Episode 24: How Much Does Liposuction Cost?
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With that, let's get into today's episode, which is all about “how much does liposuction cost?” And this is something that is on everyone's mind when they're thinking about having a liposuction procedure. You know, this is something that people are very excited about. They want to change their body. They might have some stubborn fat that they just can't get rid of in the gym or with exercise, or by modifying their diet. And they really want to get going and make a change with liposuction, but they want to know how much it is likely to cost.
What determines the cost of liposuction?
We're going to dive into that today and we can break this question down into a few different segments. First of all, when you're considering how much liposuction costs, it depends on the way that the procedure is performed. It depends on factors related to the individual patient, their anatomy, and the things that need to be done specifically for an individual case. Then there are a set of factors that depend on the surgeon, and then there are some general things that we're going to get to at the end. And by the time we come to a close, you should have a much better sense of how much liposuction costs so that you can think about things from that perspective as well.
The first set of things to consider when we are asking how much liposuction costs have to do with the way that the procedure is performed. And the two big things to consider here are the type of technology being used, the way that the actual operation is being done, and then the type of anesthesia that is used to do the procedure.
What are the different kinds of liposuction?
In terms of the type of technology, liposuction at its core has to do with making tiny two to three millimeter incisions in well-hidden parts of the body, as you've heard me describe in other episodes and then injecting a numbing solution into those incisions to numb the areas that we're going to be working on. And that's how liposuction has now gotten the more modern term tumescent liposuction, because the name of the fluid that we're using, that we're putting into those incisions to numb up the area of the body that we're going to be treating with liposuction, it's called tumescent fluid.
Almost all liposuction that you're going to see in the modern world is tumescent liposuction, so that doesn't really so much come into the cost of things, but there are several different kinds of technologies that can be added onto liposuction that can affect the cost. And the first one is something called how PAL, P A L, or power assisted liposuction. And this again is a technology that's almost universally used and to understand the advantages of power assisted liposuction and what it is, we first have to describe what happens in regular liposuction.
And in regular liposuction, the surgeon is taking a long, thin instrument called a cannula, which almost looks like a long metal straw and passes it back and forth rapidly through those very small access incisions to extract with suction the fat cells out of the treatment area to kind of sculpt a really nice result. And what power assisted liposuction does is provide an automatic device that causes that cannula to vibrate back and forth very quickly to accelerate the process by which fat is removed in the course of liposuction. And that has a number of advantages, but perhaps one of the primary ones is that it allows the surgeon to achieve excellent results with a lot less physical effort, which lets the surgeon concentrate on achieving a very refined aesthetic outcome. The other major technologies that you're likely to hear about with reference to liposuction are Smartlipo or smart liposuction, VASER liposuction and radio-frequency assisted liposuction.
Whereas the vast majority of plastic surgeons that are performing liposuction are using power assisted liposuction, these other technologies like Smartlipo, VASER lipo and radio-frequency assisted liposuction are used a lot more selectively and in specific cases to deal with specific indications. For example, Smartlipo is essentially liposuction like I previously described, but paired with laser energy. And the goal of that procedure is to achieve some degree of skin tightening with the heat from the laser, which in theory sounds appealing. However, I personally haven't been that impressed with this technology for achieving the results that are advertised.
The other two technologies, VASER liposuction and radio-frequency assisted liposuction, I think play a much more potentially effective role when used for the right patients and specifically, VASER liposuction is ultrasound assisted liposuction. And the way that this works is before the cannula is used to extract the fat cells, ultrasound energy is used to make a wand vibrate very rapidly in the treatment area using a process called cavitation.
And this literally shakes the fat cells off of the connective tissue. And at the same time, it generates a significant amount of heat. And together this has a couple of different effects. First of all, the heat does cause some skin contraction and there's very good data to document this. And at the same time, by using cavitation to shake the fat cells off the connective tissue, it makes it a lot easier to perform effective liposuction in difficult to treat areas.
So for me, the specific areas where I like to use VASER liposuction are in secondary liposuction cases, meaning in people that have had liposuction previously, they now have scar tissue in addition to leftover fat and connective tissue. And the ultrasound used with the VASER liposuction can make it a lot easier to remove a significant amount of fat from those scarred areas. And the other place that I really liked to use VASER liposuction is for gynecomastia or in male breast reduction. And the reason for this is, again, the connective tissue in the male breast, the chest area can be extremely tough. And with the VASER system, we can really free up a lot more fat and do some much more effective contouring of the male chest in the context of gynecomastia.
