Traditional vs. High Definition Liposuction
Plastic surgeon preparation, marking the breast of a man

This 37 year old man desired a more athletic physique. He worked out extensively, but still had unwanted fatty tissue over this tummy, love handles. He had two procedures almost one year apart. He provides a unique opportunity to see: 1. How do the results from Traditional (water and power liposuction) compare to High Definition Liposuction with VASER, and 2: what happens when you gain weight after liposuction.

Comparing Types of Liposuction

Prior to coming to see me, at age 35, this man had tried laser liposuction, also called Smart Liposuction. I do not recommend or use Laser liposuction or Smart Lipo because of the intense scarring that results from this type of energy. While very popular in 2007 when first introduced, it is not the best type of liposuction today.

Water liposuction is a very effective yet gentle type of liposuction. In his case, having had previous laser liposuction that created scar tissue, the water liposuction was not strong enough to remove the fat. Power liposuction is a type of machine that uses electrical energy to vibrate the cannula. A more aggressive approach with Power liposuction and a larger cannula was able to remove enough fat to give him better shape. A total of 2 lbs of fat was removed over 95 minutes from this abdomen and love handles in the first procedure.

Weight Gain After Liposuction

When this man returned for follow-up 8 months later, he had gained 24lbs and wanted more sculpting. His tummy is flatter, his posture is better, but he has regained fat in the love handle lower back area.

At his second procedure, VASER ultrasonic-assisted liposuction was used to remove additional fat from the same areas. Using the High Definition Liposuction Approach, fat was specifically removed from different areas with the intention of creating shape and definition, not simply to remove fat. You can see in the photo on the left how his back is more defined. The lower chest, the pelvis and buttocks have shape. Looking at his profile, notice how the chest is now more projecting and his spine and posture are straighter. There is more mass of the chest compared to the tummy and waist, reflecting a masculine shape. In the front view, you see how the muscular definition of the rectus and oblique muscles creates an athletic torso reflecting his true muscle development. With the High Definition Liposuction approach, the muscular anatomy, the midline (linea alba) and the lateral V lines (linea semilunares) all have definition. Because there are natural ligaments from the skin to the deeper muscle, when the fatty tissue layer over the inscriptions is made thinner, the muscle shape is defined. It is the three-dimensional contouring that produces the shadows and highlights that create the etching effect.

Why did his love handles come back when he gained weight?

It is interesting to notice that with his weight gain, his tummy remained flat, but his love handles got larger. When you gain weight, every fat cell in your body will get larger (hypertrophy). Liposuction permanently removes fat cells. Fat cells do not grow back. So ,what you are seeing in his love handles is the remaining fat cells that have gotten larger as the body continues to try and store fat in that area. The tummy fat cells were more completely removed in the first operation and so the tummy remained flat.

High Definition Liposuction Results

High Definition Liposuction is a more advanced approach to body sculpting. It has more recovery and can have complications. It is not a procedure I suggest for the occasional liposuction surgeon. It requires an intense understanding of the underlying anatomy and how to sculpt the fatty tissue layers to make the muscles stand out. The results from High Definition Liposuction can be outstanding, especially in the athletic male patient.

Schedule a Consultation

If you are ready to schedule a High Definition Liposuction procedure or if you need more information, Gina is here to help you. She is an amazing patient coordinator and can arrange either a virtual or in-office consultation for you to meet Dr. Ditesheim. 704-542-8686 or

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