Everything about liposuction – procedure, methods, costs

Brief overview: What is liposuction and how does it work?

Liposuction is a cosmetic surgical procedure that removes excess fat from a specific area of the body. It is usually used to improve body contour and reduce stubborn fat deposits that do not respond to diet and exercise. Typical areas where liposuction is performed are: Abdomen, thighs and hips, but in principle liposuction is possible on almost any part of the body where fat deposits can form.

During liposuction, the surgeon makes small incisions in the skin and inserts a thin tube called a cannula. Using different techniques, the fat cells are then released from the tissue and suctioned out with the help of the cannula.

Liposuction is one of the most common treatments within plastic surgery.

When is liposuction an option?

Cosmetic surgery usually considers liposuction when patients are dissatisfied with the contours of a particular area of the body. This is especially the case in the following situations:

• In case of fat deposits despite weight loss, i.e. when diet and exercise have not been successful in reducing stubborn fat deposits
• For significant amounts of excess fat
• For flabby skin or stretched muscles e.g. in the abdominal area after pregnancy.
• In case of asymmetries, e.g. after accidents or if asymmetries have been caused by scars

Medical requirements for liposuction

You should discuss in detail with your attending physician whether you meet the requirements for liposuction. The medical conditions for liposuction are typically:

• In general, patients should be in good physical condition and have realistic expectations about the results of the procedure
• Stable weight before liposuction – significant weight gain or loss after the procedure may affect the results
• No presence of chronic diseases or genetic conditions that could increase the risk of complications, such as diabetes, heart disease, hypertension, or blood clotting disorders
• No embolisms, phlebitis or wound healing disorders
• Do not take anticoagulant medications (ASA, Markumar, Heparin, etc.)
• No severe obesity (BMI > 35)
• No inflammation or scars in the area designated for liposuction
• In addition, patients should not be pregnant or breastfeeding at the time of the procedure

What are the techniques for liposuction?

There are several techniques for liposuction, including tumescent liposuction, waterjet, vibration, ultrasound-assisted liposuction (UAL), and laser-assisted liposuction. The regions of the body to be treated, the patient’s individual ideas and the physician’s expertise usually determine which specific technique is used. Various doctors use other methods of liposuction, but these are often hybrid forms or proprietary names developed for marketing purposes.

Tumescent liposuction (TAL)

Aesthetic surgery most often uses tumescent liposuction as a liposuction technique. In this procedure, a so-called tumescent solution – a mixture of saline solution with anesthetic and cortisone – is injected into the area to be treated under the skin. The tumescent solution ensures that the fat cells detach from the tissue in the affected area, while the treatment is almost painless due to the anesthetic it contains. After an exposure time of approx. 30 minutes, the excess fat can be suctioned off with fine cannulas. This solution helps reduce bleeding and swelling during the procedure.

TAL is relatively low risk, however, the surgeon must have excellent skills with the technique in order to achieve aesthetically good results, as this method can be used to suction larger amounts of fat, but the contours of the suctioned areas of the body cannot be 100% controlled.

Water jet technology (WAL)

The water jet technique is a relatively new method of liposuction that uses high-pressure water jets to break up the fat cells and then suction them out. Tumescent solution is used in this procedure, as in Tumszenz liposuction. A fan-shaped water jet is used to gently loosen fat cells from the tissue and suck them out directly.

This technique can be performed without general anesthesia for smaller fat deposits, but is also suitable for treating larger areas of the body such as the abdomen, hips, thighs and buttocks. The waterjet technique is a gentle, fast and low-risk technique that allows precise modeling, especially during initial treatment. However, larger volumes of tumescent solution are often required, which often results in pronounced, postoperative edema (swelling).

Vibration technique / Power Assisted Liposuction (PAL)

Vibration liposuction is a relatively new technique that uses vibration to break up fat cells before they are suctioned out. For this purpose, a saline solution together with a local anesthetic is first injected into the area to be treated and then the fatty tissue is loosened and small vibrating cannulas are inserted. The vibrating cannulas move up to 80 times per second.

