Gentle liposuction: a light, effective technique

Inspired by traditional liposuction, gentle liposuction is an increasingly popular cosmetic procedure for tackling localized fat deposits. Performed under local anesthesia, it amounts to liposuction without major surgery — a less invasive alternative to conventional liposuction for small fat excesses, yet it can target different areas of the body just as precisely. How does gentle liposuction work? Who is it for? What are its benefits and its price? Here is an overview of how this effective, atraumatic procedure works.

What does gentle liposuction involve?

Conventional liposuction is a cosmetic surgery procedure that is now so widely used to treat stubborn fat cells that it has become the second most performed operation in France, after breast augmentation.

Yet many people who consider it never take the plunge, for fear of general anesthesia and the sometimes fairly heavy recovery. Gentle liposuction is the ideal solution for patients who want to remove a localized fat excess without having to undergo a relatively major procedure. It is also sometimes referred to as micro-liposuction, mini-liposuction or non-invasive liposuction: it is always the same approach — lighter and more targeted than classic liposuction.

It consists of a special method of suctioning fat at very low pressure to refine the body contour. This far gentler suction improves the final result and produces smoother skin while reducing the risk of skin irregularities (waviness or a crepey appearance), and in particular the « washboard » effect. Despite being painless, this method can still extract a not-insignificant amount of fat per session.

What are its benefits?

Gentle liposuction offers several advantages over traditional liposuction:

• First, the low suction pressure of the syringe (half as strong as in a conventional procedure) is applied only once the cannula is perfectly positioned over the area to be treated, allowing precise, adjustable control throughout the process, with suction power decreasing as the cannula fills. The cannulas used are also finer than in conventional liposuction;
• Next, because it is performed under local anesthesia, it is liposuction without general anesthesia: the procedure is logically less invasive than classic liposuction performed under general anesthesia, whose very small but possible risks are thereby avoided. The harvested tissues are also numbed with a serum that is both anesthetic and anti-bleeding;
• Finally, recovery is less painful and restrictive for patients, who can return to their daily activities more quickly and with no hospital stay required.

Gentle liposuction can also be used alone or combined with ultrasound laser sessions to treat cellulite and skin laxity. It can also be used to correct an initial liposculpture that did not deliver the expected results, particularly in terms of skin appearance — a point we cover in detail in our article on the differences between liposuction, lipoaspiration and liposculpture.

In a liposuction, when the amount of fat removed is sufficient, it can be combined with a reinjection of fat tissue (autologous fat transfer) into the breasts or buttocks. This is then referred to as breast lipofilling and buttock lipofilling (or Brazilian butt lift) respectively. The amount harvested in a gentle liposuction, however, is not enough to perform a fat graft.

Which patients is it for?

Gentle liposuction is not suitable for all patients. It is intended for those who already have a relatively slim figure but who want to erase a slight, localized fat excess (lipomeria) that is resistant to physical exercise and a balanced diet. It is therefore not a substitute for weight loss or a balanced diet.

This new-generation method cannot, however, treat a large number of body areas at the same time. In that case, conventional liposuction is still recommended. Nor is it intended to treat being overweight, or even cellulite or excess skin (an abdominoplasty or a dermolipectomy for loose belly skin are far better suited to that). For patients who instead want to slim down entirely without incision or anesthesia, an aesthetic medicine technique such as cryolipolysis, which eliminates fat using cold, may be another option.

On which parts of the body?

The gentle liposuction technique works on all the areas usually treated by liposuction, including:

• the belly, and in particular the rolls around the navel — this is the most sought-after belly liposuction without surgery;
• the hips and love handles;
• the buttocks;
• saddlebags;
• the arms when they have become too flabby and need firming;
• the chin and neck to remove a double chin;
• the ankles and the inner knees;
• the inner and outer thighs to restore slimmer legs.

How much volume can be removed with gentle liposuction?

The volume of fat that can be extracted during a gentle liposuction depends on the patient’s body shape. The maximum amount of anesthetic that can be administered to « numb » the fat tissue to be extracted is in fact determined by the patient’s weight.

