Frequently Asked Questions

Liposculpture (also known as liposuction) is a cosmetic surgical procedure designed to remove localised deposits of fat to change body shape or proportions. It is not a weight-loss procedure. Liposculpture is a body-contouring tool that targets specific areas of unwanted fat. It is performed using Dr Klein’s tumescent local anaesthetic technique. In 1987 in California, USA, Dr Klein revolutionised liposuction by developing the tumescent technique, which involves carefully preparing and anaesthetising the fatty tissue before removal, along with the use of fine, blunt instruments known as micro-cannulas.

Liposculpture is a refinement in the technique of liposuction. Firstly, liposculpture is performed under local anaesthetic which makes it easier to achieve a regular, more even result, by assessing the patient at a later stage of the procedure. This is because it is possible to move into different positions and to stand up toward the end of the procedure which allows the effect of gravity to be seen on the areas that had liposculpture. This enables a much more predictable result to be achieved as more liposculpture is done to refine the areas and try to establish symmetry. 

Secondly, as no general anaesthetic is needed for liposculpture, the inherent risks associated with a general anaesthetic are avoided. 

Thirdly, liposculpture involves the injection of fluid into the fatty tissues before the procedure is performed. This fluid contains the local anaesthetic (lignocaine) and also a medication which effectively constricts blood vessels (adrenaline). Adrenaline vastly decreases the amount of bruising that occurs with liposculpture while the local anaesthetic produces effective relief of discomfort during the procedure and for up to 12 hours afterwards (and longer). 

Fourthly, liposculpture is day surgery. There is usually no need for the person having liposculpture to stay overnight in hospital or to have blood transfusions. You are encouraged to remain active following the procedure, walking soon after, and often returning to work after a few days to a week. Time off work and normal or vigorous activities is usually kept to a minimum. A week off work is advisable for most individuals.  

Liposculpture takes time to achieve the desired outcomes. The average procedure lasts 4 hours, especially when liposculpture of a few areas is performed. Smaller areas may only take up to 2 hours to do. In contrast, liposuction performed under general anaesthesia must be done in a shorter time as longer anaesthetic time increases anaesthetic risks. The recovery period is usually shorter with usually less bruising and less discomfort. However, due to different procedures, different patients will heal differently, and have different pain thresholds and will therefore experience different recovery times for different activities. The subcutaneous fatty tissue is thoroughly anaesthetised (numbed) and vasoconstricted when using the tumescent local anaesthetic technique and this generally contributes to a reduction of pain after the procedure. Liposculpture is performed by many doctors from many specialties.  

Dr Heckenberg is specifically trained in liposculpture. She is dedicated and will take the necessary time to strive for the desired results and performs only liposculpture and no other cosmetic surgery procedures. It is important to have these procedures performed by doctors who do the same procedures often, as with any surgery. Allowing enough time, using microcannulas and having patience are the most important factors when performing liposculpture.  

Risks associated with liposculpture are reported in international peer reviewed medical journals. These are made available to you and may be accessed below: 

Boeni, R., & Waechter-Gniadek, P. V. (2021). Safety of Tumescent Liposuction Under Local Anesthesia in 9,002 Consecutive Patients. Dermatologic Surgery, 47(5), e184–e187.  

https://journals.lww.com/dermatologicsurgery/Abstract/2021/05000/Safety_of_Tumescent_Liposuction_Under_Local.24.aspx 

This recent 2021 study comprising of 9,000 cases, also concluded that liposuction using the tumescent local anaesthetic technique “is a reliable and safe procedure if it is performed by an experienced surgeon and the guidelines of care are strictly followed”. 

 Dixit, V., & Wagh, M. S. (2013b). Unfavourable outcomes of liposuction and their management. Indian Journal of Plastic Surgery, 46(2),377. 

 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3901919/ 

 This detailed 2013 article compiles unfavourable outcomes, possible risk factors and their management associated liposuction and the importance of appropriate training in this procedure. 

 Hanke, C. W., Bernstein, G. S., & Bullock, S. (1995b). Safety of Tumescent Liposuction in 15,336 Patients. Dermatologic Surgery, 21(5), 459–462.   

https://journals.lww.com/dermatologicsurgery/Abstract/1995/05000/Safety_of_Tumescent_Liposuction_in_15,336.17.aspx 

A landmark article in the prestigious Dermatographic Surgery Journal reported the survey results of over 15,000 cases of liposculpture performed in America between 1994 and 1995. Authors concluded that complications during the procedure were few, as were problems following the procedure, and the level of complications was much less. Bruising is minimal, but does occur in most cases. It usually lasts for 10 to 14 days. Infections may occur with any surgery, but are fortunately quite rare and antibiotics are given before and after the procedure. Local areas of numbness may occur, although these usually resolve within a few months but may take up to a year. 