The vibration technique is a relatively gentle liposuction procedure. Patients run a much lower risk of injury to tissue, nerves and vessels, and for the physician, handling the vibrating cannulas is much easier.

The vibration technique is suitable for the removal of larger fat deposits.

Ultrasound assisted liposuction (UAL)

Ultrasound-assisted liposuction uses ultrasound energy to break up fat cells before they are suctioned out. A special probe enters the fatty tissue through a cannula and releases energy via ultrasound, which destroys the fat cells and liquefies the fatty tissue. It is important to keep the probe moving continuously to prevent tissue burns. The probe requires a larger cannula than other methods of liposuction, which requires special training of the plastic surgeon, as it is more difficult to insert the probe precisely.

Like PAL, ultrasound-assisted liposuction is often used for larger fat deposits.

Laser-assisted liposuction / laser lipolysis (LAL)

In laser-assisted liposuction, a laser is used to break up the fat cells before they are suctioned out. This technique involves inserting a cannula into the fat layer, which releases heat energy through a laser and liquefies the fat cells. The advantage of the laser is that it spares surrounding tissue and closes blood vessels directly, resulting in less swelling and bleeding.

Laser-assisted liposuction is particularly suitable for smaller fat deposits. Up to 500 ml of fat can be removed in one session, with larger fat deposits requiring multiple sessions.

How does liposuction work?

Treatment duration

Liposuction can be performed as an outpatient surgical procedure in consultation with the attending physician, i.e. an overnight hospital stay is not necessarily required. Liposuction can be performed under local anesthesia, twilight sleep or general anesthesia, depending on the extent and method, as well as the patient’s wishes. The actual procedure takes about 1.5 – 4 h.

Consultation and health check

Choose your plastic and aesthetic surgery specialist carefully, as this person is central to their treatment! It is important that your specialist is an expert in liposuction, i.e. has performed many liposuction procedures, and can demonstrate the highest standards of hygiene and quality, as well as professional competence at the highest level. A personal consultation is central for you as a patient to be able to assess this.

Liposuction usually begins with a personal consultation with your surgeon and a health check. A detailed consultation helps to ensure that liposuction meets their expectations and risks of the treatments are minimized. At this appointment, you will discuss your desired outcome and the surgeon will evaluate your individual initial situation. The attending physician will also explain various liposuction techniques available, if any, as well as the risks associated with the procedure.

If you regularly take medication, have allergies or known illnesses, be sure to inform your doctor. If you have a tendency to bruise or bleed for a longer period of time from minor injuries, you should also inform your doctor, as a blood clotting disorder should be ruled out before the procedure.

A health check can help ensure that you do not have any of the contraindications to liposuction (such as blood clotting disorders).

Operation procedure

Before starting the operation, the surgeon marks the appropriate areas for liposuction with a pencil.

The actual procedure then begins with the patient receiving a general anesthetic or local anesthetic for mild pain, depending on the size and location of the fat deposits. Then the surgeon makes small incisions in the skin of the area to be treated (5 to 10 mm long) and inserts a cannula into the fatty tissue.

Depending on the treatment method, excess fatty tissue is loosened and suctioned out with the help of the cannula. With some methods, e.g. tumescent liposuction, there is a certain exposure time between solution and suction of the fatty tissue, during which the technique develops its full effect; with other techniques, solution and suction of the fatty tissue take place simultaneously (e.g. waterjet technique).

After completion of the surgery, the patient is bandaged by the surgical team; suturing of the incisions is not necessary due to their small size.

Healing process and aftercare

Compression garments: After surgery, patients should put on compression garments of the affected areas, which should be worn for about 6 weeks after surgery for optimal treatment results.

Analgesic medication: In addition, painkilling medication can be administered at the patient’s request.

Healing process: In the first period after the procedure, swelling may still occur in the treated area, after about 14 days the preliminary result is usually visible. It can take 3 – 6 months until the deeper tissue is completely healed, the final result is also visible only after 3 – 6 months.

Exercise: The fluid injected for liposuction must drain in the first few days after liposuction – for this, it is important that patients move a lot to speed up the drainage and reduce the risk of thrombosis.

