Liposuction (liposculpting)

Why is liposuction the most performed surgical procedure in the world? It is because without a liposuction is not possible to get the skin tightness once you have gained the fat. When fat is lost with diet and exercise only a portion of the external fat is lost with resulting looseness of the skin. In short, anybody who is overweight and would like to get back into the best shape possible with diet and exercise should start with liposuction of the excess outer fat layer in affected areas before going on a diet and exercise program. Please review the pictures of skin loss after weight loss. Why should everybody be interested in doing the liposuction only under local anesthesia? It is because liposuction is a cosmetic procedure and there is no need to risk you life when you are only trying to get into a better shape. Traditional liposuction under general anesthesia carries a death rate about 1/5000 in developed countries like USA. Invariably the death rate must be higher in Sri Lanka. You can read more about the safety of our technique here. Usually you have to come for a consultation about two to three weeks before booking the surgery. The procedure takes about two to four hours and you get to go home right after that. Since we are usually booked for 2-3 weeks ahead of time it is important to get your consultation early. Usually the area gets swollen for two weeks after the surgery. If you are planning to look good for an event it is important to plan for the procedure about one month prior to the event.

Dr Nimal Gamage is introducing the latest and safest techniques of liposuction to Sri Lanka. Old technique with general anesthesia has the risk of mortality. Mortality depends on the medical conditions and the age of the patient. It can average about 1 death for 5000 liposuctions according to several studies. When several areas of the body is done at the same time the risk increases to about 1 death for 3000 patients. These numbers are from USA and Europe where hospital standards are at their best.  For the best results it is important that you have a surgeon with ample experience in the latest techniques. Dr Nimal Gamage has done a very large number of liposuctions (over 11000) during the past several years with the new techniques and is able to recommend the best procedure and get the best results for your given situation.  According to a new study and Dr Nimal Gamage's experience fat does not return after a properly done liposuction.  Read the study here.  The proper technique is a must for safety. Dr Gamage has performed over 12000 liposuction without a single incidence of mortality, infection, pulmonary embolism proving the superiority of his meticulous technique.  Here is the history of liposuction and more technical details. Understand the complications of General Anesthesia including death.

The removal of fat via liposuction requires disruption of adipose tissue and the intrinsic collagen-based septal fiber network that supports and protects the blood and nerve supply to adipose tissue. When studies were done to see which technique preserved the septal fibers power assisted liposuction was shown as the best technique with highest preservation of septal fibers. Ultrasound liposuction techniques as well as traditional liposuction techniques destroyed more of the septal fibers. Laser techniques did not damage the septal fibers but did not remove enough fat.  It also damaged nerves and some patients had died of damage done by the laser liposuction techniques. There is nothing smart about using laser liposuction techniques. You can never use the laser liposuction extracted fat for fat grafting since fat cells are irreversibly damaged when laser is applied.

With the new techniques the liposuction can be performed without general anesthesia. Only the fat collection is numbed using an injection of a specially prepared solution. The fat becomes softer within minutes of the injection. Lean More about tumescent liposuction. The solution has a very small concentration of epinephrine which causes closure of blood vessels minimizing the risk of fat embolism and bruises. The numbing causes only minimum discomfort to the patient. After the numbing is over the rest of the procedure is painless. The patients are usually able to carry on a normal conversation or listen to music and relax. Many patients fall asleep due to the comfort of the procedure which is felt like a deep massage.

With Exclusive tumescent local anesthesia there have not been any mortalities. About 400,000 of these procedures had been performed worldwide yet there had not been any risk of mortality associated with this technique. Dr Nimal Gamage has performed over 10500 of liposuctions using only local anesthesia. Procedure starts with a small local anesthetic injection to the skin. Following that, the fat is numbed using a tumescent solution which dissolves the fat. Liposuction is performed using Power Assisted Liposuction technique. This technique provides faster and more complete removal of the fat collection with less trauma when compared with the old technique. For example during the traditional liposuction blood loss is much higher and in some cases blood transfusions become necessary. With Dr Nimal Gamage's unique technique under local anesthesia blood loss is about one test tube and there is no risk of internal bleeding.

