Ultrasonographic Quantification of Reduction in Subcutaneous Fat Thickness Following Large-Volume Liposuction

Large‑volume liposuction is widely performed for abdominal contouring, yet objective, site‑specific quantification of subcutaneous fat reduction remains limited. Ultrasonography (USG) offers a practical, radiation‑free method for serial assessment, but its postoperative utility is under‑reported.

This study aimed to quantify changes in abdominal subcutaneous fat thickness following large‑volume liposuction using USG and to evaluate associated changes in waist circumference, complications, and patient satisfaction.

A prospective observational study was conducted on 50 patients (21-45 years) undergoing large‑volume abdominal liposuction (>5 L aspirate). Subcutaneous fat thickness was measured ultrasonographically at four standardized abdominal sites (supra‑umbilical (S), infra‑umbilical (I), right (R), and left (L)), pre‑operatively, one week, one month, and six months. Waist circumference was recorded at six months. Complications and patient satisfaction were documented. Repeated‑measures ANOVA assessed changes over time, and Pearson correlations evaluated associations between fat‑thickness reduction and waist‑circumference change.

Significant reductions in subcutaneous fat thickness were observed at all sites (p < 0.001), with mean reductions of 36%-44% at six months. Early maximal reductions at one week were followed by partial rebound at one month and stabilization by six months, reflecting edema resolution and tissue remodeling. Waist circumference decreased by a mean of 9.82 cm (≈10%). Correlations between waist‑circumference reduction and ultrasonographic fat‑thickness changes were weak and non‑significant, indicating that circumferential measures do not reliably reflect localized fat removal. Postoperative seromas/hematomas occurred in 84% at one week and resolved by one month. No major complications were observed. Patient satisfaction at six months was 96%.

Large‑volume abdominal liposuction produces substantial and durable reductions in subcutaneous fat thickness and waist circumference. USG is a reliable, accessible, and cost‑effective modality for objective, site‑specific postoperative assessment, outperforming waist circumference in detecting localized fat‑layer changes. Larger studies with extended follow‑up and comparative imaging may further refine its role in body‑contouring evaluation.