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Liposuction is a minimally invasive body contouring procedure that effectively removes localized fat cells from the body, resulting in a slimmer and smoother appearance in areas that have been resistant to traditional weight loss methods such as diet and exercise. Over the years, this procedure has proven to be highly successful in enhancing patients' aesthetic outcomes.


However, conventional liposuction techniques were often associated with significant pain and prolonged recovery periods. Fortunately, advancements in technology have revolutionized the field, allowing for the development of new liposuction techniques that prioritize accuracy and minimize patient discomfort. Today, liposuction can be performed using the tumescent technique, Ultrasonic-assisted (VASER Liposuction), and Radiofrequency-assisted devices (Renuvion and/or Bodytite), transforming it into a safer and less invasive procedure.

What is VASER Liposuction?

  • VASER stands for Vibration Amplification of Sound Energy at Resonance.  It's is a 3rd-generation ultrasound-assisted lipocustion tool that delivers energy in pulses through a specially designed probe. The Vaser instrument used during surgery liquefies the fat and allows the surgeon to target specific areas of the body.   

  • The VASER device is capable of selectively delivering ultrasound energy to liquefy the fat in the body without damaging other types of tissues. Once the fat has been melted, it can be suctioned out of the body through very small 2.2 mm to 3.7 mm sized cannulae without causing great trauma to the surrounding tissue structures.  Thus, the incisions made are less than 5mm in size.

What is the 4D VASER Hi-Definition Liposuction?

  • The 4 D High-definition liposuction, also known as hi-definition liposuction, hi-definition liposculpture, or simply hi-def lipo, is a surgical procedure  that involves suctioning excess fat out of target areas of the body to create a slim, muscular and athletic appearance in different areas of the body.     

  • This procedure may involve transferring fat to different areas of the body, such as the chest muscles/Trapezius/Deltoids in men or buttock in women (Brazilian Butt Lift), to enhance one's features. 

  • Typically the procedure may involve liposculpture of the arms, abdomen, flanks, back, and possibly thighs.  This would be based on an individual basis since every patient is different.

  • Make sure your plastic surgeon is certified and trained to perform the 4D VASER High-Definition liposculpture.  

  • Dr. De La Cruz learned the art of the 4D VASER High-Definition Body Sculpting with Dr. Alfredo Hoyos in Bogota, Colombia in addition to 9 years of surgical training in Plastic Surgery, General Surgery and Microsurgery in the United States.

What surgical technologies are used in the High-Definition Liposuction performed by Dr. De La Cruz?

  • VASER Liposuction Machine - This emulsifies the fat which is associated with less bleeding, less contour irregularities and more skin retraction.

  • Vent X Cannulae System - The liposuction cannulae system was designed to minimize trauma to the surrounding tissues during aspiration.

  • MicroAire Power-Assisted Liposuction-  This technology enables the surgeon to remove more fat in less time for a safer and faster recovery.  The removal of fat is more efficient in which the cannula moves through your tissues quickly and smoothly.

  • Renuvion or J-Plasma - This technology uses radiofrequency energy that is converted to plasma.  The plasma energy is placed underneath the skin which causes retraction of the fibrous septa and retraction of the skin. 


Who is a candidate for liposuction?


Liposuction is ideal for patients who are in good overall health and maintain a healthy lifestyle, but have one or more problem areas with unresponsive fat deposits. It is important to realize that liposuction is not a means for major weight loss, but instead removes localized areas of stubborn fat after the patient has attempted other natural weight loss methods.

Figure 1: Before & After Photos of 4D VASER Hi-Def Liposuction of the Abdomen & Flanks (2 months after surgery) performed by Dr. Emmanuel De La Cruz, Houston Plastic Surgeon

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Figure 2: Before & After Photos of 4 D VASER Liposuction (Back View 2 months after surgery)

What areas of the body can be treated with liposuction?


Liposuction can be used to remove unwanted areas of localized fat from nearly any area of the body, and is most commonly used on the:

  • Stomach

  • Arms

  • Back

  • Hips

  • Knees

  • Love handles

  • Saddlebags

  • Neck

  • Chin

  • Thighs

In many cases, more than one area can be treated during the same procedure in order to reduce operating costs and recovery times. Your doctor will develop an individualized treatment plan for you during your initial consultation.The results of liposuction can be permanent as long as patients maintain a healthy and active lifestyle. If substantial weight is gained after this procedure, results may be altered.

Figure 3: Before & After Photos of 4 D VASER Liposuction (Oblique View 6 months after surgery.)  Procedure performed by Dr. Emmanuel De La Cruz M.D.














Figure 4: Before And After Photos of VASER Hi-Definition Liposuction with Renuvion performed by Emmanuel De La Cruz MD, Houston Plastic Surgeon.

What happens during the 4D Hi-Definition liposuction procedure?

  • This procedure consists of  high-definition liposculpting of the abdomen, flanks, back, arms, and  possibly the thighs or chest in men with gynecomastia.  This procedure also involves reshaping the buttock in women as well which would involve either liposculpture or fat transfer to the buttock.  In men, fat may be transferred to the deltoids to improve the shoulders or to the chest to create a more masculine pectoralis muscle. 

  • The extent of the procedure varies from individual to individual since every patient is different.  Dr. De La Cruz will tailor the procedure based on the patient's body habitus and based on what the patient desires.

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Video: 6 months after 4D VASER Hi-Def Liposculpture performed by Dr. De La Cruz

What is the difference between VASER Liposuction versus Traditional Liposuction?

  • Recent randomized clinical trials showed that the VASER liposuction is superior over traditional liposuction methods.    With the VASER liposuction, there is LESS BLEEDING, and MORE SKIN RETRACTION compared to traditional liposuction methods. [1]

[1] Nagy, et al.  A multicenter, prospective, randomized, single-blind, controlled clinical trial comparing VASER-assisted Lipoplasty and suction-assisted Lipoplasty.  Plastic Reconstructive Surgery  2012 Apr;129(4):681e-9e 

  • There's also less contour irregularities with the VASER liposuction in the hands of an experienced plastic surgeon.   Dr. De La Cruz refined and honed his lipoplasty techniques, especially the 4D VASER liposuction, under the tutelage of Dr. Alfredo Hoyos, the pioneer of the 4D VASER High-Definition liposculpture.  

Is  Lipo360 the same as Hi-Def liposuction?

  • Lipo360 is a comprehensive liposuction procedure that specifically targets the abdomen, flanks, and back. While some surgeons may claim that Lipo360 involves liposuction of the entire body in supine and prone positions, it is important to note that true Lipo360 entails liposuction performed in the supine, lateral, and prone positions. This multi-position approach allows for a more thorough and precise removal of excess fat in the targeted areas.

  • Furthermore, it is worth mentioning that hi-def liposuction can be effectively combined with Lipo360 to further enhance the aesthetic outcome. By utilizing advanced liposuction techniques, such as hi-definition liposuction, Dr. de la Cruz has developed expertise in performing true Lipo360 procedures that yield superior results.

  • With extensive experience and a focus on achieving optimal body contouring, Dr. de la Cruz is renowned for his proficiency in performing true Lipo360 with hi-definition liposuction techniques. Patients can trust in his expertise, as he consistently delivers professional and authoritative results in the field of liposuction.

Patient Safety during Surgery


Dr. De La Cruz values patient safety during your surgery.  For the 4D VASER high-definition liposuction, there are certain criterias that should be met prior your plastic surgery.

  1. In order to ensure the utmost safety and well-being of our patients, it is imperative that individuals with pre-existing medical conditions such as diabetes, obstructive sleep apnea, and hypertension undergo a thorough medical evaluation before undergoing surgery at our esteemed practice. Dr. De La Cruz, in adherence to the highest standards of care, requires cardiology clearance from a board-certified Cardiologist prior to any surgical procedure.

  2. Prevention of Infection:  During your surgery, a peri-operative intravenous antibiotics are given during your surgery to prevent a wound infection. If fat transfer is involved, such as the Braziliant Butt lift procedure, the fat that is harvested is washed with antibiotic irrigation to further reduce your risk of infection.