        Liposuction of the abdomen involves the area above and below the belle button and the sides. The procedure can be performed in about 4 hours depending on the size of the fat collection. The incisions are only about 2mm and usually heal with a very small scar. In most patients it is difficult to see this scar after about three months. Before the surgery patients require a consultation for preoperative assessment. Once selected for the procedure patients are asked to avoid taking aspirin, vitamin E and Garlic for a period of about two weeks. Patients who are on coumadin for medical conditions are not good candidates for this surgery. Patients are able to have their regular meals even on the day of surgery. It is best to avoid drinking a lot of water. Patients are usually able to go to the toilet in the middle of the surgery if necessary. Patients are required to wear bandages to keep the skin tight for only 24 hours after the surgery. With the tumescent anesthesia there is minimal bleeding unlike the traditional liposuction therefore long term compression garments are not necessary. Long term compression only increases the risk of skin complications such as skin blisters and contact dermatitis.

        Even if you have a very large stomach you can get that removed safely. The legal limit of fat removal is 1500ml in one sitting in one area.

       Here is one of our recent Sri Lankan patients who posed happily right after she had 1300cc of pure fat (Supernatant Fat) removed from her abdomen. We are planning to do a tummy tuck in a few months to give her a flat stomach. We recommend exercises to the abdomen to be started one week after the liposuction.

         Even a large volume of fat can be safely removed with this procedure. Patients as young as 12 yrs and as old as 82 yrs have undergone this liposuction safely. Many patients with hypertension or diabetes have had liposuction as long as their conditions are under control. Patients are able to take their regular medications on the day of surgery.

        One week after liposuction patient can start doing exercises to improve abdominal muscles.

             Before                                       After

        For male patients lower back fat collection can be quite bothersome. For female patients like the one above the upper back and lower back collections of fat hide their underlying shape. With the laser liposuction you can remove all of that fat and improve the shape within weeks.


        Fat collections under the arm can be quite bothersome for females. The collection of fat in this region is called a batwing collection. Fat can be removed with resulting tightness of the skin. In a few cases the patient may require an arm tuck to remove the excess skin caused by the fat collections.

       This is a patient who underwent multiple liposuctions on different occasions. The results she obtained after removing the underarm fat is shown here. The incision was placed close to the elbow and at the shoulder. The loose skin has tightened following the surgery and the patient did not need an arm tuck.

         Even a very large collection of arm fat can be removed successfully to improve the underarm hanging skin. This a a recently performed arms liposuction of a Sri Lankan Patient.

        Liposuction is not only reserved for females. Above picture is from a male patient who had liposuction of the chest and abdomen to obtain better definition of his musculature.

        Liposuction has been used remove about 500ml of the fat from this man's chest to obtain the result on the right. 

       Above results were obtained just after two days of the chin and lower face liposuction.

               Before                                         After

       Even with a larger collection of fat under the chin and in the lower face just one liposuction can enhance the jaw line and make you look years younger and prettier in a few weeks.


        Above is the results obtained in two weeks following chin neck and lower face liposuction. The skin incisions are only 2mm and the patients are able to recover from the initial swelling in about 4-5 days. This picture is from a Sri Lankan patient. Fat collections under the chin can be a common problem for males and females. You can look prettier as well as younger by removing this fat collection. Usually the loose skin will tighten with two months.


        Liposuction of breast can reduce the uncomfortably big breast to a comfortable size without cutting.

        Liposuction with our new techniques provide the best option for male breast enlargement which occurs with puberty. In some cases it can be repeated in about three months to obtain better skin tightening.


        Outer thigh collections of fat or "Saddle Bags" are common in females. It usually is associated with cellulite. Cellulite is the abnormal collection of fat associated with dimpling of the skin. Dimpling is caused by fibrous tissue pulling on the skin. Traditional liposuction is not suitable for cellulite.



