The most exciting part of a liposculpting surgery, especially for the patient awake, is the aspiration of the fat, as the fat is suctioned with a cannula, travels in the tubing, and is deposited in the fat canister. Patients are in awe and satisfied to see that finally, those pockets of stubborn, accumulated fat will be gone for good.

Local tumescent anesthesia fluid is used to anesthetize the areas treated by liposuction. Upon
aspiration, fat and blood-tinged tumescent anesthesia fluid will be extracted. Aspirate fills the canister and settles, the contents divide into:

• A top layer of oil
• A yellow layer of fat (supranatant fat) FAT FLOATS!
• A bottom layer of blood-tinged anesthetic solution (infranatant fluid)


• The total aspirate volume is an inaccurate measure of post-operative complications as the vasoconstriction offered by the tumescent anesthesia eliminates surgical blood loss.
• It is essential to maintain the extract count, as the amount of pure fat taken out at a time varies by state/country regulations. This regulation is for patients’ safety.
• The patient’s size and amount of areas to be treated are essential factors in maintaining the patient’s safety and avoiding potential complications.
• At the end of the surgery, the total volume collected in the canisters is added. Then the total is divided into what is pure fat and blood-tinged-tumescent anesthesia fluid.
• Sufficient time (> 30 minutes) needs to pass for the fat and the tumescent fluid to separate. The time passed will provide a good indication of the volume of fat aspirated.
• Factors that will determine the supranatant volume/infranatant volume ratio, making the aspirate contain more infranatant tumescent fluid, are:
• Time elapsed between the completion of anesthesia fluid infiltration and the beginning of surgery
• Fibrous areas of liposuction
• Males (more fibrous fat)
• Patients that have lost significant weight
• Experience in the liposuction technique

Safety is always first, but patients will always ask about the amount of fat extracted as they will still be in awe and fascinated by how much was taken out of their bodies. Safety + results = satisfied patient.

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