Dr Heckenberg is a medical practitioner specifically trained in liposuction / liposculpture. She holds a medical fellowship from The Australasian College of Cosmetic Surgery and Medicine (ACCSM) plus a specific fellowship in liposuction- the ACCSM Lipoplasty Fellowship. She is listed on the ACCSM Registry as an approved liposuction proceduralist: ACCSM Liposuction Registry. (https://www.accsm.org.au/cosmetic-procedures/liposuction)

Dr Heckenberg has been performing liposuction/liposculpture since 2008, completing over 1,600 procedures, and has been teaching other doctors this procedure since 2014. Liposuction/liposculpture is the only cosmetic procedure she performs, allowing her to maintain highly specific skills. She was appointed the clinical head of liposuction training for The ACCSM in 2025 and is a co-author of The ACCSM Liposuction Guidelines, updated in June 2023: https://www.accsm.org.au/images/uploads/images/accsm-liposuction-guidelines-revison-3-june-2023.pdf

She also holds Specialist Registration in General Practice (FRACGP, 1997; not practising as a general practitioner for over 27 years) and a Diploma in Obstetrics and Gynaecology (DRANZCOG, 1996), with extensive experience in outpatient reproductive health and gynaecological procedures since 1998. Over nearly three decades, her clinical scope of practice has been devoted entirely to surgical procedures. Medical registration number: MED0001158434

Dr Klein’s tumescent local anaesthetic technique is a method of providing local anaesthesia for liposculpture by infiltrating a large volume of dilute local anaesthetic solution into the subcutaneous (under the skin) fatty tissue before fat removal.

Before the procedure begins, this saline solution is injected into the fatty tissue. This solution contains:

• a local anaesthetic (lignocaine) to reduce discomfort during and after the procedure
• a medication (adrenaline) that constricts blood vessels, which reduces bleeding and bruising. 

In many patients, the effects of the local anaesthetic can last for several hours after the procedure. This technique allows liposculpture to be performed without general anaesthesia, while providing effective pain control during and for several hours after the procedure. Because effective local anaesthesia is used, general anaesthesia is not required. Instead, patients are mildly to moderately sedated. This allows patients to cooperate during the procedure by changing position when asked. At the latter stage of the procedure, patients are asked to briefly stand so that body contours can be visually assessed under the effect of gravity. When standing, gravity can make any remaining areas of fat more noticeable, helping to fine tune the result.

Larger total doses of lignocaine can be administered into subcutaneous fat using the tumescent technique because absorption of lignocaine into the bloodstream is slow. This is different from tissues such as muscle or skin, where absorption is faster and higher peak blood levels can occur.

The slow absorption of lignocaine from fatty tissue occurs for several reasons:

• Low blood flow in fatty tissue
  Subcutaneous fat has a relatively low blood supply compared with muscle or other tissues, reducing the rate at which lignocaine enters the systemic circulation.

• Lignocaine is lipophilic
  Lignocaine is attracted to fat (lipophilic) and readily partitions into fatty tissue, where it is temporarily sequestered (isolated from surrounding tissue), further slowing systemic absorption.

• Vasoconstriction from adrenaline
  The dilute adrenaline in the solution causes constriction of blood vessels, which reduces both bleeding and the rate of lignocaine absorption into the bloodstream.

• Hydrostatic compression of blood vessels
  The large volume of fluid infiltrated into the tissue creates pressure that physically compresses small blood vessels, further limiting absorption.

• Low concentration of lignocaine
  Although the total amount of lignocaine used may be higher, it is highly diluted in a large volume of saline. This low concentration reduces the concentration gradient needed for rapid systemic absorption.
• Removal of solution during liposuction
  A significant proportion of the tumescent solution is removed during fat aspiration, reducing the amount of lignocaine available for absorption over time.

Yes. There is a maximum safe dose of lignocaine that can be used during each liposuction procedure. For this reason, procedures are carefully planned and, if necessary, staged over more than one session. Exceeding safe lignocaine limits may lead to local anaesthetic toxicity, which can be serious and potentially life-threatening. To minimise this risk, the dose is calculated based on individual factors such as body weight, medical history, and the extent of the procedure. Patient safety is always prioritised, and these limits are strictly observed. Liposuction is generally limited to a maximum of three anatomical areas in a single procedure. This limitation ensures that an adequate dose of lignocaine is available to effectively anaesthetise (numb) the fatty tissue, without exceeding recommended dosage limits or compromising anaesthetic effectiveness. 

Nationally or internationally, there is no single legal maximum for fat removal in liposuction, but medical guidelines recommend safe limits to reduce the risk of complications such as bleeding, fluid imbalance, and anaesthetic-related issues. Many guidelines suggest that removing large volumes in a single procedure increases risk, and that very high-volume liposuction should be staged across multiple sessions. Doctors worldwide follow evidence-based recommendations to prioritise patient safety and minimise complications, rather than aiming for a fixed “maximum volume.” Limits depend on factors such as patient size, health, and the anaesthetic method used. This is why procedures are planned and staged. In addition to the lignocaine restrictions outlined above, the total volume of fat removed must also be carefully considered.

Liposculpture is performed as a day procedure. There is rarely a need for the person having liposculpture to stay overnight in hospital, or to have blood transfusions. A half to ¾ of a day is required to perform the procedure and to stay in the hospital recovery. You are encouraged to remain active following the procedure, gentle walking soon after, and often returning to work after 1 week or possibly after a few days. Time off work and normal activities is usually kept to a minimum. More vigorous exercise may be resumed 3- 4 weeks after the procedure.  

Suitability for liposculpture varies between individuals and can only be determined following a comprehensive medical and psychosocial assessment. Expression of interest in the procedure does not imply suitability. Although liposculpture techniques, including tumescent methods, have been used in clinical practice for several decades, individual risk, outcome, and recovery vary and cannot be predicted based on population data or procedure volume.