         This patient had an abnormal collection of fat in her buttocks. It was successfully removed with liposuction restoring a more attractive shape for her buttocks.

        There is a big difference between Dr Nimal Gamage's techniques and the old techniques done under general anesthesia by plastic surgeons of Sri Lanka. Not only do our techniques have no risk to life, it also gives better results without irregularities of the skin. Below are two examples of bad results I had seen in two Sri Lankan patients. Patients should  seek the most qualified surgeon if they don't want permanent ugly scars.


          Six pack abs

         This is how a natural six pack abs look like.   Once you remove the fat from the abdomen with high definition liposculpting you have to maintain your body with regular exercises to obtain a six pack.

        Lipomas which are benign tumors of the fatty tissue can be successfully removed by liposuction through a small hole. In these cases high pressure tumescence combined with suction is used for good results which can be seen in the above before and after pictures.

These are instructions to be followed after liposuctio

1.     Wear the bandages for a day.

2.     A quick shower is ok. Do not swim or go under water until the tiny holes have healed and closed in about three days.

3.     There will be some pain starting on the second day for which you may take pain medication. It is ok to take two panadol tablets every four hours.

4.     Avoid aspirin and vitamin E for two weeks.

5.    Avoid lifting weights over 25 pounds or doing heavy work such as running for one week.

7.     Eat and drink well for at least three days prior to starting a diet. 

8.     The dressings can be removed next day after the surgery.  It is good to keep a small plaster(bandaid) over the tiny holes.

9.     It is normal to see the swelling go down in about two weeks. You will see the full results of the liposuction in about two to three months.

Frequently asked question.

1. How soon after a liposuction can I see the results ?
Answer: It takes two weeks for the swelling to reduce. Best results are seen after about 3 month.

e. Will the fat come back after I get the liposuction ?
Answer: It is more difficult for your body to deposit fat in the same area. It is important to change your lifestyle and eat properly and exercise to prevent further fat deposition.

What are the major benefits of Liposuction to the patients

                Biggest benefit comes from the improved self esteem which results from enhancement of the body shape and beauty. The patients definitely make a greater effort to stay on a better diet and exercise program resulting in health benefits which are priceless. Proper diet for any human being is a Vegan Diet which promotes longevity, anti aging and weight loss. Prevention of heart disease, Cancer, Strokes and myriads of other degenerative diseases can be the biggest gift to our patients who are following the recommended life style. For more information please buy and read Dr Nimal Gamage's book "Secrets of everlasting youth"

Why is pain much less after tumescent liposuction. Read More






At a Glance: Plastic Surgery Costs

As with any major investment, the cost of plastic surgery is critical to almost any prospective patient's decision making process. Plastic Surgery Portal can help you schedule consultations with trusted, board certified plastic surgeons near you, but once you decide that a certain procedure is right for you, only you can determine what sort of plastic surgery costs will work within your budget.

Choosing a plastic surgeon should never come down to price alone. The investment is far too important. The good news, however, is that with plastic surgery costs dropping in recent years, it's quite likely that you'll pay considerably less for a breast augmentation or face-lift than you might have in years passed. Part of this is economy related, but part of it is also a result of better technology and greater demand for cosmetic surgery nationwide.

Below, you can find statistics on the average costs of plastic surgery, broken down by popular procedures. These numbers are based on an in-depth national study by the American Society for Aesthetic Plastic Surgery, conducted in 2009, and they include primary surgeon fees only. Extra charges may include facility fees, anesthesia, medical tests, and implant costs.

Average Cost of Blepharoplasty (Eyelid Surgery):

Average Cost of Breast Augmentation (Saline):

Average Cost of Breast Augmentation (Silicone):

Average Cost of Breast Reduction (Female):

Average Cost of Breast Reduction (Male, Gynecomastia):

Average Cost of Facelift:

Average Cost of Hair Transplant Surgery:

Average Cost of Liposuction (Tumescent):

Average Cost of Liposuction (Ultrasound-assisted):

Average Cost of Rhinoplasty:

Average Cost of Tummy Tuck: