Everything You Need To Know About High-Definition Liposuction

New ‘hi-def’ liposuction techniques do more than remove excess fat. They have the power to create chiseled contours without crunches. Is there a catch? The AEDITION investigates.
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Written by Krista Smith
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Everything You Need To Know About High-Definition Liposuction Standret/Shutterstock

Pining for super sculpted ab definition? We feel your pain. Endless crunches can burn in more ways than one. Truth is, it’s just not possible for most of us to naturally achieve the chiseled physique of a competitive bodybuilder or a body-tuned IG influencer, no matter how many gym hours logged or macros carefully measured.

Fat is like a fingerprint. Each person’s pattern of deposits is unique, which means that the same quantity of fat can look very different between individuals. It's also why lifestyle changes can only take us so far. For many, that’s where plastic surgery comes in.

The origins of liposuction date back to the 1920s, when a French surgeon removed a portion of skin and soft tissue to improve the contour of a dancer’s knees and ankles. The result was tragic. His overly aggressive sculpting and too-tight suturing led to necrosis and, ultimately, amputation.

In the ensuing decades, European plastic surgeons experimented with body sculpting techniques that minimized incisions and superficial tissue removal, instead scraping and suctioning the subcutaneous fat deposits. The technique proved problematic, however, due to its high risk of hematoma and seroma (blood and fluid pooling, respectively), infection, and necrosis.

The breakthrough finally came in the 1970s, when Italian and French surgeons pioneered excess fat removing techniques using varying sizes of blunt cannulas attached to suction to more gently remove the fat cells. The injection of saline mixed with enzymes to break up the fat cells prior to removal further refined the procedure.

In the years since, liposuction has gained popularity worldwide. According to the American Society of Plastic Surgeons, over 250,000 lipo procedures were performed on so-called ‘problem areas’ in 2018 in the United States alone. Surgical innovators, meanwhile, have continued to hone the procedure to produce increasingly fine-tuned results.

The latest technique, known as high-definition or hi-def liposuction, uses more precise tools and methods to create incredibly natural-looking curves that mimic muscle contours and was first popularized in South America.

Difference Between Traditional and High Definition Liposuction

“Traditional lipo is just fat removal in areas that are excessively full or problematic,” explains board certified plastic surgeon Jacob Unger, MD, of Nashville’s Maxwell Aesthetics. With this new approach, surgeons selectively remove fat from certain areas and leave a little bit extra in others “to create aesthetically pleasing peaks and valleys,” he continues.

The increasingly sculpted results come from a combination of both the plastic surgeon’s training and skill, along with the application of modern modalities that ease fat removal while safeguarding surrounding tissue. Some of these devices liquify fat cells prior to removal using different types of energy, like ultrasonic (see: Vaser liposuction) or laser (i.e. Smartlipo). Others, like power-assisted liposuction (PAL), use a vibrating cannula to help break up fat and keep the cells intact for potential fat grafting. Dr. Unger favors power-assisted liposculpture using varying cannula sizes in conjunction with skin-tightening radiofrequency energy (like BodyTite) to achieve his chiseled contours.

Areas of the Body to Treat With Hi-Def Lipo

“Hi-def lipo is a complete game changer,” says New York- and Beverly Hills-based board certified plastic surgeon Douglas Steinbrech, MD, who adds that the technique has applications far beyond the stereotypical six pack.

“Not only can we enhance the patient’s own natural abdominal musculature, but also other areas such as the deltoids, the shoulders, biceps, triceps, and the pecs because we are looking at creating a total torso transformation,” he explains. Surgeons are also able to treat the back, arms, thighs, and calves.

Best Candidate for Hi-Def Lipo

The best candidates for hi-def lipo are those patients with a BMI in the normal range and good skin quality (think: minimal or no laxity), who already lead a healthy lifestyle but want to be rid of problem fat pockets. Basically, it’s best for those seeking that ‘the gym is my day job’-type definition.

Although hi-def lipo is a popular body contouring treatment for men and women alike, more and more guys are seeking out the procedure. Kevin*, 26, sought Dr. Steinbrech’s help after multiple lifestyle changes just couldn’t meet his goals. “For the longest time I tried to lose the fat on my flanks, chest and stomach,” he shares. “But no matter how hard I worked out and tried different diets, I could not lose the fat in those areas.”

Dr. Steinbrech performed high-definition liposuction and autologous fat transfer on Kevin — a technique he’s dubbed “BodyBanking.” For Kevin, the results were life changing. “I have the body I never thought I could have before,” he shares. “I am a lot happier with myself now. Everything got better since my procedure: sex, friends, love life — all of it became 100 times better.”

How to Find the Right Provider to Perform Hi-Def Lipo

With hi-def demand on the rise, Dr. Steinbrech and Dr. Unger urge people to be extra cautious when researching potential providers. Not only is it crucial to seek out a board certified plastic surgeon to perform your hi-def liposuction surgery, but you also need to make sure that surgeon specializes in the technique. “The biggest word of caution is to go to a surgeon that has a lot of experience with men’s body contouring and has a ton of before and after photos on the website to prove it,” Dr. Steinbrech shares.

The consequences of settling for cosmetic surgery ‘deals’ promised by less-than-expert providers are both immediate and long term. Not only are you increasing your chances of experiencing complications like bleeding and infection (a statistical possibility with even the most skilled surgeon), but you’re at much higher risk of experiencing disappointing results in the future. We naturally lose superficial fat as we age, which can prove problematic if a surgeon removes too much fat.

“Overly resecting the fatty tissue beneath the skin can cause scarring and unnatural appearing lines and contours. That is why I perform ‘soft def’ liposuction,” explains Dr. Unger. “I feel that getting some elegant and athletic contours is great, but I would never perform that at the cost of a natural-looking and long-lasting result.”

Hi-Def Lipo Surgery and Results

High-definition liposuction is typically performed under general anesthesia as an outpatient procedure (unless it’s very high volume). Downtime varies by procedure and patient, but it typically entails two to five days at home. Patients must wear compression garments 24/7 for the first two to four weeks and should expect some bruising and soreness. Most patients feel up to light exercise at the two-week mark and can hit the gym by one month post-op. Full restrictions are lifted after six weeks.

“Recovery was very easy for me and it was very straightforward,” says Kevin. “Dr. Steinbrech had a recovery plan set up for me and provided all the medications tools necessary for my recovery.” Although every patient’s postoperative experience is different, sticking to your plastic surgeon’s recovery instructions will certainly make things smoother.

Expect to budget a minimum of $4,000 for a single area of hi-def lipo, but costs vary widely (think: upwards of $20K) depending upon the surgeon and the patient’s anatomy and goals.

The Takeaway

While liposuction has been among the most popular cosmetic procedures for decades now, hi-def techniques are particularly en vogue right now thanks to social media. “Patients are working out more and showing off the results on Instagram and other social media,” Dr. Steinbrech says. Similarly, Dr. Unger has also noticed a shift in aesthetic ideals. “What was once considered a nice figure has been ratcheted up significantly,” he shares. “Now a flat tummy is the minimum, with people wanting to see definition and abs.”

Even so, finding the right provider for your procedure is imperative to ensure the long-term results are both safe and satisfying. “Don’t get sucked into advertising from device companies,” Dr. Steinbrech warns. “It’s the conductor of the symphony — not the baton — that creates the most beautiful music.”

*Patient’s name has been changed

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KRISTA SMITHis a contributing writer for AEDIT.

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