Liposculpture isn’t suitable for everyone. Only patients with a Body Mass Index (BMI) of under 35 will be considered but only after they have been properly assessed during the consultation. Your BMI can be checked using the following online calculator   

Smoking increases the level of carbon monoxide in the blood, which deprives tissues of oxygen. Blood supply is a major concern during any surgical procedure. Combining smoking and cosmetic surgery can categorically result in increased pain, loss of skin, infections, death of tissue or fat cells, delayed healing, thick scarring, permanent vessel damage, or blood clots. Smokers should cease smoking 6 weeks prior to the procedure or consider to not have the procedure at all. 

Patients with Body Dysmorphia Disorder (BDD) are inappropriate for liposuction / liposculpture or any type of cosmetic surgery or procedure. BDD is a mental illness. People who have this illness constantly worry about the way they look. They may believe an inconspicuous or non-existent physical attribute is a serious defect. They respond to this by performing repetitive acts such as mirror checking or comparing their appearance with others. The severity of BDD varies. For example, some people know their feelings and / or perceptions aren’t rational or justified, while others are almost delusional in their conviction. BDD causes severe emotional distress. It is not just vanity and is not something a person can just ‘forget about’ or ‘get over’. The preoccupation of their appearance can be so extreme that the affected person has trouble functioning at work, school or in social situations. People who suffer from BDD can target any part of the body. They may seek out numerous cosmetic procedures to try to “fix” the perceived flaw. Afterward, they may feel temporary satisfaction or a reduction in distress, but often the anxiety returns and the search for other flaws resumes. Along with ways to “fix” them. Treatment of BDD may include cognitive behavioural therapy and medication after an assessment by a psychiatrist. 

During the initial consultation, you will be assessed for suitability for the procedure and you must be in good health. You will be assessed for Body Dysmorphia Disorder (BDD). You will be provided written pre-operative instructions. You will require a second consultation (either in person or via video) prior to any procedure that may be booked (at least 7 days prior to surgery). You will require a referral from a general practitioner (not involved in any cosmetic medicine or surgery practice) from 1st July 2023. It is important that aspirin and anti-inflammatory medications (Nurofen, Naprogesic, Feldene, Voltaren etc.) and multi-vitamins not be taken for two weeks before the procedure. These medications decrease the effect of platelets in the blood and can increase the amount of bruising and risk of bleeding. An anti-bacterial soap should be used for two days prior to the procedure. Antibiotic tablets are started the night before the procedure to reduce the risk of infection. Patients should not smoke as that increases complications, including infection, fat necrosis, blood clots, increased pain, and thick scars. After the procedure, a Lycra garment is worn over areas treated for one to two weeks (sometimes longer). The garment is quite a light, comfortable garment and may be worn under normal but usually looser clothing. 

After the saline solution is introduced into the tissues through small incisions (3-5mm) in the skin, and the local anaesthetic in the fluid has had enough time to work, small blunt tubes (cannulae) are introduced into the fatty layers (located under the skin and on top of the muscles). Suction is applied to the cannula while it is moved back and forth through the tissues and the unwanted fat is removed in a progressive fashion. Most cannulae used are 2mm to 3mm or less in diameter (sometimes 4mm) and are substantially narrower than the cannulae used in older liposuction methods. The movement of the cannula through the fatty tissue will “strip” the fat cells away from the connective tissue and the suction merely takes the fat cell away from the site of disruption. This fat is not removed “like a vacuum cleaner” as each fat cell removed needs to be parted from its supportive tissue. This is the reason it can take quite a few hours to perform.  

Bruising, seen as skin discolouration or black and blue areas, are expected, and this usually persists for a few weeks.  Occasionally there may be excessive bruising under the skin, or there may be an accumulation of fluid in the areas. This may take a few days to a few weeks to resolve and the procedure is planned to accelerate the drainage of this fluid and so reduce bruising and facilitate healing.  

Severe discomfort is less likely. There is usually some discomfort mild to moderate discomfort for a few days to a few weeks after the procedure.  Discomfort is usually described as soreness and stiffness which may or may not require paracetamol.  Some patients may require stronger pain relief. This varies with each individual depending on the extent of the procedure, the patient’s personal pain tolerance and if any complications should occur.  Persistent soreness or pain should be reported to the doctor.  If undue pain is experienced it may be the sign of an impending complication and the doctor must be notified immediately.  

Numbness can also occur after the procedure which may take a few weeks to many months to resolve, sometimes up to a year.  It is possible but quite rare, to have persistent numbness in an area. The instruments used in liposculpture are blunt and therefore do not cut tissue in the same way as a surgical cut. Numbness is less likely to be permanent.  

Texture irregularities or lumpy areas on the skin may occur and may take a several months to resolve, sometimes up to a year.  These are usually normal healing reactions and represent “remodelling” of the tissue. Initially swelling occurs where the procedure has been carried out, with the most swelling occurring in the lowermost parts of the body because of the effects of gravity. Ankle swelling may occur and can last for several months, even up to a year. This is the reason when liposculpture is performed on the lower legs, a fitted stocking is required for 4 weeks or more. Itchiness is a normal post-operative side effect and may last a month or so. It is the result of the nerve endings in the skin starting to heal and regenerate. However, texture or contour irregularities may however persist indefinitely where patients may need reassessment.  

