Liposuction on the legs

Slim legs have a particularly seductive effect. On the legs, fat reserves are reduced only very late or not at all despite a diet plan, exercise and leg exercises ^[1]. Liposuction can be used to remove excess fatty tissue from the hips or knees in a targeted manner. Liposuction under tumescent local anesthesia is considered effective and low risk. The procedure is among the most common plastic surgery procedures in the world ^[2].

Why liposuction on the legs

Many women with curvy legs feel severely limited in their clothing choices. Some find wearing legless dresses or a bathing suit oppressive. Common problem areas of the legs are fat deposits on the hips, inner thighs or knees. Flared hips are perceived as unattractive by both women and men of all ages across cultures ^[3].

If you have curvy thighs, rubbing the insides of the thighs together is particularly annoying. The friction between the inner thighs can also cause skin problems ^[4].

Excess fat on the inside of the knees affects the aesthetic perception of the legs. On the one hand, the fat deposits on the inside of the knees reinforce the impression of bandy legs. On the other hand, fat pads on the knees tend to make women look stockier ^[5].

Facts about liposuction on the legs

Which legs are considered beautiful?

The length and size of the legs vary depending on the physique and fitness level. There are no ideal values regarding length and circumferences. Nevertheless, certain characteristics, proportions and benchmarks influence the evaluation of the attractiveness of women and men:

• The internal contours of the female legs are almost straight ^[6].
• The lateral and rear contours of the calves have a slight bulge.
• Women as well as men prefer legs of a length of 46 to 47 percent of body size ^{[7] [8]}.
• In women, the length of the leg from the back of the knee to the heel is ideally 26 percent of the body height ^[9].
• An attractive calf circumference in women is 32 cm, or about 75 percent of the leg length or slightly less than one-fifth of the body height ^{[10] [11]}.

Thigh liposuction

The circumference of the thighs can increase regardless of body weight. Excess fat usually accumulates on the inner or outer thighs. During the examination it is therefore important to determine the distribution and thickness of the fatty tissue. With the following measures, we ensure that the best possible surgical result is achieved:

• All equipment and materials meet the highest hygiene and safety standards.
• Cosmetic surgery is performed exclusively by highly trained and experienced specialists in plastic and aesthetic surgery.
• We use particularly gentle and effective techniques such as vibration-assisted liposuction.
• We discuss all treatment alternatives with you for a holistically harmonious and optimal result.
• We will develop a treatment plan based on your goals.
• At the beginning of the operation, the tissue is injected with an anaesthetic and vasoconstrictor solution.
• Before liposuction (liposuction), the fatty tissue is loosened with fine vibrating cannulas.
• For defined smooth contours we use especially fine cannulas.
• We accompany you after the operation to ensure an undisturbed healing process.

Liposuction of the hips

Under the influence of estrogen, fat cells on the hips become larger ^[12]. Therefore, especially young women before menopause suffer from riding pants.

Women have more and smaller fat cells on their hips than men ^[13]. Compared to the fat cells of the abdomen, the fat cells on the hips are larger and consume more oxygen. Fat cells on the hips are characterized by a particular metabolism and their response to certain hormones ^[14].

During liposuction of the fat on the hips, enlarged fat cells in the deeper layer of the adipose tissue are permanently removed. We use a particularly gentle procedure to level the contours of the hips.

Beautiful calves

The contours of the calves are decisive for the harmonious and aesthetic appearance of the legs. Especially for women, shapely calves are very attractive. The shape of the calf is determined by the structure and training status of the calf muscles, individual fat distribution, and the length and position of the tibia ^[15].

Calf circumference is usually measured in three places. For this, the lower leg between the back of the knee and the heel can be divided into four equal sections. The circumferences are measured at the following transitions:

• Between the first quarter close to the body and the second quarter (A)
• At the middle of the lower leg (B)
• Between the third quarter and the quarter far from the body (C)

The maximum calf circumference is usually located just below the point (A) and is approximately 32 centimeters. In the middle, the circumference is about 26 centimeters and at the site (C) about 20 centimeters ^[16].

Calf augmentation

Very slender calves give the impression of bowlegs and can be equally burdensome for men and women. Underdevelopment of the calves can be corrected with a silicone implant or with autologous fat treatment. The following advantages speak for calf correction with autologous fat:

• The procedure leaves barely visible scars.
• The recovery time is shorter than with a calf implant.
• The results look natural.
• Unlike implants, there are no long-term side effects to worry about ^{[17] [18]}.

