VASER liposuction

VASER liposuction (ultrasound-assisted fat removal) is an operation that shapes body contours by removing localized excess fat. You may be researching it for fat that remains around your waist, abdomen, or another area despite your eating and exercise habits. During the examination, we explain which tissue creates the contour you would like to change and how fat removal relates to your body structure.

In ultrasonic liposuction, which uses sound waves, we add ultrasound energy to the fat removal procedure. Delivered to the fat tissue through specialized probes, the tips that transmit energy to the tissue, this energy breaks fat tissue apart and separates it from the surrounding connective tissue. We then remove the fat by suction.

Body contours are formed by the skin, underlying fat, muscles, and skeleton. Liposuction works in the fat layer between the skin and the structures covering the muscles. Fat inside the abdominal cavity, around the organs, lies outside this area, so not every form of abdominal fullness can be addressed by fat removal.

Who is suitable for liposuction?

Liposuction may be considered for people who are not significantly overweight and have good skin elasticity. With substantial excess weight, weight management treatment may be considered; with excess sagging skin, lift options may be discussed. You can point out the change you have in mind during the examination. We can then explain the distribution of fat in that area and whether the overlying skin is suitable for the fat removal plan.

Liposuction addresses the fat layer beneath the skin. Lift surgery is considered when sagging skin needs to be removed. For example, when there is excess abdominal skin, a tummy tuck and fat removal may be included in the same plan.

Localized fat means that fat tissue is prominent in a particular area. For example, fat may accumulate at the sides of the waist while the fat layer over the front of the abdomen is thin. Body weight or clothing size does not show this distribution, so areas for fat removal are selected through direct tissue examination.

If weight loss is still a goal, the body contouring decision depends on the current stage of weight management. A stable weight helps clarify where localized excess fat and excess skin remain. Weight loss through dietary changes and bariatric surgery address overall weight management, while liposuction targets subcutaneous fat in selected areas.

Skin elasticity concerns the skin’s ability to adapt to changes in the volume beneath it. A broad skin fold over a thin fat layer and elastic skin over thick fat do not require the same surgical plan. After pregnancy or substantial weight loss, the amount of excess skin is also considered, and the area for fat removal may differ from the area requiring skin treatment.

Suitable skin elasticity and fat distribution do not replace a general health assessment. Cosmetic fat removal is not planned during pregnancy, with an uncontrolled systemic illness, or when there is an active skin infection in the treatment area. Even when the concern is localized fat at the waist, abdomen, or thighs, current treatments and previous operations form part of the suitability decision. If weight management treatment is ongoing, fat removal is considered in relation to the current weight goal.

Treatment areas and examination

Common treatment areas include the abdomen, waist, back, outer thighs, legs, arms, and neck in women, and the abdomen, waist, chest, and neck in men. One of these areas may be the reason for your consultation. When marking the fat removal area, we also examine neighboring regions, keeping transitions between the abdomen, waist, and back, for example, within the same plan.

The examination assesses fat layer thickness, skin elasticity, and differences between the right and left sides. Fat distribution may vary between neighboring regions. These findings determine the treatment boundaries and which parts can be thinned, and to what extent.

If you have had fat removal or body contouring surgery before, you can share which areas were treated at the first consultation. The boundaries of the previous procedure help clarify whether the new concern relates to excess fat or the skin in that area.

Fat layers around the navel, lower abdomen, and sides of the waist can differ in thickness. Fat on the back may extend from the side of the rib cage toward the waist. Views from the front, side, and back help map transitions between areas for fat removal.

The outer hip area lies along the outside of the upper thigh, while the inner thigh refers to the fat and skin along its inner surface. Transitions toward the buttocks and around the knees also form part of the treatment boundaries. In the arm, upper arm fat is distinguished from excess skin on the inner surface, because a thick-looking arm does not indicate the same amount of fat in every person.

In the neck and under-chin area, subcutaneous fat, chin structure, and neck skin laxity affect appearance. In the male chest, glandular breast tissue may accompany the fat. When defining the extent of fat removal, the contribution of each tissue is distinguished, and any need to address the breast gland or excess skin is identified separately.

A bulge at the side of the waist, fullness at the front of the abdomen, and a lower abdominal skin fold are different concerns. You can point to the area you would like to change to explain which one bothers you. The examination clarifies its relationship to fat, excess skin, and the underlying muscles.

