LARGE VOLUME HIGH-DEFINITION LIPOSUCTION
LARGE VOLUME
liposuction - Houston
Liposuction is a minimally invasive body contouring procedure that suctions localized fat cells from the body to slim and smooth stubborn areas that have been unresponsive to traditional weight loss techniques such as diet and exercise. This procedure has successfully helped patients achieve an enhanced appearance for many years.
Although effective, the conventional liposuction procedure was often painful and involved long recovery times. New technology has allowed for different liposuction techniques that improve the accuracy and reduce the pain associated with this procedure. Today, liposuction can be performed using the tumescent technique or with the help of ultrasound imaging or a laser, which has transformed liposuction into a much safer and less invasive procedure.
Dr. De La Cruz performs both the traditional suction-assisted lipectomy (liposuction), and VASER Liposuction.
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What is a VASER?
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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.
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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.
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What is the 4D VASER Hi-Definition Liposuction?
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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.
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This procedure may involve transferring fat to different areas of the body, such as the chest muscles in men or buttock in women (Brazilian Butt Lift), to enhance one's features.
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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.
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Make sure your plastic surgeon is certified and trained to perform the 4D VASER High-Definition liposculpture.
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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.
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Dr. De La Cruz has been invited to speak at prestigious conferences such as The MEETING 2020 by the American Society of Plastic Surgeons, the AestheticStanbul Meeting, and the TD ABS Plastic Surgery Meeting in Cartagena, Colombia. Additionally, his expertise has been recognized by reputable publications in the field, including "Clinics in Plastic Surgery," where he authored an article titled "Lipoplasty in the Overweight Patient." This publication highlights his use of advanced techniques and unwavering dedication to patient safety in plastic surgery.
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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 Large Volume Hi-Definition Liposuction (2 months after surgery) performed by Dr. Emmanuel De La Cruz, Houston Plastic Surgeon
Figure 2: Before & After Photos of 4 D VASER Liposuction (Back View 2 months after surgery)
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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:
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Stomach
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Arms
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Back
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Hips
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Knees
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Love handles
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Saddlebags
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Neck
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Chin
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Thighs
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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.
Figure 3: Before & After Photos of 4 D VASER Liposuction (Oblique View 2 months after surgery.) Procedure performed by Dr. Emmanuel De La Cruz M.D.
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What happens during the 4D Hi-Definition liposuction procedure?
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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.
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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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What is the difference between VASER Liposuction versus Traditional Liposuction?
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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
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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.
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Multiple Advanced Technologies Combined for Large-Volume Liposuction
Maximizing Safety, Precision, and Aesthetic Outcomes
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Dr. Emmanuel De La Cruz strategically combines multiple cutting-edge technologies to optimize results for patients undergoing large-volume liposuction. Each modality plays a unique role in enhancing fat removal, minimizing trauma, and tightening skin for a more refined, natural-looking outcome.
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1. VASER® Liposuction (Ultrasound-Assisted Liposuction)
VASER liposuction utilizes ultrasonic energy to selectively emulsify fat while preserving surrounding tissues, including nerves and lymphatics. This technique is particularly effective for:
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Breaking down dense, fibrous fat commonly seen in lipedema or revision cases
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Enhancing fat removal precision in large-volume procedures
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Minimizing bleeding, bruising, and postoperative pain
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Improving skin retraction and contour smoothness
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By liquefying the fat before extraction, VASER allows for a gentler and more controlled removal process, reducing the risk of contour irregularities.
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2. MicroAire® Power-Assisted Liposuction (PAL)
MicroAire PAL utilizes a vibrating cannula to mechanically dislodge fat, making it easier to extract—especially in areas of fibrosis or previously treated zones.
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Works synergistically with VASER for enhanced fat disruption
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Reduces trauma to surrounding tissues, leading to faster recovery
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Allows for precise sculpting in difficult anatomical areas
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Improves consistency in high-volume fat removal
This dual-approach (VASER + PAL) is particularly advantageous in treating lipedema, secondary liposuction cases, or large-volume body contouring.