Calf reduction

Many women suffer from thick muscular calves ^[19]. In normal weight women Many women suffer from thick muscular calves ^[20]. In normal weight women, an increase in girth is divided into mild (34 to 38 centimeters), moderate (34 to 38 centimeters) and severe (over 38 centimeters). A difference in calf circumference of two centimeters or more is referred to as a lateral difference ^[21]. Enlargement of the calf muscle and increased subcutaneous fat may cause circumferential enlargement ^[22]. There are several techniques to choose from for calf reduction: liposuction of the calves and empowerment of enlarged calf muscles. According to individual findings, these techniques can be performed individually or in combination.

Liposuction on the calves

If the fat layer of the lower leg is larger than three centimeters, liposuction contributes noticeably to calf reduction. Calves, unlike the abdomen, have only one layer of fatty tissue between the skin and the muscle. Lymphatic vessels, nerves and veins run here. A cautious approach is necessary to preserve these structures and not cause any irregularities. The fibrous nature of the fat and disruption of lymphatic drainage favor the development of swelling after liposuction. We therefore recommend lymphatic drainage, massages and compression stockings for up to three months after surgery.

Enlarged calf muscle aggravation

In the case of thick calves and low fat tissue, calf reduction is achieved by thickening a muscle. With the injection of a muscle relaxant, the muscle relaxes. But does liposuction leave scars? The answer is clear: no, the treatment does not leave small scars and also has very few side effects. The muscle relaxing effect wears off after three months. With repetition, the calf muscles become smaller over time ^[23].

Alternatively, the nerves of certain fibers of the calf muscles can be permanently interrupted. The relaxed muscle fibers become noticeably thinner after a few months. The treatment is associated with a small scar in the popliteal fossa and results in permanent muscle relaxation ^[24]. Ablation of bulging portions of the calf muscles is much more invasive and therefore we do not recommend it ^[25].

Liposuction of the inner thighs

Liposuction gently and effectively improves contours in young people and small fat deposits. If excess fatty tissue is removed, the skin must adapt to the slimmer circumferential dimensions.

The risk of skin sagging depends, among other things, on the nature of the fatty tissue and the skin. At the inner thigh, the elasticity of the skin is lower than at other parts of the body ^[26]. Also, there are few collagen fibers on the inner thigh that anchor the skin to the muscle fascia ^[27]. The elasticity of the skin already decreases after the age of thirty ^[28]. If necessary, we recommend simultaneous skin tightening and liposuction of the inner thighs.

The inner thighs are among the preferred donor sites for autologous fat treatment, especially in younger women ^[29]. If there is a desire for fuller breasts or a beautiful buttock contour, the liposuctioned fat tissue is prepared and injected in the desired areas.

Knee liposuction

The accumulation of fatty tissue on the inner sides of the knees is largely genetically predetermined. Exercise and diet usually do not help here. Liposuction effectively and permanently removes the excess fatty tissue. The scars are a few millimeters in size and barely visible. The procedure is performed on an outpatient basis and under twilight sleep.

Malalignment of the knees, also known as bow legs, is accentuated by the fat pads on the knees. Many suffer from the appearance of crooked legs. The contours are corrected by liposuction and autologous fat treatment. In this procedure, the fat pads of the knees are removed, and the fatty tissue below the knees is injected. The injection does not leave any scars. You can move freely immediately after the operation. The results are durable ^[30].

Liposuction for lipedema

Lipedema is a condition in which there is excessive deposition of fatty tissue. Contrary to the disease name, edema is present only in rare cases. Mostly the legs are affected, but the feet are always spared. Characteristic of lipedema is an increased sensitivity to pain in the legs. Lipedema can take different forms, so that different degrees of pain are heard. It is not possible to predict the course of the disease.

Lipedema can be triggered and worsened by weight gain. The cause is not known. However, hormonal and genetic influences are suspected. Lipedema affects almost exclusively women. There are no investigative procedures or tests to confirm the diagnosis. Estimates of the incidence of lipedema vary widely from 0.1 to ten percent ^{[31] [32]}. In observational studies, liposuction has been shown to result in durable relief ^{[33] [34]}. Vibration-assisted liposuction using the tumescent technique is considered to be particularly gentle.

Tumescent liposuction makes it easier to release the fat cells from the composite. We always use rounded, thin cannulas to reduce the risk of injury to vessels and nerves. For your safety, your body mass index should be under thirty before liposuction. Body weight, health status, and the amount of fat tissue suctioned out all affect surgical risks. To keep the risks low, larger amounts of fatty tissue are therefore suctioned out in several procedures.

Liposuction against cellulite?

Cellulite is a common change in skin relief around the buttocks and back of the thighs. Approximately eighty to ninety percent of post-pubertal women are affected ^[35]. Shortened connective tissue strands in adipose tissue lead to the formation of dimples ^[36]. Weight fluctuations, hormones and a family predisposition are discussed as possible causes.

There is no good scientific evidence for the long-term effects of creams (Ginkgo biloba, retinol, caffeine, herbal extracts), lymphatic drainage, radiofrequency, and the ultrasound-assisted method ^[37]. Surgical transection of the shortened connective tissue strands shows good and long-term success ^[38].

A fine needle can be used to release the anchors of the skin with the underlying fascia. Transection of the tissue strands can also be achieved during liposuction with special cannulas and in combination with autologous fat treatment ^[39]. However, liposuction alone is not suitable for the treatment of cellulite. In case of thin and inelastic skin, a complementary microneedling treatment is useful.

Is liposuction possible on the legs and other parts of the body such as the abdomen, buttocks or arms at the same time?

Correction of fat deposits on several parts of the body in one procedure is usually possible and useful for several reasons. Combining multiple procedures into one surgery saves you the recovery time of another cosmetic surgery. Also, performing multiple surgeries under one anesthesia is more cost effective. In the case of pronounced findings, liposuction is safer if it is divided into several procedures.

Suction of 5 liters of adipose tissue or five percent of body weight is considered very safe ^[40]. These limits may change depending on the state of health. A frequently asked question is also whether liposuction of the legs can be combined with PO shaping or butt augmentation. It is important to adjust a plan according to your individual findings and goals. Therefore, before each treatment we discuss with you the safest way to achieve your wishes.

Combination with autologous fat treatment of the breast

If liposuction is performed on the legs, abdomen, back or arms, the liposuctioned fat can be transplanted to augment the breasts. The combination is of great advantage, because several problem areas are treated in one operation. The first step is to obtain the desired amount of fat cells. Special cannulas and filter systems are used to extract the patient’s own fat. In the second step, the cells are injected with fine cannulas. There are no scars during the injection. The oxygen and nutrients from the surrounding tissue ensure that the transplanted cells heal quickly on the breast. In the final step of the surgery, fine contouring of the legs is performed using appropriate cannulas.

What happens if I gain weight again?

Fat cells cannot multiply in adulthood. This means that liposuctioned fat cells are not replaced by the body. When the body takes in more energy than it uses, the energy is stored in fat cells of the body. As a result, the fat cells become larger. The ability of fat cells to store energy is not affected by liposuction. Therefore, liposuction cannot prevent body circumference from increasing with weight gain. However, the circumference increase will be less in the suctioned regions than in other parts of the body.

What aftercare after liposuction on the legs?

• Schedule three to four examination appointments after surgery to monitor the healing process.
• If you feel well, you can drive a car for short distances the very next day after the operation.
• Walks of about 15 minutes are quite beneficial to stimulate circulation. Avoid persistent heavy physical activity and sports not only for the first few days, but for the first two weeks.
• A five-minute shower is easily possible on the first day after the surgery appointment. Remove the patches before showering and dry the legs with a fresh towel after showering. Disinfect the plastered areas before applying a new plaster.
• Wearing compression pants promotes rapid decongestion and helps prevent thrombosis. We recommend that you wear the compression pants day and night for a period of two to six weeks depending on the state of swelling.
• The smallest skin threads are removed after about ten days.
• Smoking tobacco cigarettes or e-cigarettes jeopardizes the final outcome of the surgery. Therefore, strictly avoid smoking at least in the six weeks after surgery.
• Also, make sure you eat a balanced diet.

Are there any risks associated with leg liposuction?

Liposuction is considered to be a very safe treatment. Complications occur in less than one percent of patients. Possible complications after liposuction include:

• The accumulation of wound water 0.04 percent
• Major bruising 0.03 to 0.15 percent
• Inflammation in 0.1 to 0.02 percent
• Thrombosis 0.01 to 0.06 percent ^{[41] [42]}.

What is the procedure for liposuction on the legs?

• During the first detailed consultation, all treatment options will be discussed with you and you will receive a personal offer.
• It is not uncommon for questions to arise after the initial consultation. It has therefore proved useful to discuss the procedure on the day of surgery and the appointment in a second appointment.
• On the day of surgery, the plastic surgery expert will receive you. After a brief review of the surgical plan, the anesthesiologist who is part of the surgical team begins the surgical preparations.
• While you sleep, the excess fatty tissue is gently suctioned out. Awakening from the light twilight sleep takes only a few minutes.
• After you have rested, you will be given a detailed report by the plastic aesthetic surgeon and offered appointments for follow-up examinations.
• Minor bruising (bruises) usually passes after seven to ten days. Compression garments, elevation of the legs, and light range-of-motion exercises usually provide swelling relief after two to three months.
• The healing process of body tissues differs a little depending on age and health condition. After six to twelve months, it can be assumed that the result will no longer change.

