VASER Liposuction
VASER (Vibration Amplification of Sound Energy at Resonance) liposuction uses focused ultrasound energy delivered through a small probe inserted into the subcutaneous fat layer to selectively emulsify fat cells before extraction. The ultrasound energy disrupts the fat cell membranes while preserving the surrounding blood vessels, nerves, lymphatics, and connective tissue — producing a smoother, more complete fat removal with significantly less trauma to the surrounding tissue architecture than traditional mechanical liposuction cannula techniques.
The clinical advantages of VASER over traditional liposuction are well-documented: less post-operative bruising and swelling (typically 30–40% reduction), faster recovery, smoother contour results due to more uniform fat extraction, better preservation of the connective tissue scaffold that supports skin retraction, and the ability to safely treat fibrous areas such as the back, male chest, and revision territories where traditional liposuction encounters resistance from dense connective tissue. Dr. Karamanoukian uses VASER as his primary liposuction platform for most body areas, combining it with traditional tumescent technique for the larger volume extractions of Lipo 360.
Best For: All body contouring areas; particularly superior for fibrous zones (back, male chest, flanks); revision liposuction with existing fibrosis; combined with Lipo 360 for circumferential contouring; lower bruising and faster recovery than traditional lipo
Lipo360 Body Sculpting
Lipo 360 treats the complete circumference of the trunk — the anterior abdomen, bilateral flanks, love handles, and posterior back rolls — in a single operative session, creating three-dimensional waist definition and the hourglass silhouette that single-area or anterior-only liposuction cannot achieve. The 360-degree approach recognizes that the body is a three-dimensional object and that the waist’s perceived narrowness is determined by the relationship between the anterior waist, the lateral flank, and the posterior width — improving only the anterior abdomen while leaving the flanks and back rolls untouched produces a result that appears narrow from the front but unchanged from the back and sides.
Dr. Karamanoukian performs Lipo 360 using VASER pre-treatment for the fibrous flanks and back, followed by meticulous tumescent liposuction in layered passes at graduated depths to create smooth, natural-looking circumferential contour. The patient is repositioned from supine to prone during the procedure to allow equal access to all treatment zones. Most Lipo 360 procedures take 2–4 hours depending on the volume of fat requiring treatment and are performed under general anesthesia or deep sedation in Kare Plastic Surgery’s accredited Santa Monica surgical facility.
Best For: Patients wanting comprehensive waist definition; hourglass silhouette creation; love handles, back rolls, flanks, and abdomen treated simultaneously; mommy makeover component; post-pregnancy body restoration
Arm/Thigh/Hip Lipo
Liposuction of the inner thighs, outer thighs (saddlebags), and hips is among the most technically demanding body contouring applications because of the complex three-dimensional curvature of the lateral hip-thigh transition, the risk of contour irregularity at the gluteal crease if the posterior thigh is over-reduced, and the importance of preserving the natural convexity of the upper lateral thigh that contributes to the feminine hip curvature. Dr. Karamanoukian contours the thigh circumferentially when treating lower body cellulite and fat excess — addressing the inner thigh gap, the outer thigh saddlebag, and the banana roll (posterior sub-gluteal fat) in a coordinated three-dimensional plan.
Dr. Karamanoukian performs fat transfer to the breasts from harvested extremity fat during liposuction in certain cases of hypomastia. In terms of BBL fat transfers; Dr. Karamanoukian focuses exclusively on BBL reversal surgery.
Best For: Saddlebag outer thighs, inner thigh excess, banana roll, posterior thigh; combined with Lipo 360 for lower body transformation;
Lipedema Liposuction
Upper arm liposuction is an alternative to formal brachioplasty (arm lift surgery) for patients with localized upper arm fat excess and sufficient skin elasticity to retract after fat removal without requiring excision. Dr. Karamanoukian evaluates each patient’s arm anatomy at consultation — assessing the proportion of fat excess to skin laxity — to determine whether liposuction alone will produce adequate arm definition without residual skin looseness, or whether the degree of skin excess requires the excision of a full brachioplasty.
For patients with predominantly fat-excess arms and good skin elasticity, VASER arm liposuction of the medial upper arm (posterior and inferior compartments) produces meaningful arm slimming without the brachioplasty scar that runs along the inner arm from axilla to elbow. For patients with significant skin laxity, Dr. Karamanoukian performs brachioplasty with liposuction combined — the liposuction reducing the fat burden before the skin excision, producing the best possible arm contour with the most conservative possible skin excision.
Best For: Localized upper arm fat with good skin elasticity; patients wanting arm slimming without brachioplasty scar; combined with tummy tuck or mommy makeover; axillary accessory breast tissue removal
Male Chest Liposuction
Gynecomastia — the benign enlargement of male breast tissue — affects approximately 40–60% of men at some point in their lives and is one of the most psychologically impactful body image concerns among male patients. At Kare Plastic Surgery, Dr. Karamanoukian evaluates every patient presenting with chest enlargement for the proportion of glandular breast tissue (firm, disk-like tissue beneath the nipple-areola) to fatty tissue (soft, diffuse breast region fat). This distinction determines the surgical approach: purely fatty gynecomastia is treated by liposuction alone, while glandular gynecomastia requires combined liposuction and gland excision through a periareolar incision for complete correction.
VASER liposuction is particularly valuable for gynecomastia correction because the fibrous nature of male chest tissue — denser and more resistant to conventional liposuction than female breast fat — is more effectively emulsified by VASER ultrasound before extraction, producing a smoother result with less skin bunching. For patients with skin excess from long-standing gynecomastia, skin excision patterns are selected at consultation to provide the necessary skin removal while minimizing scar visibility.
Best For: Male breast enlargement from fatty and/or glandular gynecomastia; VASER preferred for fibrous male chest tissue; combined gland excision for significant glandular component; meaningful improvement in chest confidence and shirtless appearance
Mommy Makeover Lipo
Liposuction body contouring of the flanks, waist, hips, and thighs is the three-dimensional complement to the abdominoplasty and breast surgery that forms the core of the mommy makeover — and is what transforms a good mommy makeover result into a genuinely transformative one. A tummy tuck addresses the anterior abdominal surface; liposuction addresses the circumferential body contour. A patient who has had an excellent tummy tuck but no flank liposuction will have a flatter abdomen but the same waist circumference — she will not achieve the hourglass silhouette that is the hallmark of comprehensive post-pregnancy body restoration.
Dr. Karamanoukian plans the liposuction components of every mommy makeover as a three-dimensional body contouring operation — treating the flanks, love handles, lateral hips, and thighs in proportions that complement the anterior abdominal result produced by the tummy tuck and the breast shape produced by the concurrent breast surgery, creating a harmonious total body transformation that is greater than the sum of its individual components.
Best For: Post-pregnancy waist and hip contouring combined with tummy tuck and breast surgery; 360-degree body transformation in single session; harvested fat available for breast or buttock fat transfer when indicated