The width of the rib cage, the structure of the pelvis, and the distance between them also contribute to the appearance of the waist. The fat layer shaped by liposuction lies over this skeletal framework. During the examination, excess fat around the waist is therefore distinguished from width due to bone structure. Fat removal does not change the position of the bones.

Fat distribution, muscle definition, and the position of skin folds may differ between the right and left sides of the body. If a bulge at the waist is more prominent on one side, local fat thickness and torso posture are examined separately. The markings reflect existing differences, and the distribution of fat to be removed is determined for each side individually.

In an area previously treated with liposuction, the new examination assesses where the remaining fat lies and the structure of the tissues beneath the skin. Previous entry points and the boundaries of fat removal are reviewed. This information helps distinguish whether the new concern involves excess fat, loose skin, or a lack of volume.

Tumescent fluid and ultrasound energy

Tumescent fluid is a specially prepared fluid introduced into the tissue where fat will be removed. Introducing fluid into tissue is called infiltration. This preparation is applied to the area where the ultrasound probe and suction cannula will work. Fluid distribution follows the treatment boundaries marked on the abdomen, waist, or thigh.

Ultrasound energy separates fat tissue. Descriptions such as breaking down or liquefying fat refer to this separation; the prepared fat is then suctioned out. The ultrasound probe that transmits energy and the cannula that removes fat have different roles in the operation.

Tumescent fluid infiltration is followed by ultrasound application and cannula-based fat removal. These steps follow the same surgical markings. For example, the fat to be removed from the side of the waist and the layer to be preserved over the abdominal muscles are determined by the anatomical goal, independently of the device’s name.

Cannula-based fat removal and contouring

We reach the fat tissue through small entry points in the skin. Suction through a cannula, a thin, hollow surgical instrument, removes the separated fat. As we work, we follow the body’s curves to shape the areas we have identified.

When working with a thin cannula, we take account of the area’s natural contours and its transitions into surrounding tissues. Alongside the energy technology, cannula technique and the locations where fat is preserved are part of our contouring plan.

The location of a cannula entry point is different from the full area of fat removal. The thin instrument passes through a small opening into the planned area beneath the skin. Because fat distribution varies between neighboring regions such as the abdomen and sides of the waist, the cannula’s directions of movement and the transition areas where fat will be preserved are also part of the surgical plan.

Liposuction does not aim to remove an equal amount of fat from every point. An outward curve in one area, an inward curve in a neighboring region, or different fat thicknesses on the right and left affect contouring decisions. Parts of the subcutaneous fat layer need to be preserved, so the procedure does not mean removing all fat tissue.

The choice of anesthesia for liposuction depends on the size of the areas for fat removal and any procedures added to the same operation. General anesthesia is one option. Anesthesia preparation for a limited area may differ in scope from a plan covering the abdomen, waist, and back. Existing illnesses and current treatments are part of the discussion with the anesthesiologist.

The name VASER does not describe where the cannula enters the skin. Entry points are selected to provide access to the area for fat removal, and the cannula moves beneath the skin in different directions from these points. Including the abdomen and sides of the waist in one plan means the working area may extend around the side of the torso. The fat removal area and cannula entry points are therefore marked separately during the examination.

High-definition (HD) body contouring

In high-definition body contouring, also called Hi-Def, we thin the fat over the muscles to different degrees to emphasize muscle contours. Differences between male and female musculature also guide the markings. While preserving some fat over the muscle masses, we can increase thinning along the lines between them. When needed, we can also add fat injections to areas where greater definition is desired.

Hi-Def may be considered for people who exercise regularly, have developed muscles, and have suitable skin elasticity. Marked skin laxity, fat within the abdominal cavity, or insufficient muscle development limit this option. If you would like more visible muscle contours, we can show you during the examination how your own muscle anatomy relates to this plan.

High-definition contouring is also known as HD or Hi-Def. The term describes emphasizing existing muscle anatomy through the distribution of fat beneath the skin. The muscle itself is not reshaped. The abdominal midline, the borders of the muscle masses, and the curves of the waist guide planning of the overlying fat tissue.

