Boston Cosmetic
Boston Cosmetic

















Boston Cosmetic

Hidef Liposculpture Faq

1. What is Hi Def Liposculpture?

Hi Def Liposculpture is an advanced body contouring technique that enhances the visibility of well toned muscles. It involves the removal of deep and superficial fat to enhance the appearance of abdominal, rib, flank, chest and back muscles resulting in a toned look for the ladies, and a sculpted cut look for the men (colloquially known as the ‘sixpacks’).

It is performed with the Smartlipo Triplex Laser and VASER® ultra-sound assisted lipoplasty technology. Hi Def Liposculpture has applications beyond just the torso, it can also be applied to the arms, the chest (‘breast definition’ in ladies), buttocks, the thighs and calves.

2. What is involved?

Hi Def Liposculpture, including VASER Hi Def, is very different than any other lipoplasty technique and it is a more sophisticated and complicated procedure than standard VASER or Laser Lipo. As such, following your initial consultation with doctor Edwin Ishoo, once you have decided you wish to proceed, you will be invited back for a pre-op check up with one of our trained staff who will perform some medical examinations such as, blood pressure, vital statistics, photography, and dietary details in order to ensure everything goes smoothly for you. You will also be given a prescription for your aftercare medications. Then a date will be scheduled for you. It is important but not necessary that you have someone to care for you in the first 48 hours following surgery as the garments are quite tricky! On the day of surgery you will meet your surgical team who will check you once more before giving you what is known as Oral Sedation, in addition to local anesthetic which give you a safe, comfortable and painless experience. Following surgery (which can take between 2-4 hours), you will be observed in the clinic for a up to couple of hours before being discharged with your companion. We will then see you for your post-op therapy sessions every day for the next 7-10 days depending on your recovery.

3. Is Hi Def Liposculpture Right for Me?

Hi Def Liposculpture including VASER Hi Def elevates liposuction and body contouring to a new and higher level, targeting a whole new patient population who would otherwise never have even considered themselves candidates for liposuction. Hi Def Liposculpture and VASER Hi Def are designed for sculpting, rather than de-bulking. Therefore, the procedure is intended for generally fit men and women who exercise regularly. They should also have nice muscle tone and good quality skin. The typical patient maintains a healthy lifestyle through diet and exercise, but is unable to achieve the desired definition.

Many healthy, fit people complain that they go to the gym but have trouble achieving the tone they desire, no matter how lean they become. This is the beauty of Hi def Liposculpting including VASER Hi Def Liposculpture with Dr. Ishoo in Boston. Fat cells can be targeted directly around specific muscle groups to help define those areas. Typical treatment sites for Hi Def Liposculpture include the muscles in the abdomen, men’s chests and the lower back and buttocks in women. Patients also use the procedure to enhance their breasts, arms, thighs, hips and waist.

4. What is the difference between all other types of liposuction and Hi Def Liposculpting?

The difference is that Hi Def Liposculpting including VASER Hi Def target muscle groups to define them, while all other types of liposuction techniques target pockets of stubborn deep fat just to get rid of them. Hi Def Liposculpting and VASER Hi Def are intended for physically fit, active individuals wishing to increase the appearance of already existent muscle tone and create a sculpted look. All other types of liposuction including VASER LipoSelection and Laser Lipolysis, however, are intended for individuals who have stubborn pockets of fat on their body that they can’t get rid of. This fat collection may be due to a predisposition to store fat in certain areas and the inability to get rid of the fat once it is stored. These are mainly deep fat de-bulking and not sculpting or toning techniques.

Hi Def Liposculpting goes beyond just fat removal and achieving inch loss that is traditionally associated with liposuction. It involves an intimate knowledge of the patient’s muscular anatomy and natural contours, to create a slim, toned and yet natural look. This creates an appearance for the torso, arms, back, buttocks and thighs that will otherwise require long hours of gym work and severe dieting.

5. How is Hi Def Liposculpture done?

It involves the usual bulk removal of fat with VASER LipoSelection and subdermal skin release with Smartlipo Triplex™ Laser for optimal skin contraction. This is followed by a detailed sculpting process following the patient’s natural muscular anatomy. A thin layer of adipose tissues is left behind in some areas while more is removed in others, to bring out a toned appearance as well as occasional transfer of fat to improve natural contour.

6. Is this cheating?

Interestingly, patients that have underwent Hi Def Liposculpture including VASER Hi Def, became more motivated in exercising in the gym and were more heath conscious after. The distinct improvements in their bodies’ appearances have a strong motivating effect to encourage them to lead a healthier lifestyle.

7. Is Hi Def Liposculpture riskier than traditional or VASER Lipo?

Hi Def Liposculpture doesn’t impose any additional risks of major complications when compared to traditional or VASER LipoSelection.

8. What if a person gains weight?

There is certain flexibility – if your weight gain does not exceed 10 pounds you will still maintain the definition sculpted. However if significant weight gain occurs, you may lose the definition.

9. What is the recovery process for Hi Def Liposculpture?

Hi Def Liposculpture does not impose a significant longer recovery compared to traditional liposuction or normal VASER LipoSelection. However, there will a specific post-lipo recovery program for high definition, which Dr. Ishoo will discuss with you in detail.

After undergoing Hi Def Liposculpture including VASER Hi Def with Dr. Ishoo in Boston, patients are usually able to return to normal activity after one to two weeks. Most individuals report minimal pain and swelling. Occasionally, there are some patients who experience more pain or bruising than others, although this is not typical.

The first signs of the improved muscle definition can be seen immediately post-op with significant fluctuation in definition within the first 2 to 3 weeks as the post-procedural edema and fluid collection gradually resolve, at about two weeks when the post-procedural swelling has resolved. After about a month the patient can usually resume their exercise routine. By two months, the appearance may be close to maximum in the morning but may be less optimal as the day progresses due to the onset of swelling throughout the day. Final results are seen after about four to six months.

10. Does a person have to exercise?

Exercise has tremendous benefits not just to patients’ health; it also offers a great boost to their well-being and outlook in life. Exercise also helps to enhance the definition created by Hi Def Liposculpture. The high definition results are created by the procedure, regardless of exercise. But exercise can certainly enhance the results.

11. Isn’t high definition only for men? Why will women want ‘six-packs’ or definition?

Hi Def Liposculpting is not just for men but for women too! Yes, Hi Def Liposculpting including VASER Hi Def can ‘carve out’ the ‘six-packs’ for men. It also sculpts the oblique and rib muscles for the torso. It can also help sculpt the arms and back.

However it is not just for men! At Boston Cosmetic Specialists, Hi Def Liposculpting has helped women achieved a naturally toned torso which can range from looking ‘soft’ to ‘defined’. Its applications are across gender for all possible areas.

For women there is a heavier emphasis to retain the feminine look. Most women do not want a six pack, but would prefer the muscles to be defined along the borders of the stomach muscles, from the bust down to the groin, without the horizontal lines. Women’s waistlines can be transformed in to hour glass figures, and we can even increase the definition around your breasts as well. Your Hi Def specialist will discuss with you your goals and ensure you have enough information to take with you to make an informed decision. It is important that, your skin tone is good, as saggy skin will not shrink back enough and cling to the muscles. Your suitability will be determined at your consultation.

12. What areas on my body are optimal for Hi Def Liposculpture?

The most common areas are: Butt, breasts, stomach (six-pack), hips, men’s pecks (chest), waist (love handles), upper legs, and triceps (back of upper arm fat).

For men this means sculpting the chest to reveal the pectoral muscles, sculpting the abdominal area to bring out the abdominal muscles or ‘six pack’ (rectus abdominis), the internal obliques and the serratus muscle. On the back it means finally getting rid of love handles. This procedure can take 20 years off a torso in four hours.

For women it means getting rid of the fat pads on the side of the breast under the armpit, creating the female six pack, which while not as overt as a man’s, is aesthetically pleasing and gives a woman a svelte look of youthful athleticism and vibrancy. It also re-creates the waist, eliminates extra hip weight and gets rid of the fat under the bra line and on the back. If necessary, fat can be transferred into the buttocks for a ‘Brazilian butt lift.’ A very feminine hourglass figure can finally be achieved.

13. Can any doctor perform Hi Def Liposculpture?

Only doctors such as Dr. Edwin Ishoo who are trained by Advanced Body Sculpting (ABS) Institute (formerly known as VASER Institute), are certified to be qualified to perform this procedure.

