Why Is Gen Z Obsessed With Liposuction?

Fact: Liposuction is the most popular plastic surgery in the world. Despite the rise of noninvasive body contouring devices, such as CoolSculpting, and the phenomenal rise of weight-loss drugs, like Ozempic, it’s still No. 1 — the GOAT of cosmetic procedures, if you will. According to the American Society of Plastic Surgeons (ASPS), liposuction was the most performed surgery in the United States in 2022, at over 325,000 procedures, marking a 23% increase since 2019. While lipo has consistently been in demand for decades, it’s downright trending now, and it’s on the rise with a younger generation. In 2019, one out of 6 liposuction patients were under 30 years old.

This continued popularity and recent surge, especially among the younger generation, is pretty astounding, since the fat removal surgery has been around for over 50 years. Despite the price (hefty), the risks (significant), and the recovery time (weeks if not months), lipo is still the most in-demand cosmetic surgery. “There’s definitely been a post-pandemic boom in plastic surgery, so it doesn’t surprise me that liposuction numbers are up,” says Dr. Alexis L. Parcells, M.D., a board-certified plastic surgeon and founder of Parcells Plastic Surgery in New Jersey. “The number of people investing in cosmetic procedures is increasing, and social media platforms like Instagram and TikTok continue to influence the popularity of cosmetic treatments in general.” This certainly accounts for liposuction’s surge in popularity for Gen Z.

What Is Liposuction?

Liposuction is typically a one-and-done procedure that provides permanent fat removal in the targeted area. And, this is important: Liposuction is not a weight loss surgery. “The goal is improving contour, and a good candidate for liposuction is somebody who is at a healthy weight with a body mass index of under 35, but just can’t lose extra fat in the belly, or thighs, or under the chin,” says Parcells. A higher BMI increases the risks of complications, and may also mean the patient has a considerable amount of visceral fat, which can’t be removed by the procedure.

The surgery has come a long way since it was pioneered in 1975. “When liposuction first started, it was a brutal procedure that involved stripping the fat out between the skin and the muscle,” says Dr. David Shafer, M.D., a double board-certified plastic surgeon and founder of Shafer Clinic in New York. In the 1980s, surgeons started injecting a tumescent (saline) solution into the treatment area first “in order to separate the skin from the underlying muscles, creating a safe buffer,” says Shafer. By 1987, that solution was infused with epinephrine, a vasoconstrictor that reduces bleeding, and diluted lidocaine (to help with pain control), which transformed liposuction into a safer surgery that often required only local anesthesia. As the technique evolved, liposuction became a common outpatient surgery that didn’t require a hospital stay. That changed the game, and increased its popularity, even more.

The Changed Perception Of Liposuction

Since it no longer requires an overnight stay in a hospital, lipo is being perceived as a low-risk procedure, a quick-fix for the social media generation who is accustomed to instant gratification, from likes on a TikTok to same-day shipping from their favorite retailer to in-and-out body contouring. In reality, though, there’s downtime — and risks.

“I think that there’s a perception that liposuction isn’t plastic surgery because it’s usually an outpatient procedure done under local anesthesia,” says Dr. Melissa Doft, M.D., a double board-certified plastic surgeon and founder of Doft Plastic Surgery in New York. “So many people have it done that it seems less risky than a big surgery.” But it is a surgical procedure. There are small incisions done to insert the cannula and stitches, and there are risks involved. In the wrong hands, liposuction can lead to complications such as infection, bleeding, dehydration, contour abnormalities, a seroma (fluid that collects under the skin), and even internal injuries. “Liposuction is not something you go to a med spa for,” says Shafer. “It’s imperative to have this surgical procedure done by a board-certified plastic surgeon who has years of rigorous training and experience.” And, the recovery time is significant, too: “It can take three to six months to see the final results,” says Shafer. On top of this, the general price of outpatient liposuction on a small area (under the chin, for example) can start at $5,000 in New York City.

Liposuction 2.0

Within the last 25 years, liposuction procedures expanded exponentially in part due to technologies utilized in tandem with the traditional surgery, such as laser, ultrasound, radiofrequency, and plasma technology. They are used to stimulate collagen production by heating up the tissue after removing the fat from the targeted area. “All of these energy devices work in the same way to tighten lax skin,” says Shafer, who offers these services at his clinic.

