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This Australian athlete in her late-20s had calves liposuction done in Manila 2 years ago with undesirable result. After spending the last 2 years researching for a revision liposuction surgeon, she finally took the plunge to fly over from Sydney to Medan to look for Dr Arthur Tjandra of Elixir de Vie for revision liposuction.

The undesirable result stems from 3 issues:

  1. Over-aspiration over the back of the calves with under-aspiration on the rest of the areas, leaving behind a linear depression which is most obvious when the patient flexes her calves.
  2. Selective liposuction on just one small area of the calves disregarding the 3-dimension concept of the human body. To achieve good result, the entire circumference and the entire length of that region has to be addressed within the same session to achieve smooth, continuous and shapely result. In this case, the entire circumference of the calves, and the entire length, from the area just below the knees all the way down to the ankles must be addressed at the same time. Unfortunately, circumferential liposuction of large areas of the body, such as circumferential thighs or calves liposuction, carries the risk of deep vein thrombosis which leads to pulmonary embolism and death. This risk is further increased if the surgery is performed under general anesthesia. This is a noteworthy complication which is well-documented in liposuction text book. This is why most surgeons refrain from offering and performing 3-dimensional/circumferential liposuction. However, after having performed more than 10,000 cases of 3-dimensional/circumferential liposuction using nothing but a syringe and micro-cannula with maximum diameter of 3 mm, Dr Arthur Tjandra of Elixir de Vie finds that syringe liposuction is extremely safe because the suction generated manually with a syringe is so low and the diameter of cannula is so small that they inflict minimal injuries as compared to machine-assisted liposuction. General anesthesia increases the risk of deep vein thrombosis and pulmonary embolism. That is why Dr Arthur Tjandra of Elixir de Vie only performs his liposuction surgeries under local anesthesia. The only drawback is syringe method leaves the surgeon with multiple repetitive strain injuries over his muscles, joints and tendons.
  3. Burn resulting in adhesion, which is a very common complication of ultrasound-assisted liposuction. The burns also result in permanent skin discoloration. Skin discoloration is common after liposuction, however it usually fades away after a year. In this case, the skin discoloration persists even after 2 years.

Dr Arthur Tjandra of Elixir de Vie proceeds to break the adhesion scars and perform liposuction on the entire circumference and length of the calves down to ankles, and inject fat in the depression over the back of her calves.

One can compare the result of liposuction performed with different concepts and different techniques in the following videos and decide which concept and which technique they think is a better one.

This patient has blogged about her experience: Calves Liposuction in Medan with Dr Arthur Tjandra, the King of Liposuction.

This is a self-taken photo she emailed to us when she made an appointment for a revision liposuction surgery:


Video 1: Complications of VASER liposuction in Manila.


For more Liposuction Case Studies, please visit our website:

More liposuction before and after surgery photos can be see here:

Combination of liposuction and autologous fat grafting to breasts or/and buttocks can be seen here:

A list of our patients’ blogs:


1 Comment on “Patient No. 498: Undesirable result of calves liposuction with ultrasound-assisted liposuction

  1. Pingback: Patient No. 498: Undesirable result of calves liposuction with ultrasound-assisted liposuction – L'Elixir de Vie, by Arthur Tjandra (曾华浚), M.D., FICS (Plastic Surgery)

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