14. Who is the ideal candidate?

Since Hi Definition Liposculpting is designed to be a sculpting procedure rather than the traditional de-bulking liposuction technique, the ideal candidate is the person who is reasonably fit and has a BMI of less than 28, good muscle tone without excessive amounts of fat or skin laxity. The majority of the people who undergo this procedure work out three to five times a week. However, they may fail to achieve the desired muscle definition because that depends on the presence of a very low level of total body fat, about 3 percent. Ideally, patients should be gym-fit to be able to continue with exercise and maintain the muscular definition. Often, Hi Def Liposculpting gives one the motivation to go back to the gym with a renewed sense of motivation and commitment to maintain a beautiful body. The people whom one might least expect to have liposuction benefit most from Hi Def Liposculpting procedures such as VASER Hi Def. Personal trainers, gym fanatics and models make up 70% of the clients for Hi Def Liposculpting techniques such as VASER Hi Def. Consultation with Dr. Ishoo is crucial in determining suitability and realistic expectations for each individual interested in the Hi Def Liposculpture procedure.

15. What happens during the Hi Def Liposculpture procedure?

First, the area to be sculpted is filled with a special saline solution that helps keep the site numb and shrink the blood vessels (this minimizes blood loss and reduces bruising). This solution wets and fills the area of focus, making fat easier to break up with the Laser and VASER System’s sound energy. Then a small, probe transmits Laser light or the VASER’s ultrasound energy (similar to what is used for cataract removal in the eye) that release the skin and breaks up fatty tissue on contact, while leaving other important tissues relatively intact. Finally, massage and suction of the sculpted site removes the fat quickly and easily. Thanks to the combination of these advanced technologies and unique technique, the result is a natural looking, toned and sculpted body.

16. What type of anesthesia is used?

At Boston Cosmetic Specialists, oral sedation and tumescent anesthetic combination is used for Hi Def Liposculpture including VASER and Smartlipo Hi Def.

The Hi Def Liposculpture including VASER Hi Def procedures takes considerably longer for each area compared with typical liposuction or normal VASER Lipo.

17. What’s the advantage of general vs. local anesthesia? Office vs. hospital procedure?

Some individuals find the thought of any surgery very disturbing. In an our facility, under local analgesia and oral sedation, you are unaware of discomfort – you are safe and comfortable. This method of anesthesia is often preferable when you are having a large amount of fat removed, having multiple sites treated, or undergoing a Hi Def Liposculpture procedure and the convenience and familiarity of the doctor’s office allows for maximum confidentiality and comfort.

18. What do Hi Def Liposculpture and VASER Hi Def Costs?

The cost of your Hi Def Liposculpture including VASER Hi Def procedure at Boston Cosmetic Specialists will be contingent on which body part is being treated. For a more personalized assessment of what the Hi Def Liposculpture procedure including VASER Hi Def prices might be for you, please meet with Dr. Edwin Ishoo and his team of professionals at Boston Cosmetic Surgery Specialists today. We welcome queries from patients across the greater Boston region, including residents of South Shore, North Shore, Cape Cod, Metrowest, Worcester, Springfield, Providence and other neighboring regions.

19. What is fat transfer?

Fat transfer, also known as fat injection, is a cosmetic procedure in which fat is removed from one area of the body (usually the waist, abdomen, or legs) and then re-injected into very specific areas of the face in order to restore the volume that gives the youthful glow that all of us lose with age or with athletic activity. Also, some individuals have a naturally gaunt or thin face, with little definition, and fat transfer can greatly improve the contours and balance of the face in these patients. While this youthful, healthy glow can also be restored with injectable fillers, the advantages of using fat are that it is your own tissue, which eliminates the chance of an allergic reaction, and that it lasts for many years, if not permanently, as opposed to fillers which typically last one year or less.

Transferring existing fat from unsightly places into your breasts is ideal for a number of reasons:

  • Fat is what comprises your natural breasts and therefore the end result is the most natural breast augmentation available.
  • The procedure tones other parts of your body in addition to your breasts.
  • Nothing artificial is required for the process.
  • Your body will not reject its own fat.
  • There is minimal need for incisions, reducing the risk of scarring.
  • Fat can be shaped and molded in ways synthetic materials cannot.
  • There is no risk of an implant rupturing.
  • The results are long-lasting.