The shape of the abdominal muscles, the position of the lines between them, and torso width vary from person to person. Muscle lines seen in a photograph of another body do not occupy the same positions in everyone’s anatomy. HD planning is based on the individual’s own muscles and skin envelope. A thin fat layer alone is not a sufficient criterion for this approach.

Liposuction and plasma skin tightening

When planning VASER liposuction, we assess skin laxity as well as fat tissue. In suitable individuals, we use J-Plasma and argon plasma devices for tightening beneath the skin. In areas with mild or moderate laxity, we can plan plasma treatment in the same session as fat removal.

We apply plasma energy through a thin cannula passed beneath the skin through small entry points. When used in the same operation as liposuction, the fat removal entry points can provide access. Controlled heat is applied to the connective tissue network beneath the skin, and contraction of collagen fibers forms the basis of this tightening approach.

In both procedures, high-frequency electrical energy (radiofrequency) turns gas into plasma. J-Plasma uses helium gas, while argon plasma uses argon gas. Whether we add these devices to a fat removal plan depends on skin elasticity and the degree of laxity. Fat thickness and skin laxity can have different distributions across the abdomen, waist, inner arms, and inner thighs.

When excess skin is substantial, lift surgery to remove it may be considered. Plasma treatment does not cut away skin, so it cannot replace lift surgery for a broad skin fold. Someone considering fat removal and tightening at the sides of the waist may have the option of skin removal for sagging at the front of the abdomen.

Fat transfer, BBL, and facial contouring

In suitable cases, if you wish, we can use the removed fat to shape the buttocks, breasts, and face. We collect the fat in specialized containers, prepare the portion suitable for transfer, and inject it into areas where added volume is desired. Fat injection into the buttocks is also known as a BBL (Brazilian butt lift, buttock contouring with fat transfer).

We use real-time ultrasound when transferring fat to the buttocks. By following the cannula tip on the image, we place fat only in the subcutaneous layer above the muscle. We do not inject fat into or beneath the muscle. We avoid this deep plane because major blood vessels run beneath the muscle.

The ultrasound energy used in VASER liposuction and the ultrasound imaging used during a BBL have different functions. VASER separates fat in the area where it will be removed, while ultrasound during a BBL provides images of the cannula and tissue layers. This allows us to explain fat removal and buttock fat injection as steps with distinct purposes.

A wish for fuller buttocks and excess skin hanging downward are separate concerns. Fat transfer adds volume, while lift surgery removes excess skin and repositions tissues. If the buttock skin remains loose after weight loss, the examination includes this skin envelope as well as areas where fat can be removed. Fat removal around the waist and adding volume to the buttocks are neighboring but separate treatment areas in body contouring planning.

In a fat transfer plan, the donor area and the area receiving volume are identified separately. Localized excess fat at the waist or abdomen is assessed independently of the needs of the buttock area where volume is desired. Both the amount of fat available for removal and the structure of the recipient tissue define the limits of the surgical plan. Fat transfer does not need to accompany every fat removal procedure.

Facial fat transfer addresses areas that have lost volume, such as the cheeks. Sagging skin along the jawline is a different tissue change and may require a separate procedure. If you are considering body fat removal, you can also raise any concerns about facial volume loss. In such a plan, the donor area and the facial area receiving volume are marked separately.

What should you pay attention to after VASER liposuction?

Nutrition, corset use, and showering

After surgery, we recommend a protein-based diet and drinking 2-3 liters of water a day to prevent edema. We ask you to wear your corset for 4-6 weeks from the day of surgery. You can remove it briefly for activities such as showering and using the toilet.

You can shower on the 4th day after surgery. The stitches in your small incisions will fall out on their own within 2-3 weeks; these areas do not need dressings.

Massage and tissue recovery

We consider lymphatic drainage massage necessary for a faster recovery and recommend 8-10 sessions. Edema, swelling, and firmness decrease over time. Your skin regains its natural consistency within 3-6 months.

Exercise and swimming in the sea or a pool

You can start walking from the 2nd week after surgery and other activities after the 4th week. You can swim in the sea or a pool from the 2nd week.

You can message our clinic coordinator on WhatsApp with any questions.

These timeframes may vary depending on the person and the extent of surgery. Dr. Hakan Bulam will clarify them for you at your follow-up appointments.