As a general rule, it is estimated that up to 2 liters of fat tissue can be extracted per session. Beyond that, the anesthesia would be insufficient for a trauma-free procedure. For cases requiring a larger suction volume, several spaced-out gentle liposuction sessions or a conventional liposuction should then be performed.

This logic of local anesthesia by infiltration is nothing new: it draws on the tumescent technique described by the American dermatologist Jeffrey Klein in the late 1980s, which involves infiltrating the area with an anesthetic and vasoconstrictive serum before suction. Long recognized for its safety, this approach helped make liposuction under local anesthesia a routine procedure, performed on an outpatient basis in many countries.

How a gentle liposuction is performed

To determine whether gentle liposuction is feasible based on the fat reserves and the areas to be treated, an initial in-office consultation is required, during which the patient sets out their motivations and expectations regarding the outcome.

Before the procedure

The surgeon will assess whether the procedure is feasible under local anesthesia, then, where applicable, explain the various preparatory steps for the procedure as well as the recovery. A quote is then given to the patient.

If they agree, a second consultation is scheduled to plan the procedure at the clinic. Pre-operative photos are taken so the post-procedure difference can be observed afterward. A blood test may also be carried out to check that nothing could interfere with the procedure (serology, liver and kidney function in particular).

During the procedure

The gentle liposuction procedure is carried out directly at the clinic on an outpatient basis (with discharge the same day). Once the patient is lying down, the surgeon begins by marking out the parts of the body to be suctioned with a pen. They then disinfect the target area.

Local anesthesia with sedation is then administered. A few minutes’ wait is needed for the product to take full effect. The surgeon can then begin the procedure, during which the patient may feel the movements being made and some tingling, but not the associated pain.

Ultra-fine cannulas (3 to 4 mm in diameter) attached to syringes are then inserted under the skin in the targeted areas to gently suction the fat cells. The suction is much gentler and slower than in classic liposuction, which helps avoid the washboard effect sometimes held against this method.

After the procedure

Once the fat has been harvested, the skin is then re-smoothed with far fewer irregularities than in traditional liposuction. The cannulas are finally removed and the surgeon applies a dressing over the incisions. A compression garment is then put in place, to be kept on for about a month.

The scars and recovery are minimal. They are limited to swelling and bruising that will disappear naturally after a few days; our tips for reducing swelling after liposuction help speed up its resorption. The results will be fully visible from a few weeks onward, once the swelling has completely subsided. The patient will then need to maintain a stable weight to preserve this result.

What results can you expect, and are they lasting?

The improvement in body contour is noticeable as soon as the procedure ends, but the final result is best assessed once the swelling has completely subsided — on average after a few weeks to a few months, depending on the volume removed and the area treated. The skin generally takes about a month to retract over the new contours.

The fat cells removed during a gentle liposuction do not reform in the treated area: the result is therefore considered lasting, provided a stable weight is maintained. Significant weight gain can, however, cause the remaining fat cells to enlarge, both elsewhere and in the treated area. Satisfaction reported after liposuction is among the highest in plastic surgery in the international literature, when the indication is well established — that is, a localized fat excess in a patient of stable weight, and not a weight-loss solution.

How much does gentle liposuction cost?

The price of a gentle liposuction depends mainly on the number of areas to be treated and the volume of fat to be suctioned: a single moderate area logically takes up less operating time than several combined areas. The price is therefore set on a case-by-case basis and is the subject of a personalized, detailed quote given during the consultation, as required by French regulations before any cosmetic surgery procedure.

As it is a purely cosmetic procedure, gentle liposuction is not covered by French national health insurance or by complementary health insurance. On top of the cost of the procedure itself, additional fees may apply: the preliminary consultation, the compression garment, any post-operative medication. The full breakdown is provided to you before any decision, with no obligation. To request a quote or an opinion on the feasibility of your project, you can book an appointment at the practice of Dr Vincent Hunsinger, in Paris (17th arrondissement, Étoile district).