In-Office Liposuction

Wide awake liposuction? Really?

Yes! Really! At Bloom Plastic Surgery we offer wide-awake small-volume liposuction in the office in our AAAASF certified procedure room. We are able to tackle small to medium areas and we can combine this with our technology from InMode, which includes FaceTite, BodyTite, and Morpheus. The ability to perform liposuction in a near painless manor has really revolutionized what we are able to accomplish for our patients.

First and foremost, AAAASF is an external organization that come in and audits procedures as well as safety protocols to make sure that patients are getting the highest level of care to match that of surgery centers and hospitals.

An accredited facility must comply with the most stringent set of applicable standards available in the nation and meet their strict requirements for facility directors, medical specialist certification and staff credentials. We also passed a thorough survey by qualified AAAASF surveyors.

And at the end of the day, it’s a testament to our commitment to making sure our patients receive the best overall care. We had the option to not qualify ourselves for AAAASF – and by doing this we have more restrictions on what we can do in the office in terms of liposuction and types of medications we can give, and types of procedures we can do. But above all, Dr. Bloom prioritizes practicing plastic surgery in a safe and ethical manner so we aren’t putting patients at higher degrees of risk then is deemed appropriate by governing bodies.

How much fat can be removed?

We can approach small and medium problem areas in the office. We like to put a cap of how much fat aspirate we can remove during liposuction procedure at 500cc. The volume of 500cc’s is somewhere between a can of coke and a 20 oz bottle – which is between 12 and 20 oz of fat. This is typically a good amount to address areas such as the neck, the anterior fat that bulges out in the bra line, small area in the medial thighs, lower abdomen, and even the posterior thighs (the banana roll) the area between the buttock and the thigh. All of these areas can be addressed during an in-office procedure. Not to mention, small volume liposuction of the arms.

When combined with our skin and soft tissue tightening device by InMode, this can be an extraordinarily powerful procedure that mimics the results that you would get in the operating room without having the need for going to a surgery center and ultimately saves the patient significant cost as we eliminate the need for a facility and anesthesia fees.

The procedure

We like to limit procedures not only by the volume of fat aspirate we’re removing, but also by the time time the patient sits on the table. All of these procedures are completed in under two hours – typically 60 to 90 minutes. What we find is that patients are able to remain comfortable for that period of time, laying on a table awake without having to shift or move. And when we get above that timeframe, we find it more challenging for patients to sit still for that long. This is why like to limit these procedures to under two hours for maximum patient comfort.

How do we complete these procedures with patients wide awake?

Prior to surgery, you have a pre-op examination where we go over all the details of procedure and consent forms. At that time, we prescribe medication with very specific instructions. Patients typically take an antibiotic within the hours preceding surgery, and we also have patients take pain medication. When these medications set in it does provide a nice background to decrease pain.

Next, we mark a patient up and then numb the areas we will be using for access points. Typically this is the part that has a slight sting, like a bees sting, but goes away within a few seconds. Once we set up for the procedure, a numbing solution (tumescent fluid) is placed into the territory that is to be treated with liposuction. Tumescent fluid is a mixture of several medications; lidocaine or novocaine, which serves as a numbing agent; epinephrine, which decreases bleeding risk; and sodium bicarbonate, which makes the application of the infused solution much more comfortable for the patient. We administer this solution in a methodical and slow fashion. The slower we infuse the medication, the more comfortable the application of the medication is for the patient.

Once that medication has been infused we let that sit, or marinade, for about 10-15 minutes to take it’s maximum effect — both from a vasoconstriction standpoint, to make sure there is no bleeding, but also to make sure the novacane is fully activated in the underlying tissue to eliminate any pain sensations. While the patient waits for the numbing to take effect, we select music that makes you relaxed – your choice – as well as making sure that you’re comfortable every step of the way.