Scars may develop over the incision sites (3-5mm) and may become darker or lighter in colour, become enlarged, known as hypertrophic scars or more rarely keloid. They generally tend to become less obvious with time. Sutures are not required for most incisions and the incision sites act as drainage points post operatively for the excess anaesthetic fluid to drain out.  

Infection is a possible complication of any surgical procedure. Infection may require additional antibiotics, incisions for drainage or admission to hospital.  Very rarely does a life-threatening infection occur after liposculpture using the tumescent local anaesthetic technique. Although very rare, fatal infections have been reported as well as necrotising fasciitis, which is a serious bacterial infection that destroys tissue under the skin.  

Allergic reactions may occur with any medications the doctor uses or prescribes.  It is important to present to Emergency at your nearest hospital if you experience any breathing difficulty or swelling of lips, tongue. This is important because you may be suffering from a general reaction to the medication which may become worse (called anaphylaxis) which, if not treated, can be life threatening.  

All major blood vessels and nerves are located at a deeper plane. Small cutaneous (skin) nerve fibres are located directly under the skin and are temporarily damaged which causes the expected numbness. It is very uncommon to get permanent numbness or permanent disability from damage to deeper nerves. Liposuction instruments are blunt, so unable to “cut” a nerve. 

Occasionally, a fluid collection (seroma) or blood collection (haematoma) may persist and may require drainage with a needle and syringe. This is less likely when micro-cannulas are used, which are the chosen cannula type, but may still occur. 

Post operative fibrosis (or hardening of the subcutaneous tissue) may occur if the body develops an extreme reaction to the trauma created by liposculpture. Collagen is the protein found abundantly in the human body. Its development in excess or its accumulation during tissue repair generates fibrosis. This may delay recovery, cause hardening or scarring of the tissue and may require steroid injections periodically to help soften the tissue, or may be permanent.  

With the older technique of liposuction, a small area of sloughing (skin loss) has been reported in the medical literature, in rare cases. Fortunately, this is infrequent with liposculpture performed under local anaesthesia with micro-cannulas but may still occur.  “Erythema Ab Lipoaspiration” is a permanent blotchy (net-like pattern) pink-brown discolouration of the skin resulting from rasping the under-surface of the skin during superficial liposuction.  

A rare complication is a Deep Vein Thrombosis (DVT).  This is rarer when liposuction is performed under local anaesthetic, where the patient frequently moves into different positions during the procedure. With the techniques utilised, whereby most normal daily activities are resumed post-operatively, it is fortunately rare. However, if any clots develop in your deep leg veins, these may travel to your lungs. A pulmonary embolus can be serious and life threatening. It can occur after any type of surgery or during or after long haul flights.  

Visceral or bowel perforation during abdominal or chest liposuction is very rare, especially when the procedure is performed under local anaesthetic and by an experienced liposuction proceduralist. The proceduralist’s non-dominant hand should be constantly following the tip of the cannula over the skin to avoid the cannula inadvertently taking an unwanted direction.  

Lignocaine is the numbing local anaesthetic drug of the fatty tissue. During the initial consultation with the doctor, liposculpture areas will be determined that may be performed in the one operative session. This is determined by the maximum dose of lignocaine that may be injected into the subcutaneous (under skin and on top of the muscle) fatty tissue. It is important not to exceed the recommended dose as the lignocaine may become toxic to the heart and brain (and even cause death) if excessive doses are given. Safe and recommended dosages of lignocaine are determined during the consultation and may limit what areas of liposculpture may be performed at the same time.  

If sedation drugs are used excessively there is a risk of damage to lung/ heart/ brain and even death, but this is extremely rare. It is important that you are adequately fasted before the procedure under sedation of any kind. No food or milk products for 6 hours before the procedure. Only water may be consumed up to 2 hours prior to the procedure. If you are not properly fasted, your procedure will be cancelled. You will be required to have a carer pick you up and take you home afterwards as you cannot drive and cannot go home unaccompanied. 

The above information mentions most of the side effects and complications that may occur from a liposculpture / liposuction procedure. Should there still be any questions, seek the answers and ask the doctor before undertaking the procedure.  The patient who is well informed about the benefits and risks is then realistic in their expectations of the liposculpture procedures and what can be achieved. Patients who would be satisfied with a 50% change and not expect perfection would likely be appropriate candidates for liposuction/ liposculpture. Diet and exercise are integral in maintaining results after liposuction/ liposculpture. Be aware and mindful that cosmetic surgery is invasive and carries risk. You have the option of choosing not to go ahead as liposuction/ liposculpture is a purely elective procedure. Cosmetic surgery may be a very positive experience for many individuals but is not the only option for those who are unhappy with their appearance.  

No. Liposculpture is not a treatment for obesity. Liposculpture may be considered in people who are slightly overweight to address localised areas of fat, such as the abdomen, arms, thighs, or flanks, where fat has been resistant to diet and exercise, and those people with early stages of lipoedema. It is a body-contouring procedure, not a weight-loss solution. Some patients describe liposculpture as a “kick-start” to healthier lifestyle changes and may continue to lose weight afterwards. However, this is not guaranteed and depends entirely on the individual’s motivation, diet, and activity levels. Liposculpture is a body-contouring procedure intended to address localised fat deposits. It is not a treatment for weight loss or obesity and does not replace lifestyle measures such as diet and exercise.