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3. Renuvion® (J-Plasma) or Quantum RF with Morpheus8
To address skin laxity following large-volume fat removal, Dr. De La Cruz incorporates advanced radiofrequency-assisted skin tightening technologies:
Renuvion® combines helium gas and radiofrequency energy to create a cold plasma stream that precisely heats subdermal tissues, triggering immediate collagen contraction and long-term remodeling.
Quantum RF with Morpheus8® uses deep fractional RF microneedling to stimulate collagen and elastin production at multiple skin depths, leading to significant skin contraction and improved tone.
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Both modalities:
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Enhance skin tightening from within
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Improve final contour definition
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Reduce the need for surgical skin excision in select cases
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Contribute to a smoother, more youthful appearance
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Why This Multi-Modality Approach Matters?
By combining these technologies—VASER, MicroAire, and Renuvion or Quantum RF—Dr. De La Cruz offers patients:
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More comprehensive fat reduction
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Minimized downtime and complications
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Superior skin tightening without extensive incisions
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Harmonious, high-definition body contouring
This integrative approach is especially beneficial for patients undergoing large-volume liposuction, lipedema surgery, or post-weight loss body contouring.
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Patient Safety During Surgery
Dr. De La Cruz values patient safety during your surgery. For large volume high-definition liposuction, there are certain criterias that should be met before your plastic surgery.
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For patients who have co-morbidities, such as Diabetes, obstructive sleep apnea, a medical and cardiac clearance are required prior to surgery. For patients whose age >45, a cardiac clearance from a cardiologist is required by Dr. De La Cruz prior to your surgery. Safety is priority in our practice.
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Prevention of Infection: During your surgery, a peri-operative intravenous antibiotics are given to prevent a wound infection. Fat that is harvested for fat transfer (if included in your procedure) will be washed with antibiotic irrigation to further reduce your risk of infection.
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DVT Prophylaxis: Dr. De La Cruz calculates your Caprini Score to evaluate your risk for Deep Venous Thrombosis. All patients would have an intermittent sequential compression device during your surgery to prevent a DVT. Moreover, an anti-coagulant, such as Heparin or Lovenox, is given to further reduce your risk for a Deep Venous Thrombosis.
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For large volume high-definition liposuction patients, all patients are admitted in the hospital overnight to monitor your recovery. A hospitalist and Dr. De La Cruz would typically oversee your care while you are in the hospital.
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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.
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How long does recovery take?
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. 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.​
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When will results be visible?
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.
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What is Large Volume Liposuction?
Large volume liposuction is when the liposuction aspirate exceeds over 5 Liters. Certain states, such as New York and Florida, are limited to 4-5 Liters of fat that can be aspirated. The maximum amount of fat that can be harvested or aspirated depends on the amount of tumescent fluid and lidocaine in the tumescent fluid infused. One cannot exceed over 35 mg/kg of lidocaine in the tumescent fluid. Some studies have shown that the safety level of lidocaine in the tumescent fluid that can be infused can be up to 50 mg/kg. Dr. De La Cruz does not exceed over 35 mg/kg to avoid any adverse outcome from lidocaine toxicity.
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Is there any criteria or pre-operative requirements before Large Volume Liposuction?
Dr. De La Cruz requires a cardiology clearance from a Board-certified cardiologist for all patients undergoing large volume liposuction. Safety is our number one priority.
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Where is the procedure performed?
Large volume high-definition liposuction is performed either in a hospital or an accredited ambulatory surgery center. Patients will be subsequently admitted overnight for observation, and for fluid maintenance. Dr. De La Cruz will oversee your care while you are in a QUADA and state-certified ambulatory surgical facility after surgery.
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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.
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Patients can reduce these risks by choosing an experienced doctor, such as a plastic surgeon, to perform their procedure and by following their doctor’s instructions before and after treatment.
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» Schedule your Liposuction Consultation with Dr. De La Cruz today by calling 832.776.1134