InMode System

Using the same place where we inserted the infusion of tumescent fluid under the skin – using the same needle poke – Dr. Bloom is able to heat up the underlying tissue with the InMode system. In the neck we typically use AccuTite or FaceTite, in larger areas such as lower thighs and abdomen we use our BodyTite System which allows for further reach of the device to treat larger areas. The great thing about the InMode system is that it predictably heats the underlying tissue and we’re able to monitor the internal and external temperatures in order to get maximum results.

This technology works by using Radiofrequency to heat up the underlying tissue to both destroy fat cells and to heat up the connection between the skin and the underlying muscle. This produces a long-term tightening effect after surgery, extending as far as nine months from the time of your procedure. What’s great about this is it’s good for minimal to moderate laxity which will give the same result as removing skin without actually making large cuts that require incisions to be sutured. So, when we are dealing with an area like the neck – a patient who may have been a neck lift candidate – we can now kick the can down the road 5-10 years by having this in-office procedure to create the tightening that would have previously required incisions and a trip to the operating room.


Once the tissue area has been appropriately heated, the next step is removing the underlying fat with liposuction. Using a combination of canulas (which are blunt objects), the fat is aspirated until we have uniformity in the skin and soft tissue creating smooth curves without any lumps or bumps. Typically the areas that use for access are closed with absorbable or an external removable suture. The incisions are so small that one or two sutures in each area will close the incisions. There is no other cutting or skin or tissue removal which makes the recovery process significantly easier.

From here, we place patients into compressive garments which are worn for variable amounts of time. Typically patients will wear these garments for approximately one month, but not 24 hours a day. We have graduated times that we allow them to be removed – for work, events, etc – and this is guided on a case-by-case basis, based on the areas treated and how the recovery is going. We see patients one week later for wound check and to remove any external sutures that may have been placed. From there, we follow up at one month, six months, and a year. The patients have full access to the office if they have any concerns of would like to be seen earlier.

What we’ve noticed is that we’re able to get patients summer ready with body contouring of small problem areas that have plagued patients. A very common area is along the under arm near the bra line that bulges out in a sports bra or tank top, as well as the area under the chin.

Accutite and Liposuction 4 months post procedure
Accutite + Liposuction 3 months post treatment

Benefits of an awake in-office liposuction

  • Easier recovery: If you can avoid intravenous or general anesthesia, your immediate recovery will be much easier. Heavy anesthetics have some known side effects like headaches, nausea, vomiting, confusion and drowsiness. This can make the first day after any procedure difficult. Using only local anesthetics with oral medication will avoid many of these issues. After an awake liposuction procedure in our office, you will be able to walk with your caretaker to the car. There is no waiting around in a recovery room for hours until you wake up. Since we do give you oral medications during the procedure, you will not be able to drive yourself home and will need to have a responsible adult with you for 24 hours after the procedure.
  • Lower overall cost: Surgical facilities and anesthesiologists fees add cost to any procedure. In-office procedures do not require an anesthesiologist or hospital operating room lowering your out of pocket expense.
  • Decreased risk: Data shows that procedures completed with you awake in the office have lower risk of postoperative infections and complications. This is true across all procedure types but the amount of decrease does vary. Therefore, you should feel confident that choosing an in office and awake procedure is a very safe choice.

Dr. Bloom is here to help

Dr. Bloom is a warm and caring surgeon whom you can trust to make your health, your comfort, and your beauty his number one priority!

Lead plastic surgeon at Bloom Plastic Surgery in Chicago, IL, Dr. Jacob Bloom is Board certified by the American Board of Plastic Surgery. His extensive knowledge of today’s advanced surgical techniques, coupled with his years of medical training in New York and Harvard University, allow him to create customized treatment plans that can match the unique goals of each and every patient, while delivering long-lasting results that will subtly—yet still dramatically—enhance your natural beauty.

To learn more about how to enhance your figure with in-office liposuction, we encourage you to contact our office to schedule your consultation today. We look forward to hearing from you!