Return to everyday life: Shortly after the procedure, patients can already leave the clinic – in some cases, no overnight hospital stay is necessary. About 3 days after the procedure, patients can already return to their usual activities, only they should refrain from sports activities for at least 14 days.

Endermological massages: It is recommended that patients start so-called endermological massages after about 2 weeks to support the healing process. Experts recommend 5 – 10 sessions. This accelerates wound healing and promotes lymphatic flow and blood circulation in the affected area.

Follow-up examinations: After liposuction, there are several follow-up examinations – usually this is scheduled after about 2 weeks, 7 weeks and after 6 months.

What are advantages of liposuction?

Liposuction of the abdomen has a number of advantages:

Permanent result: The liposuctioned fat cells are permanently removed by the treatment and do not grow back.

Aesthetic improvement of the body contour: The body contour and silhouette can be improved enormously by targeted liposuction.

Elimination of stubborn fat deposits: Liposuction can eliminate stubborn fat deposits that cannot be eliminated by exercise or dietary changes.

Relatively short treatment duration and healing phase: In most cases, only one intervention is necessary and the healing process is comparatively short, lasting 3 – 6 months.

Modern treatment techniques: Modern techniques are associated with relatively low risks and reduce the stress of the procedure on the body. Partial liposuction is even possible under local anesthesia

Only minimal scarring: The small incisions (5 – 10 mm long) required for the procedure are only barely noticeable after a few weeks.

Improved self-confidence and self-esteem: As an indirect effect, liposuction often also boosts patients’ self-confidence and self-esteem.

What are the risks of liposuction?

As a rule, liposuction using proven methods and performed by a qualified physician is considered a safe and low-risk operation. However, the risk of complications increases with the amount of fat removed. As with any surgical procedure, the highest standards of medical hygiene must also be maintained to avoid inflammation and complications. Nevertheless, any liposuction is associated with a number of risks:

Aesthetically unsatisfactory result: It may happen that the result does not coincide with the original expectations of the treatment. In this case, it may be necessary to perform a second treatment.

Temporary discomfort / numbness: Temporary discomfort / numbness may occur on the skin of the affected area.

Skin irregularities / dents: If the skin of the affected area no longer has sufficient elasticity, it may not conform sufficiently, resulting in skin irregularities. If necessary, skin tightening can be performed in the affected area to restore a smooth skin appearance.

Serious complications: If hygiene and treatment standards are not adequately maintained, fat embolism or fat necrosis may occur. In a fat embolism, fat particles enter the bloodstream and possibly clog pulmonary capillaries. Fat necrosis results in inflammation and death of the fatty tissue, which must be corrected by surgery.

In summary, complications can be kept to a minimum by choosing the right doctor. Before undergoing liposuction, be sure to consult with your doctor regarding the risks involved.

How much does liposuction cost?

Tumescent liposuction is the most common and usually the least expensive method of liposuction, the following price comparisons refer to this method. In general, the more fat that is to be removed and the more areas of the body that are affected, the higher the cost of liposuction – for example, there is typically a greater range of prices for the treatment of thighs, as it may involve the treatment of the inner thigh only, the outer thigh only (the so-called riding breeches), or all four areas.

In Switzerland, Germany and Austria

In German-speaking countries, the following costs for liposuction can be expected:

• Switzerland:
  • Belly: CHF 2’900 – 8’000
  • Upper leg: CHF 2’500 – 8’000
  • Hip: CHF 2’500 – 8’000
• Germany:
  • Belly: EUR 1’700 – 4’400
  • Thigh: EUR 1’000 – 8’000
  • Hip: EUR 1’500 – 4’500
• Austria:
  • Belly: EUR 2’000 – 6’000
  • Thigh: EUR 3’000 – 7’800
  • Hip: EUR 3’000 – 4’900

In other European countries

Liposuction of the abdomen can be performed significantly cheaper in other European countries than in Switzerland, Germany or Austria:

• Czech Republic and Hungary:
  • Belly: EUR 1’100 – 3’200
  • Thigh: EUR 1’600 – 2’700
  • Hip: EUR 1’600 – 2’150
• Greece:
  • Belly: EUR 1’500 – 4’500
  • Thigh: 1’500 – 5’500
  • Hip: 1’500 – 4’500