And then finally, the third technology that I mentioned, the radio frequency assisted liposuction, I think of all of these probably has had the most impressive results as far as I'm concerned in terms of skin tightening. And I've mentioned this in a couple of other episodes because I really like the device, but this is a device called Body Tight, where it essentially has two prongs. One prong goes under the skin using one of those liposuction access incisions. The other goes over the skin and radiofrequency energy is shot back and forth between those two prongs heating the skin and causing shrinkage, but unlike power assisted liposuction, which we use in pretty much every case, smart liposuction, VASER liposuction and radio-frequency assisted liposuction are things that really only have a place in specific cases.
So these aren't things you should be paying for, unless you really have a specific need for them. So for instance, with the VASER liposuction, that's something that really only has a place with skin laxity or secondary liposuction, or if you're a man having a male breast reduction or gynecomastia reduction procedure. And similarly with the radiofrequency energy, that's something you should really only be needing if you have significant skin laxity.
And going back to the Smartlipo or smart liposuction, I just haven't been that impressed with those results overall. And if you are looking for some skin tightening, in addition to your liposuction, I would be looking more towards either the VASER liposuction or the radio frequency assisted liposuction. But the reason again, that I bring all of these different technologies up is that they will invariably lead to an increase in the cost of your procedure for a couple of different reasons.
First, they make the procedure take longer. And as with so many other things, the more time you're spending on something, the more it's going to cost. And also we have to open specialized equipment for each case, and that has an associated cost. So again, only be using these technologies unless there is a clear indication to do so. Otherwise you're exposing yourself to unnecessary cost.
How does anesthesia impact the cost of liposuction?
The other variable in terms of the way that a procedure is performed, that has a significant impact on the cost of that procedure, is the type of anesthesia that's used. And there are essentially three kinds of anesthesia that might be used to perform a liposuction procedure. And the first one is straight local anesthesia, which means we use that tumescent fluid, which makes the area numb. And that's it. You might get some medication by mouth to make you less nervous, but essentially it's that local numbing medication.
And there's really minor discomfort when this is performed by an expert. And we use this for kind of limited areas of liposuction, small abdominal cases, or just doing the flanks or maybe just the inner outer thighs or just the arms. But as soon as we start combining multiple areas or doing larger areas of liposuction, we really need to either be using twilight anesthesia or general anesthesia. And twilight anesthesia is essentially when you're given medications to make you drowsy and essentially dissociate you from what's going on. So in addition to the numbing medicine, you really are kind of loopy and just don't care what's happening. And that's a very reasonable way to perform larger liposuction cases.
And then for very big cases, or just sometimes as a matter of personal preference, some folks will prefer to be completely asleep for their procedure. And that's general anesthesia and kind of the defining characteristic between twilight anesthesia and general anesthesia is that with twilight anesthesia, you are ultimately awake and breathing on your own, whereas with general anesthesia, you are asleep and there's a machine helping you breathe.
And the way to think about how these things affect costs is that with local anesthesia, since you're only getting the tumescent solution, and there are no medications that are affecting your level of consciousness, you really don't need an anesthesiologist present to administer this kind of anesthesia, so simply put, you don't need to be paying for an anesthesiologist in addition to a surgeon. However, as soon as you start getting into twilight anesthesia or general anesthesia, you really need an anesthesiologist present to administer these forms of anesthesia.
Now there are some surgeons that will administer these things themselves. I personally don't feel comfortable with that. So I would say, as a conservative person that always put safety first, if you are having twilight anesthesia or certainly general anesthesia, you should have an anesthesiologist present. And this can take the form of a board certified anesthesiologist that is a physician or a CRNA. That's a certified registered nurse anesthetist.
And there are surgeons that operate with both of these setups. I personally always operate with a board certified anesthesiologist in my private surgical center because again, I'm just a kind of a conservative safety first kind of person. As you can imagine, though, as you are having more advanced anesthesia, the cost does go up from having that present.
How can patient factors affect liposuction cost?