Body mass index is one of several factors considered during assessment.
In general, only patients with a BMI under 35 may be considered for liposculpture subject to individual clinical judgement. BMI alone does not determine suitability or outcome. BMI is calculated by your weight divided by your height squared (eg. 70kg / 1.7m squared = 24.2) Your BMI can be calculated using online calculators: https://www.healthdirect.gov.au/bmi-calculator

Liposculpture is also not suitable for visceral fat, which is fat stored deep inside the abdomen around internal organs such as the liver and intestines. This type of fat cannot be removed with liposuction or liposculpture.

Visceral fat is best managed with:

• Diet and lifestyle modification
• Exercise
• Medical weight-loss programs +/- weight loss drugs (eg. GLP1-RA, eg. Ozempic, Mounjaro, Wegovy)
• In some cases, bariatric surgery (such as gastric sleeve, gastric banding, or gastric bypass), following appropriate medical assessment

A thorough consultation is required to determine whether liposculpture is appropriate and to discuss risks, benefits, alternatives, and realistic outcomes.

There is no theoretical upper age limit for liposculpture, provided a patient is in good general health and does not have medical conditions that would increase the risks associated with the procedure or recovery. During the initial consultation with Dr Heckenberg, it is essential to provide a complete a medical history and an accurate list of all medications and supplements you are taking. The local anaesthetic used in liposculpture (lignocaine) can interact with certain medications or supplements. In rare cases, excessive levels may lead to local anaesthetic toxicity, which can affect the heart or brain and may be life-threatening. There are safety guidelines on how much fat can be removed at one time, so extensive liposuction may need to be staged. As per medical board regulations for cosmetic surgery, only patients aged 18 years and over are accepted for liposculpture. A thorough medical assessment is required to determine individual suitability and to discuss risks, benefits, and alternatives.

Yes. Small scars are expected with liposculpture, as the procedure requires tiny skin incisions for the cannulas. Because the cannulas used are very narrow, the incisions are small (typically 3–5 mm) and are usually placed within natural skin creases (where possible) to help minimise their visibility. These entry points are not sutured after the procedure, as they allow drainage of excess anaesthetic fluid in the immediate post-operative period. In most cases, these entry sites heal to become fine, subtle scars over time. However, the presence of small scars is unavoidable. Patients who feel they would be significantly distressed by even small scars should carefully consider whether liposuction or liposculpture is an appropriate procedure for them. Individual healing and scar appearance vary and will be discussed during consultation as part of the informed consent process. 

As with any skin incision, individual healing varies. In some cases, scars may:

• Become lighter than the surrounding skin (hypopigmentation)
• Become darker (hyperpigmentation)
• Thicken or become raised (hypertrophic or keloid scarring)

Your individual risk of noticeable scarring will be discussed during consultation, considering your skin type, medical history, and previous scar formation.

Yes. Genetic factors can influence how your skin heals, which means that scars may appear more noticeable in some individuals. Some people are naturally prone to thicker, raised, or darker scars, while others may heal with fine, barely visible lines. Individual healing can also be affected by skin type, previous scarring, and overall health, as well as post-operative care. While every effort is made to minimise scarring, it is not possible to predict exactly how a person’s scars will look. This variability will be discussed during consultation as part of setting realistic expectations.

For people who live busy lives the timing of their procedure is paramount. At Be Sculptured we realise that you may only have a window of time to have your procedure. Coordinating the hospital and the anaesthetist may limit what day is available, so it is best to plan ahead. Procedures can usually be performed within 6 weeks of the consultation but this timing may be variable. The Australian Medical Board, in October 2016, advised a mandatory 7-day cooling-off period from the time of consultation to the time of cosmetic surgical procedures. You can consult online for possible times but a face-to-face consultation is necessary at least 7 days prior to the procedure.  

The cost of this procedure varies according to the areas requested. The hospital theatre fee is time based as is the anaesthetist’s fee.  

Liposuction / liposculpture is NOT covered by Medicare or Private Health Insurance. For an accurate costing, please use the online consultation or make an appointment by phoning 0484898977. 

Liposculpture is a careful and time-dependent procedure. Fine instruments (micro-cannulas) are used to gradually remove fat and shape the targeted areas. The duration of surgery depends on the number and size of chosen liposuction areas. On average, the procedure takes approximately 2 to 4 hours, particularly when multiple areas are involved.

Patients undergoing liposculpture for lipoedema may experience a longer recovery period compared with patients having cosmetic liposculpture for localised fat deposits alone. Post-operative fluid leakage (oozing) from incision sites may also persist for a longer duration in patients with lipoedema. This is related to the nature of the condition and the characteristics of the affected fatty tissue. Recovery time, swelling, bruising, and the duration of leakage vary between individuals, but lipoedema patients tend to have longer recovery and more recovery side effects. 

Yes. Please refer to this separate information leaflet on lipoedema.

Yes. Liposuction (also known as liposculpture) has been examined in large observational studies published in international, peer-reviewed medical journals. Some studies have reported outcomes in large numbers of patients undergoing tumescent liposuction performed under local anaesthesia. These publications contribute to the broader medical understanding of the procedure and its potential risks and complications.

