the breasts without a surgical incision, so wound concerns are minimal; the recovery period is short, postoperative care is easy, and the risk of damage to the mammary glands is low. For these reasons it can be a good option for women who plan to give birth in the future or for unmarried women, as it can reduce the breasts in a natural shape with minimal visible scarring. Its drawback is that the breasts cannot be reduced by more than 50%.

At Venus Clinic, the volume is reduced by about 40% on average; if the volume is measured at 1,000 cc, this means about 400 cc of fat can be removed. Results vary by individual, but people with a higher degree of obesity usually have more fatty tissue in the breasts as well, so the effect tends to be greater.

In practice, however, despite these advantages, some patients wish for an even greater reduction in volume and feel somewhat disappointed after surgery.

Before breast reduction by liposuction, we first measure the volume of the breasts, as in the photo below. The purpose of measuring is to determine the volume to be aspirated before surgery and to correct any difference in size between the two breasts. If one breast has a volume of 1,200 ml, about 40% of that volume, or 480 ml, should be removed; then, by leaving the other breast with the same remaining volume of 720 ml and aspirating the rest, both breasts can be made the same size.

 

In the breast, the fat layer is not limited to the subcutaneous layer; there is also a fat layer beneath the glandular tissue, that is, above the chest muscle. The breast therefore has a peach-like anatomical structure, with the glandular tissue as a central core surrounded by layers of fat, so unlike the thigh, it seems more accurate to calculate its volume as a sphere.

 

As the table above shows, if the preoperative volume of one breast was 696.6 ml and the amount of fat aspirated was 315 ml, the breast reduction by liposuction can be said to have reduced the volume by 45%. While the thigh decreases by about 20%, the breast is spherical and contains more fat than muscle, so nearly twice as much is removed.

Also, if we know the breast volume measured before surgery and the amount of fat aspirated, we can determine the breast volume remaining after surgery. Since the volume of a sphere is calculated as V = 4πr³/3, we can work backward to calculate the breast diameter. The table above shows the breast diameter decreasing from 11 cm before surgery to 9 cm after surgery, which means we can predict in advance that the diameter will decrease by about 2 cm.

One point to keep in mind is that even if the volume is reduced by 45% of the preoperative volume, the breast diameter decreases not by 5 cm but by only 2 cm, so to the naked eye it may not look much smaller. This seems to be because, within the three-dimensional volume of the breast, it is the diameter of the wide outer region that decreases, so the volume decreases a great deal while the length decreases only a little.

 

To explain with the figure above: when a breast with a diameter of 11 cm shrinks to a diameter of 9 cm, a reduction of only 2 cm in length, the volume still decreases by 45%. The volume of the outer blue region, 315 ml, is the volume of fat aspirated and removed, and the volume of the central yellow region, 381.6 ml, is the breast volume remaining after breast reduction liposuction. Contrary to how it looks, the blue region and the yellow region actually have similar volumes. It becomes easier to understand if you imagine the flat circle as a three-dimensional sphere.

This follows the same principle as in mathematics, where a ratio of lengths becomes a cube when converted to a ratio of volumes: when the diameter decreases by 2 cm, the volume decreases by a factor of 2 cubed, or 8.

 

The photo above shows breast reduction before and after, one month after the procedure at Venus Clinic. To the naked eye, the size seems only slightly reduced, but the actual volume, calculated from the preoperative volume and the amount of fat aspirated, was reduced by about 50%. This photo shows an even greater size reduction than the diagram above, and the figure has changed into a balanced, natural shape.

In actual consultations, I explain that liposuction cannot change a person's skeletal structure or muscle shape and is therefore limited in how much it can reduce size. Even when I point out that a patient's figure has improved aesthetically compared with before, without complications, some patients do not take this into account and are disappointed that there is no dramatic size reduction visible in the photos.

Removing too much fat increases the likelihood that adhesions form between muscle and skin where the fat has been removed, leaving the surface uneven and lumpy, and wrinkles may also develop. In addition, muscle contours previously hidden by subcutaneous fat may protrude, which can lead to aesthetically undesirable results. I hope you will understand that doctors who perform liposuction struggle to catch two rabbits at once: size reduction and a harmonious, natural figure.

In conclusion, before choosing liposuction, it is important to understand the size reduction that is realistically possible, but you should also consider that successful liposuction is a procedure that creates a smooth, natural, and beautiful figure with good proportion and balance, in addition to size reduction. You should understand that removing too much fat out of a fixation on size reduction can instead result in an unnatural figure, and that complications may occur that are difficult to fully recover from and may require revision surgery.

Dr. Fischer, the Italian pioneer of liposuction, said that a doctor performing liposuction should leave enough fat that, after finishing surgery, he always regrets, "I should have removed more fat." I believe that not only people who want liposuction but also the doctors who perform it must not fall, together with their patients, into the trap of size reduction.

[ Dr. Jung, Director, Venus Clinic ]