So now we've addressed the procedure related factors in terms of determining how much liposuction costs. And now we're going to turn our attention to patient factors with regards to determining the cost of a liposuction procedure. And this really comes down to three things, the number of areas that you're going to treat with liposuction, the volume of those areas and the complexity of the case as a whole, and this is really fairly straightforward.
So when we talk about the number of areas that we're treating, you'll find that most surgeons price a liposuction by what they're doing. So for instance, the abdomen is considered one area, the flanks or love handles are considered an area, the arms are an area and so on. And as you might expect, the more of these areas that you're doing, the more the procedure is going to cost. However, what we do in my practice and what a lot of other folks do is they'll charge a set fee for the first area of liposuction. And as you add additional areas, the cost of each additional area goes down.
And the kind of scale that all this is at is determined in large part by the volume of those areas. So for example, in a much larger person, the price of that first area of liposuction is probably going to be more than in someone who's very small simply because again, it takes longer to do more liposuction in a larger person than it does to do less liposuction in a smaller person.
And the third factor that I mentioned, the complexity of the case, takes into account how difficult the case is for the surgeon. And things will come into play such as, is this a secondary procedure? Has the person had liposuction before? Is there scarring present? Is it an anatomically difficult area for any number of reasons, or has the patient had a previous noninvasive body contouring procedure like CoolSculpting? And sometimes CoolSculpting can cause fat growth instead of fat removal, and that's something called paradoxical hyperplasia. And that can be very stubborn, difficult, fat to remove.
All of these things kind of come into play as patient specific factors in determining the cost of a liposuction procedure.
How does your choice of surgeon affect liposuction cost?
The next thing to look at in terms of determining how much a liposuction procedure is going to cost are surgeon-specific factors. And these are things like surgeon experience, the surgeon's level of training and the surgeons qualifications. So specifically surgeon experience, is this someone that's been in practice for a long time, or that's done a very large number of procedures.
So are they well prepared to provide you with an excellent result? Similarly, what is this person's training? Where do they train? Do they do a residency? Do they do a dedicated aesthetic surgery fellowship? Those things, we're going to go into the pricing as well. And finally, surgeon qualifications, are they members of selective professional societies and perhaps most importantly, are they a board certified plastic surgeon? And that means board certified by the American Board of Plastic Surgery. So again, the more experienced the surgeon is, the better their training and the more advanced their qualifications, the more the cost is going to be.
How does geography affect liposuction cost?
And the last thing that kind of affects all of these things and determines where they fall on the greater scale of cost across the board is geography. So if you're having your procedure done in a major metropolitan area where the cost of everything tends to be higher, the cost of your plastic surgery procedure will generally be higher in these areas as well.
What are the different parts of a liposuction quote?
Those are the factors that are going to largely determine the cost of your liposuction procedure. And now to kind of get into the nitty gritty of how much your liposuction procedure is going to cost. We have to also understand that there are a few different parts of any quote for a liposuction procedure, and those are essentially the surgeon's fee, the fee for anesthesia and the fee for the operating room, or what's sometimes called the facility fee. And to keep things simple in terms of the anesthesia fee and the facility fee, it's going to be safe to assume that that's going to cost anywhere from about $500 to a few thousand dollars. If you're having that performed in a private surgical center, again, as influenced by the various factors that we were discussing earlier.
In terms of the surgeon's fee, I'm really going to speak from personal experience here. My practice is a New York City based plastic surgery practice on the upper East Side of Manhattan, where things do tend to be pricier. And in my market, for the first area of liposuction, with reputable people, you're generally going to be paying somewhere between 3 and $6,000 for that first area. And then each additional area generally goes down by about a thousand dollars until it levels off somewhere at 2 to $3,000 per additional area.
And don't get me wrong. It is extremely possible to find rates that are much lower than this, but you're often going to be sacrificing in terms of quality and safety. And if you have a very inexpensive procedure that may cost less upfront, you're often going to accrue significant costs in having things fixed afterwards, saying nothing of possible health consequences of having a suboptimal procedure. So I hope that this provides some framework for you and your decision making as you go about investigating the right kind of liposuction procedure for yourself.
And I will just add that these are ranges and just what I've seen in my personal experience in New York City, but this really can vary significantly by surgeon and by the difficulty of the case and by several of the other factors that we've discussed.