Examples of commonly cited studies include:

Boeni, R., & Waechter-Gniadek, P. V. (2021). Safety of Tumescent Liposuction Under Local Anesthesia in 9,002 Consecutive Patients. Dermatologic Surgery, 47(5), e184–e187. https://journals.lww.com/dermatologicsurgery/Abstract/2021/05000/Safety_of_Tumescent_Liposuction_Under_Local.24.aspx

Hanke, C. W., Bernstein, G. S., & Bullock, S. (1995b). Safety of Tumescent Liposuction in 15,336 Patients. Dermatologic Surgery, 21(5), 459–462.  https://journals.lww.com/dermatologicsurgery/Abstract/1995/05000/Safety_of_Tumescent_Liposuction_in_15,336.17.aspx

While such studies provide useful information, they do not eliminate risk, and their findings cannot be assumed to apply to every individual. The appropriateness of liposculpture, and the risks involved, depend on individual factors including medical history, anatomy, extent of liposuction, and post-operative care. These issues are discussed in detail during consultation and as part of the informed consent process.

Smoking adversely affects tissue oxygenation and blood supply and is associated with an increased risk of surgical complications, including but not limited to delayed healing, infection, skin or fat necrosis, adverse scarring, thromboembolic events, and other serious complications. Patients who smoke will be advised to cease smoking prior to surgery or may be advised that liposculpture is not clinically appropriate due to increased risk.

Patients with Body Dysmorphic Disorder (BDD) are NOT suitable candidates for liposculpture or other cosmetic procedures. BDD is a recognised mental health condition characterised by excessive preoccupation with perceived physical defects and may be associated with significant distress and functional impairment. Cosmetic procedures do NOT treat BDD and may exacerbate symptoms. Psychological screening and assessment form part of the consultation process and is mandatory. Where concerns are identified, referral for appropriate mental health assessment and treatment may be recommended.

Some individuals who seek consultation for liposculpture include: men or women with genetically, hormonally or ageing influenced localised fat accumulation, individuals seeking limited alteration of body proportions, individuals who have lost weight but retain localised fat deposits, women following pregnancy with persistent localised fat deposits, men with fatty breast tissue related to genetic, hormonal, or medication factors and individuals who have early stages of lipoedema. These examples, however, do not imply that the procedure is appropriate or recommended, but are typical examples.

Important regulatory statements:

• Not all patients are suitable for liposculpture.
• All surgical procedures involve risk, including liposculpture.
• Outcomes and recovery vary between individuals.
• No result, timeframe, or benefit can be guaranteed.
• A detailed discussion of risks, benefits, alternatives, and expectations is required as part of informed consent.

Yes. You can gain weight after liposuction / liposculpture.

Liposuction removes fat cells from specific areas, but it does not prevent future weight gain. If a person consumes more calories than they burn after the procedure, the remaining fat cells in the body can still enlarge, leading to weight gain.

Generally, yes – weight gain after liposuction tends to be proportionate to the new shape, but only within limits. After liposuction, the number of fat cells is permanently reduced in the areas that were contoured. If weight is gained modestly, fat usually accumulates in proportion to the new body shape, meaning the overall contour is largely maintained.

However:

• Areas that did not undergo liposuction may gain fat more readily than the contoured areas if there is excessive calorie intake.
• With significant weight gain, fat will accumulate throughout the whole body, including the areas that were reshaped, and proportions can become less predictable.
• Liposuction does not “lock in” a shape; it improves contour, but weight stability is key to preserving results.

In summary, small to moderate weight changes are usually accommodated proportionately, but larger weight gain can alter the contour and reduce the aesthetic result.

Liposculpture is a medical procedure that requires careful assessment, informed consent, and appropriate cooling-off periods in accordance with AHPRA and Medical Board of Australia guidelines.

At the initial consultation, your medical history and overall health will be assessed to determine your suitability for the procedure. This consultation includes mandatory screening for Body Dysmorphic Disorder (BDD). You will be provided with written information outlining the procedure, risks, benefits, alternatives, and pre-operative instructions.

A second consultation is mandatory and must occur at least 7 days before any procedure is booked. This consultation may be conducted in person or via video and allows further discussion, questions, and confirmation of informed consent. At least one of the 2 consultations must be in-person.

From 1 July 2023, patients undergoing cosmetic surgical procedures are required to have a referral from an independent general practitioner who is not associated with cosmetic medicine or surgery, in line with Medical Board of Australia requirements.

Certain medications must be avoided for two weeks prior to surgery, including aspirin, anti-inflammatory medications (such as Nurofen, Naprogesic, Feldene, Voltaren) and multivitamins, as these may increase the risk of bleeding and bruising. Patients should avoid caffeine for at least 24 hours before liposculpture using the tumescent local anaesthetic technique. Caffeine can affect how lignocaine (the local anaesthetic) is metabolised, which may slightly increase the risk of local anaesthetic toxicity. An antibacterial soap / wash is used for two days prior to the procedure, and prophylactic antibiotics are commenced the night before surgery to reduce the risk of infection.

Patients are advised not to smoke, as smoking significantly increases the risk of complications including infection, delayed healing, fat necrosis, blood clots, increased pain, and adverse scarring.

After a sterile saline solution containing local anaesthetic is introduced into the tissues through very small skin incisions (approximately 3–5 mm), time is allowed for the anaesthetic to take effect.