First used for breast augmentation in 1985, fat transfers have, in recent years, come to be one of the most popular ways to improve the overall appearance of your body.

20. How much fat can be taken with Hi Def Liposculpture including VASER Hi Def?

There are limits to how much fatty tissue can be safely removed from the body. One way to get a good idea for yourself is to stand and try bending at the waist. The amount of ‘loose-hanging’ fat (the stuff we all hate!) you can easily grab above / below your waist will be, approximately, what can be removed. Keep in mind that this procedure is not intended as a solution to weight loss. The goal is to create a slimmer figure or silhouette. You may not notice a significant amount of weight loss, but should be pleased with your slimmer new figure. In the past there was a limit to how much could be removed in any given area and how much could be removed specifically from the superficial layer. With that advanced technique and tools of Hi Def Liposculpting including VASER Hi Def there is much less bleeding, more fat can be removed and the skin shrinks better. In addition by following the artistic and anatomic geography of the body, the patient’s muscle outlines are brought out and emphasized.

21. What are the limitations of Fat Transfer procedure?

Although this technique is gaining attention and scientific validity, many surgeons are still on the fence about the real potential of the procedure. There are several very important drawbacks associated with the fat grafting technique, drawbacks that all surgeons must be careful to explain to their patients:

  1. Results possible with fat transfer are nowhere near as dramatic as results possible with traditional breast augmentation (with implants). It’s an important distinction between the two options.
  2. Fat transfers sometimes produce inconsistent results. While a skilled surgeon may be able to help prevent things like asymmetry, fat could calcify and harden into lumps (without any surgeon error).
  3. The body tends to absorb a good deal of the transferred fat, so size increase over time may be even less than expected.

For these reasons, fat transfer is generally suggested for women who want a very modest size increase. But, with such potential drawbacks, why consider it at all? Proponents explain that patients get a dual benefit – reduction of fat deposits (through liposuction) and slight augmentation. They also point out that, because no implant is used, there is no risk of capsular contracture, implant rupture, or other implant-related complications.

22. Is fat transfer right for me?

A hot trend in body sculpting, fat transfer procedures use your own fat (removed from one area of your body) to volumize or contour another part of the body. If you are looking to gain or restore the healthy glow and volume of youth, then fat transfer may be right for you. VASER Lipo-treated fat is highly viable, high quality, and easier to transfer for these types of procedures.

Fat transfers for breast augmentation are not suitable for everyone. In order to be qualified for this procedure you need to:

  • Have adequate fat on your body to transfer to the breast
  • Have a healthy mammogram prior to the procedure
  • Have realistic goals and understand that this is a natural process and may not produce results similar to traditional implants

Dr. Ishoo is happy to meet with you for a complimentary consultation to show you what results you can expect from a fat transfer and help you decide if fat transfer can address your needs.

23. Where can I stay?

We can help you arrange local accommodations depending on your budget. There are several B&B facilities and smaller hotels in the MetroWest area so please just ask us.

24. What if I don’t have a companion?

Although many patients are comfortable without a companion, if you do not wish to be alone after the Hi Def Liposculpting procedure we can arrange a nurse to stay with your for as long as you need assistance, which is usually for the first 48 hours.

25. What do I do now?

If you would like to book a consultation with Dr. Edwin Ishoo to find out if Hi Def Liposculpture using Smartlipo Triplex and VASER LipoSelection is suitable for you, please call our friendly team at 508.861.7007.


Boston Cosmetic Surgery Center is a leading cosmetic care center in Massachusetts and New England. Boston Cosmetic Surgery Center is committed to providing improved quality of life through enhanced physical appearance, offering a complete range of services including liposuction, Smartlipo Triplex, VASER Hi Def Liposculpture, injectables, autologous fat transfer and facial laser enhancements to communities within MetroWest and greater Boston . For more information on VASER Hi Def or to schedule a complimentary consultation with Dr. Ishoo regarding any of our services at Boston Cosmetic Specialists, please call 508.861.7007 or visit the clinic’s website at