Liposuction of the legs without general anesthesia

The goal of any anesthesia is to eliminate pain under the safest possible circumstances. Unlike other minor local procedures with local anesthesia (local anesthesia), a larger area is deprived of pain sensitivity. Liposuction under surface anesthesia, also called tumescent anesthesia, or twilight sleep is safer than under general anesthesia ^[43]. General anesthesia is accompanied by the administration of larger amounts of sleeping pills and artificial respiration. Patients after liposuction without general anesthesia recover faster and very rarely suffer from nausea. Sore throat as a result of artificial respiration is excluded with the tumescent technique.

Testimonials of liposuction on the legs

Before seeking medical treatment, patients usually want to make sure that the doctor they choose has extensive, long-term experience and expertise in the field. On the one hand, it is possible to read the CV of the attending physician on the website. On the other hand, it has become common practice to reassure oneself that one is in good hands through patient testimonials and reviews that can be found online in appropriate medical portals but also in Google listings. The reviews provide a way to get an overall average picture of former patients’ satisfaction. You will also find corresponding reviews on CenterPlast doctors, which we have also bundled for you on our homepage and a separate menu item to make your search easier.

Before and after pictures of liposuction on legs

According to the Therapeutic Products Advertising Act § 1 Paragraph 1 No. 2, before/after pictures may not be published on the Internet. The legislator has determined that such a comparative representation constitutes unduly influencing advertising.

The impression of an image is influenced by various factors such as the camera setting, the perspective, the background, the cropping as well as the lighting. Makeup or manipulated images can simulate results.

For this reason, CenterPlast plastic and aesthetic surgery specialists document the results of the procedures under uniform conditions. This creates an appropriate level of comparability. Doctors will show you these images during an educational consultation. In this way, you will get an objective view of the limits and possibilities of liposuction on the legs.

Cost of liposuction on the legs

If you would like to know how much liposuction on the legs costs, try our price calculator now. With a few clicks there you can quickly and easily find out the price of this treatment.

Financing liposuction on the legs

If you don’t currently have the financial resources to realize the dream of slim legs, there are several financing options for cosmetic surgery. We would be happy to explain this to you in a personal consultation. You can find more information under our menu item “Financing” in the category Costs.

Liposuction on the legs abroad?

Not only the prices can differ from country to country. The safety and hygiene standards, the qualifications of the medical staff and the technical equipment also do not necessarily comply with German guidelines. For follow-up treatment in Istanbul/Turkey or in Prague/Czech Republic, you should plan for additional travel expenses. If the price is more important than anything else, it should be considered whether the aesthetic plastic surgeon is available if you are not satisfied, that is, the result does not meet your expectations.

Liposuction of the legs by the health insurance company

Under certain conditions, health insurance covers the cost of liposuction for stage three lipedema. At this stage, liposuction usually needs to be performed in two to three surgeries. The tightening of excess skin is not covered by health insurance.

Liposuction on the legs vs. fat-away injection

The so-called fat way injection is used to reduce small fat pads and is therefore not suitable for realizing the dream of slimmer legs by removing stubborn fat pads. For more information on injection lipolysis, see Fat Way Injection.

How many liters of fat are suctioned from the legs?

When specifying the volume aspirated, a distinction must be made between fatty tissue and water. Before liposuction of the legs, three to nine liters of water (tumescent solution) are injected, depending on the treatment goals and body weight. This tumescent solution numbs the body area and prevents the development of bruising. Along with the fatty tissue, much of the fluid is also suctioned out during the cosmetic surgery. Body fat usually represents 30 to 50 percent of the total fluid aspirated. It is recommended to limit the amount of fat tissue aspirated to five liters or five percent of body weight ^[44]. Depending on the state of health, these limits may change.

Rumors about beautiful legs, true or false?

1. high heels increase the attractiveness of a woman.

Legs look longer by wearing high heels and are perceived as more attractive. Interestingly, women are more sensitive to the sexual attractiveness and length of their legs than men ^[45].

The author

Dr. med. Stéphane Stahl

“We provide you with extensive expert knowledge so that we can work with you to select the best possible treatment path.”

Dr. med. Stéphane steel is the former director of the Clinic for Plastic, Reconstructive and Aesthetic Surgery / Hand Surgery at the Lüdenscheid Clinic. Dr. Stahl studied medicine at the Universities of Freiburg and Berlin. In 2011 he passed the European and 2012 the German specialist examination for plastic and aesthetic surgery. Further specialist qualifications and additional qualifications followed (including quality management, medical didactics, physical therapy, emergency medicine, laser protection officers, hand surgery) as well as prizes and awards. In 2015 he completed his habilitation in plastic and aesthetic surgery in Tübingen. He is an experienced microsurgeon, a sought-after expert and a regular speaker at specialist congresses. After a multi-stage selection process, Stéphane Stahl became a member of the American Society for Aesthetic Plastic Surgery (ASAPS), one of the world’s largest and most influential specialist societies for aesthetic surgery. His authorship includes numerous articles in respected peer review journals and standard surgical textbooks.