Once adequate anaesthesia is achieved and the blood vessels have constricted effectively, small, blunt-ended tubes (cannulas) are gently inserted into the fatty layer beneath the skin and above the muscle. Suction is applied while the cannula is carefully moved through the fatty tissue to progressively remove unwanted fat.

The cannulas used in liposculpture are very fine, typically 2–3 mm in diameter (occasionally up to 4 mm) and are significantly smaller than those used in older liposuction techniques. This allows for greater precision and contouring.

Fat removal during liposuction is a controlled and gradual process and is highly dependent on the proceduralist’s technique. The cannula is inserted through small incisions and moved back and forth through the fatty tissue, carefully separating fat cells from their supporting connective tissue before they are removed by suction.

Fat is not simply removed like a vacuum cleaner; each fat cell must be freed from surrounding structures to ensure effective removal. This careful technique is why the procedure takes time and requires skill.

Following the procedure, a compression garment is worn over the procedure sites for one to two weeks, or longer if advised, to assist with healing and contouring. The garment is lightweight and typically worn under loose-fitting clothing. Lipoedema patients usually require longer time for compression garments that may be on-going. Prescription pain relief will be provided by the anaesthetist following the procedure, to be taken when required.

Patients taking GLP-1 receptor agonist medications (e.g., Ozempic, Mounjaro, Wegovy, Trulicity) for weight loss, inflammation, or general wellbeing must follow a 24-hour clear liquid diet before receiving sedation for a liposuction procedure. Strict adherence to these instructions is essential. Failure to follow the diet will result in your procedure being cancelled by the anaesthetist. These instructions are in accordance with the fasting guidelines from the Australian and New Zealand College of Anaesthetists (ANZCA). Clear liquids include water, clear fruit juices without pulp, black tea or coffee (without milk), and clear broths. 

Yes. Liposuction or liposculpture may be performed in carefully selected patients with lipoedema following appropriate assessment. Lipoedema is a chronic condition characterised by an abnormal accumulation of fat, most commonly affecting the legs and sometimes the arms, often resistant to diet and exercise. It occurs predominantly in women and typically affects both sides of the body symmetrically. Lipoedema can be associated with pain, tenderness, easy bruising, and may significantly affect daily activities and quality of life. Conservative management plays an important role and may include compression therapy, dietary modification, manual lymphatic drainage or massage therapy, and low-impact or water-based exercise. These measures may help manage symptoms but do not remove the abnormal fat cells. In appropriately selected patients, liposuction or liposculpture may be used to reduce the excess fat cells associated with lipoedema and change limb shape and symptoms. The procedure does not cure lipoedema, and results vary between individuals. Repeat procedures of the same areas may be necessary to achieve desired results. Secondary obesity may also co-exist, and this may require other weight loss measures in addition to liposuction. 

Ongoing compression therapy is required for lipoedema patients after surgery for longer than cosmetic liposuction patients and often may be required long term, to help support healing, reduce swelling, and maintain results. A thorough medical assessment and discussion of realistic expectations, risks, benefits, and alternatives is required before considering surgery. Currently, there is no Medicare or private health insurance rebates for liposuction for lipoedema.

Liposuction cannot reliably reach all areas using only one or two incision points. Access to the fatty tissue in different areas of the body is important, so multiple small incisions may be required to allow the cannula to reach these areas. During the procedure, the cannula is moved back and forth and in a criss-cross pattern to separate and remove fat cells. This technique helps create a more even and consistent body contour. If a patient is worried about the number of small incisions required, they may wish to reconsider whether liposuction is the right procedure for them. Multiple incisions are often necessary to access the fatty tissue and achieve the best possible contour, and this is an unavoidable part of the procedure.

No. Liposuction reshapes fat. It does not tighten skin or cure cellulite. Liposuction does not cure cellulite because cellulite is primarily a problem of connective tissue structure and skin tethering, not excess fat alone. Cellulite forms when fibrous connective tissue septa tether the skin downward. Fat bulges upwards between these bands, creating dimpling. Liposuction removes fat but does not release or correct the fibrous bands. Liposuction does not improve skin architecture. It does not strengthen collagen, nor thicken the dermis, nor improve skin elasticity. Cellulite is not related to overall fat amount. Thin patients can have significant cellulite. Overweight patients may have minimal cellulite. This highlights that cellulite is structural, not volumetric. Liposuction is designed for contour, not surface texture. Liposuction reduces fat bulges and changes the body shape and proportions. It is not a skin-smoothing procedure. The bottom line is that liposuction removes fat; cellulite is caused by fibrous tethering and skin structure. Because it does not address the underlying cause, liposuction cannot cure cellulite and may sometimes make it more noticeable. Skin laxity can exaggerate the appearance of cellulite. 

The skin is a flexible and adaptive organ. Liposuction removes fat, not skin. After fat removal, the skin is essentially “de-weighted” and it will retract or contract or shrink to some degree. The amount of skin response varies depending on:

• skin quality and elasticity
• age and genetics
• amount and location of fat removed

In many cases, removal of excess skin is not required, but this cannot be assumed. Pre-operative assessment includes a skin quality evaluation and discussion of patient expectations. Loose skin usually remains loose. In some cases, it can appear more obvious after fat removal.

