Liposuction Incision Sites — How Many, Where, and How Small

Today I will explain what an incision site is in liposuction, how its size, number, and location are decided, and how it is cared for after surgery. Although it varies by area and extent, at Venus Clinic we perform surgery with as few holes and as small incision sites as possible.

Liposuction removes fat from the body, but the skin is not opened lengthwise. We make a small opening just large enough for a thin suction tube (cannula) to pass through, inject tumescent solution through it, and then suction out the fat. This small opening is called an incision site. Unlike excision procedures, liposuction does not leave a long incision line.

The incision sites at Venus Clinic are a few millimeters in size, and in areas where a thin cannula is used, such as the arms, about 1.5mm. The literature also notes that keeping the incision small is an essential approach for scars that are barely noticeable [4]. It also explains that the incision is made slightly larger than the cannula so that the suction tube does not rub against and irritate the skin [3].

This is the question we receive most often, but we cannot give a single number. In a wide treatment area or an area with complex body contours, the cannula needs to reach more directions, so more incision sites may be needed; a smaller area may need fewer.

The reason a wide area can be treated evenly with few holes is that the cannula is not moved in only one direction. When the cannula is fanned out from a single incision site, tunnels run in several directions, and when they cross over the tunnels made from neighboring incision sites, the fat can be removed evenly without concentrating on one spot [2]. It is also explained that limiting the amount of fat removed through each incision site is important [2].

Incision sites are placed where they are hard to see after surgery. Common places are where the skin folds, such as the crease under the breast, the armpit crease, and below the crease behind the knee. The literature also summarizes inconspicuous locations for each area.

The table above gives examples; the actual locations vary with the treatment area and extent, and with the condition and color of the skin. The literature explains that incisions are sometimes placed symmetrically and sometimes irregularly to conceal them, and reports that most incisions heal well enough to be barely visible in about a year [5]. However, how much scarring remains differs depending on each person's skin type, so we cannot say that no scar will remain at all.

After surgery, tumescent anesthetic fluid mixed with a little blood drains out through the incision sites where fat was suctioned, for several days. This is called drainage, and drainage goes well when a compression garment presses evenly on the treated area. After the drainage stops, the incision sites are kept clean for a month by applying a prescribed ointment.

As the cannula moves back and forth repeatedly, the incision sites can become irritated and the skin around the scar may turn red. The literature also explains that such cases can be managed with ointment [3]. The scar of an incision site seen on the surface and a scar that forms inside the fat layer under the skin are different things. Firmness or lumps felt after surgery are not from the incision sites but are part of the recovery process within the fat layer; the schedule and care after surgery are explained in detail in a separate article (Liposuction Recovery Timeline).

Below is an incision site example. It is a rear view one week after arm and back liposuction, and the circled spots at the elbows are the small marks left by the incision sites.

The incision site is the smallest yet an important part of liposuction when it comes to scarring. Although it varies by area and extent, our principle at Venus Clinic is to use as few holes and as small incision sites as possible, placed where they are not noticeable after surgery. At your consultation, be sure to ask how many incision sites will be made in your area, where, and at what size.

Related Articles: For Smooth Liposuction Liposuction Recovery Timeline Arm Liposuction Inner Knee Liposuction Liposuction After Mastectomy