The following table provides a detailed overview of treatment costs in the respective countries:

Country	Price liposuction abdomen	Price liposuction thigh	Price liposuction hip
Switzerland	CHF 2’900 – 8’000	CHF 2’500 – 8’000	CHF 2’500 – 8’000
Germany	EUR 1’700 – 4’400	EUR 1’000 – 8’000	EUR 1’500 – 4’500
Austria	EUR 2’000 – 6’000	EUR 3’000 – 7’800	EUR 3’000 – 4’900
Greece	EUR 1’500 – 4’500	EUR 1’500 – 5’500	EUR 1’500 – 4’500
Czech Republic	EUR 1’450 – 3’150	EUR 1’600 – 2’700	EUR 1’600 – 2’150
Hungary	EUR 1’100 – 3’200	EUR 1’100 – 2’500	EUR 1’100 – 1’600

Sources: Various price lists of cosmetic surgeons and comparison portals for medical treatment costs (see end of source list).

When does the insurance cover the costs?

Insurance in Switzerland, Germany and Austria generally does not cover costs for purely cosmetic procedures, and this is usually the case for liposuction.

In the case of liposuction for lipedema (storage of fatty tissue and water in the subcutaneous tissue of both legs), the treatment costs may be covered by your insurance company on a pro-rata basis under certain conditions – however, it is essential to consult your basic insurance / health insurance company about this; decisions on cost coverage are usually made on the basis of the individual case.

More questions about liposuction

When will the final result of liposuction be seen?

Immediately after liposuction, swelling may still occur, after about 14 days, the preliminary result is usually visible. It may take 3 – 6 months for complete healing of even the deeper tissue.

When can I start my work and sports again after liposuction?

Experts recommend that everyday activities such as work should not be resumed until about 3 days after the procedure.

Sport should be avoided for at least 14 days in consultation with the attending physician.

Does liposuction leave scars?

Scarring after liposuction is minimal, as usually only very small incisions are necessary (5 to 10 mm in length). Really visible scars are rare.

What are the alternatives?

There are two methods of fat reduction that do not require incisions:

Cryolipolysis: In this procedure, local fat deposits are exposed to a particularly low temperature. Fat cells are sensitive to temperature and are broken down and removed by the body after exposure to cold, so fat deposits can be specifically reduced by cold application. A special applicator is attached to the corresponding part of the body and exposes the local fat deposits to a temperature of up to -4° C, while surrounding tissue and skin are protected by a gel pad.

Injection lipolysis (fat-away injection): In this procedure, small needles are used to inject the preparation phosphatidylcholine into the fat deposits, which dissolves fat cells that are then transported away by the lymphatic system. The treatment is performed on an outpatient basis under local anesthesia and can be performed over several sessions, each about 2-6 weeks apart. The disadvantage of injection lipolysis is that it can only treat smaller fat deposits or problem areas and that several sessions are usually necessary.

In general, however, only relatively small fat deposits can be reduced by these two alternatives.

How long does the result of liposuction last?

The results of liposuction are permanent as long as patients maintain a healthy diet and get enough exercise.

Does the suctioned fat grow back?

The removed fat cells do not grow back, however, the remaining fat cells can replenish or grow larger. Therefore, even after liposuction, weight loss may occur and, consequently, fat may accumulate again. You can counteract this with the help of a balanced diet and sufficient exercise.

Should I change my diet after liposuction?

Liposuction is not a substitute for dieting and is not intended for weight loss but for aesthetic body contouring. After the procedure, weight gain may occur and, in particular, fat may be stored in other parts of the body, since fat cells once suctioned out will not grow back.

As mentioned above, stable weight development is a basic requirement for liposuction. If you have mastered this in the past, they do not have to fundamentally change their diet and other habits after liposuction. However, after liposuction, they should continue to maintain a balanced lifestyle based on a healthy diet and sufficient physical activity to prevent long-term weight gain.

Last update: January 10, 2023

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