On that note of multi-tech gratification, a fat removal technique that’s getting a lot of buzz recently — thanks to TikTok VIP Audrey Peters, among others — is AirSculpt. This is touted by influencers as a minimally invasive version of liposuction with less pain and downtime than the traditional procedure because it requires no stitches or general anesthesia. As a needle- and stitch-free option, AirSculpt may be perceived as less severe than a traditional lipo surgery, but essentially, according to all three of our experts, AirSculpt is simply another version of laser- and power-assisted liposuction. It utilizes laser energy (via a cannula) first to melt some of the fat cells, and then employs a “proprietary cannula” that uses power-assisted vibrations and vacuum pressure to break up the fat and suck it out. “The type of [local] anesthesia required would be dependent on the same factors as traditional liposuction,” says Shafer, “and the downtime will be the same, too. With any kind of liposuction procedure, the recovery depends on the amount of fat being removed and the size of the areas being treated.”

Another technology that’s taken lipo next-level? Fat transfer. “When I do lipo, I can save some of the fat and re-insert it somewhere else, such as into the cheeks or the nasolabial folds,” says Doft. Talk about sustainability.

Body Contouring Treatments Are Not The Same As Lipo

When it comes to permanently removing fat in a one-time procedure, liposuction is the gold standard and can’t be beat, which is why it continues to be a top choice among the younger generation. Non-surgical body contouring treatments, such as CoolSculpting and SculpSure, utilize devices that either freeze or heat and melt away fat cells, which work very differently than liposuction and require a series of treatments to get optimal results. “These devices are not interchangeable with surgical liposuction. They simply do different things,” says Shafer. “Energy-based devices that you put on the outside of the skin are treating the superficial layers of fat, and are much less effective at removing the deeper layers of fat than performing liposuction.” Parcells adds, “There are limits to the capabilities of these noninvasive treatments. Liposuction gives much more precise, customizable, and reliable results.”

The Ozempic Of It All

In the larger context of body improvement, the rise of weight-loss medications among those who do not have Type 2 diabetes reflects the culture’s fixation on being a certain size. These medications exploded into a full-blown phenomenon in the last year, and the trend is only rising. The in-demand drugs include Ozempic and Mounjaro, prescribed to treat Type 2 diabetes and off-label for weight loss, as well as Wegovy and Zepbound (both FDA-approved for weight loss). But will they dim liposuction’s popularity? Not likely. In fact, it may increase the amount of people who are able to have the procedure done. “We have a whole floor of our practice dedicated to metabolism and weight loss, so I think these options go hand in hand,” says Shafer. “I have patients who have lost weight on a combination of diet and exercise, and sometimes with one of these medications, but still have problem areas to address, and that’s where liposuction is really beneficial. Lipo takes you to a level that can’t be achieved with weight loss, or Ozempic, alone.”

The Future Of Liposuction

Those under 30 are not only more knowledgeable about liposuction, but they are also open to the point of TMI about having it done. Thanks to social media personalities and celebrities like Cardi B, who are vocal about sharing their experiences about getting the surgery (both the pros and the cons), lipo has gone mainstream. Just a few years ago, plastic surgery was a hush-hush thing, and now, the hashtag #liposuction has over 3 billion views on TikTok and influencers are posting before-and-afters on Instagram.

“For a younger generation of patients, plastic surgery and cosmetic procedures in general are more accepted, to the point that they want to video the procedure for social media,” says Shafer. “But patients may see something on Instagram, TikTok, or YouTube that’s very deceptive in terms of the recovery involved or realistic expectations for their results. There’s a lot of misinformation out there, and this is why consultation with a board-certified plastic surgeon is essential.”

Parcells adds, “I think the fact that celebrities are honest and totally transparent about getting work done is actually a good thing because it’s a healthier mindset than hiding it. There’s still a lot of guilt and judgment around plastic surgery for people over 40 or 50. That being said, younger patients will come in for a consultation and show me filtered versions of themselves, requesting to look like that in real life.” That’s a sharp reminder that as the popularity of liposuction rises, there’s a fine line between TikTok openness and unhealthy, unrealistic expectations.

“For many patients, liposuction actually serves as a springboard to living a healthier lifestyle,” says Doft. “They are excited to see an immediate change in their appearance, and then start eating better and exercising more. This younger generation is different: They own their bodies and their decisions, they’re proud of their choices, and they like to share the experience.” In 2024, the ideas of body positivity and self-improvement (including Ozempic or liposuction) co-exist. Gen Z embraces fitspo and lipo simultaneously. The key is to find a happy medium.

Studies referenced:

American Society of Plastic Surgeons (ASPS) (2022). ASPS Procedural Statistics Release. https://www.plasticsurgery.org/documents/News/Statistics/2022/plastic-surgery-statistics-report-2022.pdf

Experts:

Dr. Alexis L. Parcells, M.D., a board-certified plastic surgeon in New Jersey

Dr. David Shafer, M.D., a double board-certified plastic surgeon in New York

Dr. Melissa Doft, M.D., a double board-certified plastic surgeon in New York