If a person has previously lost a significant amount of weight and requests liposculpture for body contouring, the skin has often been stretched beyond its elastic capacity. Collagen fibres are thinned and disorganised. Elastic recoil is reduced or absent. Liposuction does NOT restore skin elasticity. Liposuction removes underlying fat, not skin. Liposuction reshapes the subcutaneous (under the skin) layer by removing fatty tissue and therefore reshapes the body form. Skin drapes over the top of the fatty layer. 

Fat may provide structural support to compromised skin. Removing that support may lead to increased wrinkling, rippling or waviness, hanging or crepey skin. This is not a complication nor the result of poor technique- it is a predictable biological outcome. While liposuction can remove residual fat, the skin may appear looser, irregular, wrinkled in areas where it was previously stretched. The degree of skin retraction depends on age, genetics, how much weight was lost, and how long the skin was stretched. It is very variable amongst individuals. In most cases, the skin will adjust gradually, but some looseness or irregularity will likely remain. Some patients may request skin excision or body / skin lifting procedures after liposuction to address the poor contraction of skin. Referral to another practitioner skilled in skin excision and body lifting procedures may be necessary for some patients. 

No. Viewing “before” and “after” photographs of patients having liposuction / liposculpture are only relevant for that patient and do not necessarily reflect the results other patients may experience, as results may vary due to many factors including the individual’s genetics, diet and exercise. 

No. Pain and recovery vary between patients depending on healing, pain tolerance, and the areas where the liposuction was performed.

Yes. Liposuction is not an exact science, and despite careful planning and technique, minor irregularities, asymmetry, or residual areas of fat may occasionally occur as healing progresses. Each patient heals differently, and factors such as individual anatomy, skin elasticity, swelling, scarring, and post-operative recovery can influence the outcome. For this reason, some patients may benefit from a “touch-up” or revision procedure to optimise contour or balance areas. “Touch-up” procedures are not routine, are usually smaller in scope than the original procedure, and are only considered after full healing has occurred, which may take several months, often > 6 months. The possibility of additional procedures, including risks, benefits, and any associated costs, will be discussed during consultation as part of the informed consent process to ensure realistic expectations.

No. Perfection should not be expected after liposuction. The procedure aims to improve body contour, not to create flawless or perfectly symmetrical results. Minor irregularities, asymmetry, or contour variations are normal and may occur despite appropriate technique and healing. Every patient’s anatomy, healing response, skin quality, and fat distribution are different. While liposuction can improve body contour, it cannot guarantee perfection, and results continue to evolve over several months as swelling settles and tissues heal. Patients must accept that outcomes vary and that liposuction cannot guarantee perfection. Setting realistic expectations is an important part of the consultation process, and the goal is improvement rather than perfection.

Both cosmetic proceduralists and plastic surgeons may perform liposuction, but there are differences in training and scope of practice:

Plastic Surgeons: Are medically trained doctors who complete specialist plastic and reconstructive surgery training. Training covers reconstructive surgery in publicly funded hospitals (repairing injuries, burns, congenital defects). Cosmetic procedures like liposuction are not publicly funded and are part of a broader surgical skill set, and these skills are developed post qualification as a plastic surgeon.

Cosmetic Proceduralists: Are medical doctors who undertake training focused specifically on cosmetic procedures, such as liposuction, breast surgery, and facial procedures. Their training is often procedure-specific, allowing them to gain a high level of experience in certain operations. Some cosmetic proceduralists, like Dr Heckenberg, focus exclusively on liposuction/liposculpture, performing it frequently to maintain procedure-focused skills.

Key point for patients: Both groups can perform liposuction, but outcomes often depend on the doctor’s training, experience, and focus on the procedure rather than the title alone. Patients should check credentials, procedural experience, and relevant fellowships when choosing a practitioner.

No. Liposuction is not covered by Medicare or private health insurance, even patients with lipoedema. This means that all aspects of the procedure, including the proceduralist’s fees, hospital theatre fees, and anaesthetist’s fees, are out-of-pocket for the patient.

Currently, Medicare does not recognise lipoedema as a medical condition, therefore there are no specific item numbers for liposuction in this context. As a result, private health insurance will not cover procedures that do not have a Medicare item number.

Yes. You can raise concerns directly with the doctor, clinic, hospital or contact the Health Care Complaints Commission (HCCC), or call the Cosmetic Surgery Hotline on 1300 361 041

1. All patients seeking cosmetic surgery must have a referral, preferably from their usual general practitioner or if that is not possible, from another general practitioner or other specialist medical practitioner. The referring medical practitioner must work independently of the medical practitioner who will perform the surgery and must not perform cosmetic surgery or non-surgical cosmetic procedures themselves. 
2. You must be assessed for underlying psychological conditions such as Body Dysmorphic Disorder (BDD) using a validated psychological screening tool for BDD. This screening tool will be in the form of a validated questionnaire and that is a mandatory requirement for anyone considering cosmetic surgery. 
3. You must have at least 2 pre-operative consultations. The first consultation must be with the medical practitioner who will perform the surgery. At least one of the 2 consultations must be in person with the medical practitioner who will perform the surgery. Other consultations can be in person or by video. 
4. There must be a “cooling-off” period of at least 7 days AFTER the patient has had 2 consultations before the surgery can be booked, performed or a deposit paid. 
5. A separate consent form is required for photography