The Question

Sometimes, patients ask a series of questions which can be answered under one rubric. This is particularly true when it comes to fat transfer and lipo questions, such as the questions our Ask Dr. Pane segment focuses on this week. The viewer, from our Instagram crowd, asks, “How much fat can be removed at one time? And how much can be transferred?” Dr. Pane appreciated this question because it gave him a chance to address several facets of liposuction treatment which are rarely discussed in a public forum, making it an important one to address.

The Answer

Dr. Pane noted his answer is Florida-specific, because of the state’s unique history with cosmetic surgery and physicians who have pushed the envelope in the past, with sometimes unfortunate results.
Under Florida state law, physicians performing liposuction in an office setting may remove up to four liters of fat from a patient in a single session. That’s actually a lot! To visualize this, Dr. Pane said, imagine going to the grocery store and picking up two 2-liter bottles of soda. The majority of people don’t have that much excess fat in their entire bodies, so it’s a fairly liberal upper end, as such things go. In addition, this doesn’t take into account other fluids which are removed during liposuction, which can increase the volume of material removed from the patient significantly.
If you can remove fat from a patient, you can also replace it, within limits. Theoretically, you could transfer all the fat taken from a patient back into them with minimal difficulty. In the case of a Brazilian butt lift, this would work out to a theoretical upper limit of 2000ml of fat per buttock. However, a great deal depends upon the elasticity of the skin and the patient’s overall build. For a small patient, Dr. Pane says 600-800ml of fat per side is generally the high end, while medium-sized patients may be able to accommodate up to 1200ml per side of transferred adipose tissue and larger patients top out around 1500ml per buttock.
The thing to keep in mind is that these numbers assume a number of variables. First, we assume the patient wants to go “as big as you can.” Second, the patient’s skin must be sufficiently supple and flexible to accommodate an abrupt increase in volume of one-third to three-quarters of a liter per side. Third, the patient’s initial build and weight must have sufficient available fat already to allow a safe fat transfer. Finally, the initial starting point must be taken into account, as well as the intended outcome.
Dr. Pane notes he is very comfortable with high-volume fat transfer procedures, and has a very low rate of post-operative issues. Many of the horror stories people see on the news about fat transfer procedures may largely be down to issues with the techniques used or improper patient evaluation. Dr. Pane says in his practice, he tends to be very close in his estimates about how much fat is available and what sort of results the patient can expect. He attributes this to experience and the fact he’s done a lot of these procedures, so he’s familiar with the outer limits of what can and cannot be done. Emphasizing the patient being able to see a visible and satisfactory difference versus a numbers game of “how big we can go” also has a positive impact on overall patient outcomes.
The best way to achieve a good result from your cosmetic surgery is to seek out a qualified physician with the experience and proven, verifiable track record to deliver an outcome which will work with your body size and shape and minimize the chances of complications. However, following post-operative aftercare recommendations and keeping follow-up appointments to evaluate the success of the procedure are just as important.

If you have a question about any aspect of cosmetic surgery, Dr. Pane and the staff of ACA welcome the opportunity to discuss your interests and concerns. Simply follow us on Facebook, Instagram, Twitter and LinkedIn; call us at (561) 422-4116; or send us an email. Your question might be selected as the topic of an upcoming Ask Dr. Pane segment, allowing us to inform and educate other patients who share your question while giving you the honest answers you need to make informed decisions and advocate for your own best outcomes. Remember, at ACA we believe the only bad question is the one you don’t ask!