  3. DVT Prophylaxis:  Dr. De La Cruz calculates your Caprini Score to evaluate your risk for Deep Venous Thrombosis. To effectively prevent DVT, we will be employing an intermittent sequential compression device (ISCD) for all patients throughout the duration of the surgical procedure. This device has demonstrated exceptional efficacy in reducing the risk of DVT.  In addition to the ISCD, you will be administered an appropriate anticoagulant medication, such as heparin or Lovenox, to further decrease the likelihood of developing DVT.    After surgery, a carefully selected oral anticoagulant will be prescribed to you to continue promoting a minimized risk of DVT. These measures have been thoughtfully implemented to ensure your safety and well-being throughout the entire surgical process.

  4. For large volume high-definition liposuction patients, all patients are admitted in the hospital or Certified Ambulatory Surgery Center overnight to monitor your recovery.   

  5. The use of the VASER liposuction system is associated with less bleeding when it comes to large volume liposuction.  A randomized clinical trial had shown that the VASER liposuction is associated with less bleeding during surgery when compared with traditional tumescent liposuction.  This is key when it comes to large volume liposuction.  It is essential to minimize your risk of bleeding when it comes to undergoing this procedure.

How long does recovery take?  Typically 1 (one) week


After the liposuction procedure, patients will be able to return to work and other regular activities as soon as they feel comfortable, which is usually after a few days (1 week). Exercise and other strenuous activities should be avoided for a few weeks. It is not uncommon to experience mild swelling, bruising and discomfort in the treated area, which can be reduced through pain medication and the use of compression garments.

When will results be visible?  Around 8 weeks or less


The results from the liposuction procedure are often visible right away, but will continue to improve as swelling and bruising subside. Typically, one would see the results 8 weeks after surgery.  Swelling will continue to decrease, and skin will continue to retract up to 6 months after surgery.  Scars usually heal well and will fade with time to become less and less noticeable.

The results of liposuction can be permanent as long as patients maintain a healthy and active lifestyle. If substantial weight is gained after this procedure, results may be altered.

Is Lymphatic Massage Therapy Important After Liposuction?  Yes

Lymphatic massage therapy is a crucial part of the recovery process after liposuction. It helps reduce the risks of complications like seroma (accumulation of fluid), uneven contours, and fibrosis (hardening of tissues). Whether you're having liposuction for the first time or getting a revision surgery, it's important to include this therapy in your treatment plan. We recommend at least 10 (ten) lymphatic massage therapy.  It is recommended to start lymphatic massage therapy one day after your surgery.

Our skilled therapists are dedicated to providing the best care possible, and they have the expertise needed to ensure you have the best possible results from your liposuction procedure.  

How long do we need to wear the compression garments after liposuction?

Wearing a highly compressive garment after a liposuction procedure is crucial for optimal results. Our patients are required to wear at least two garments during their recovery.

1)  The foam corset garment should be worn for a minimum of two months to prevent complications such as seroma, fibrosis, and pressure sores caused by the garment.

2)  Additionally, a highly compressive garment should be worn for six months as the skin continues to retract during this period. This ensures a consistent and uniform skin retraction, leading to the best possible outcome from the procedure.

Are there any risks or complications associated with liposuction?


Liposuction is considered a safe procedure with only minimal downtime and a low occurrence of mild side effects. However, as with any kind of treatment, there is a risk of complications such as infection, scarring, allergic reactions, hematoma or unsatisfactory results. Liposuction is one of the most commonly performed cosmetic procedures and is almost always performed with no serious complications.

Patients can reduce these risks by choosing a board-certified plastic surgeon to perform their procedure and by following their doctor’s instructions before and after treatment.

Emmanuel De La Cruz MD, PLLC

Double-Board Certified Plastic Surgeon

Diplomate, American Board of Plastic Surgery

Diplomate, American Board of Surgery

» Schedule your Liposuction Consultation with Dr. De La Cruz today by calling 832.520.1844

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