WARNING: This is a medical blog intended ONLY for medical professionals!!! This blog contains nudity and graphic images of cosmetic surgeries. If you are offended by nudity and graphic images, or if your religion does not allow you to look at such images or to get cosmetic surgery done on yourself, please leave NOW!!! 

This woman in her mid-30s weighs just 49 kg, but yet her entire body is covered with thick layer of fat! This is what we call skinny-fat, and is a condition which is extremely prevalent in South East Asia and the Far East. This is why this patient flies all the way to Medan to look for Dr Arthur Tjandra of Elixir de Vie for arms liposuction. However, after watching most of the videos which Dr Arthur Tjandra of Elixir de Vie has published on his YouTube channel and this Vlog, as well as seeing the result on her sister’s arms, she makes it clear that she does not want to appear “muscular” after liposuction. Perhaps what she means is that she does not want her arms muscles to be visible. Well, is there such an option? Her sister is extremely unhappy with the result of arms liposuction Dr Arthur Tjandra performed for her. We have published the case study:

Patient No. 481: You call the result of this arms liposuction your masterpiece? Damn you! I want a refund! 

So, is there an option to hide one’s muscles? Yes, there is! As a matter of fact, depending on whether liposuction is performed on deep-seated fat only or both deep-seated and superficial fat, liposuction can be categorized as high-definition liposuction or non-high-definition liposuction. In high-definition liposuction, after taking out all the deep-seated fat, a surgeon proceeds to aspirate superficial fat located just underneath the skin. By making superficial fat as thin as possible, one’s muscles will show through such thin layer of fat. In the past, many surgeons tried marketing high-definition liposuction with ultrasound-assisted liposuction device, making it sound as if high-definition liposuction could only be done with ultrasound-assisted device and nothing else. On the contrary, high-definition liposuction can be done with just a plastic syringe and a small cannula. As a matter of fact, superficial liposuction should only be attempted by a skillful and extremely experienced surgeon using nothing but a plastic syringe and micro-cannula, because the risk of causing burns which result in ugly burn marks and adhesion scarring is extremely high if done with ultrasound device which uses heat to burn the fat. Superficial liposuction should also not be done with powered-suction because the risk of over-suctioning is extremely high, which will result in dents and irregularity. Less experienced surgeons should not attempt high-definition liposuction at all, and should just concentrate on aspirating fat from deeper layer. Dr Arthur Tjandra of Elixir de Vie has published so many case studies of the revision liposuction surgeries he performed, which show these complications on both his YouTube channel as well as this Vlog. This is perhaps why, we do not see any advertisements of high-definition liposuction anymore these days. It was so popular a decade ago. There have been too many high-definition liposuction cases went wrong in the past one decade!

By default, Dr Arthur Tjandra of Elixir de Vie performs high-definition liposuction on all his patients, unless stated otherwise, just like in this case study. And he performs high-definition liposuction with nothing but just a plastic syringe and a micro-cannula, which is a very tedious and challenging task. But, this is also the safest method which almost guarantees an almost perfect result with smooth surface, as what he has shown in the thousands of videos he has published on both his YouTube channel and this Vlog.

What, if a patient, does not want to appear “muscular”? We have received many complaints from our female patients after arms liposuction, previously. The complaints fall into 2 major categories:

  1. Those who complained about visible “grooves” and “dents” on their arms after liposuction, such as Patient No. 481.
  2. Those who complained about suddenly becoming “muscular” after liposuction.

Patients who belong to category number 1 above probably have never seen muscles before their entire lives. They may not even know what normal muscles appear like. They may be surrounded by fat women their entire lives, which is why when they finally see their own muscles, they consider the definition of the muscles as “grooves” and “dents” caused by over-aspiration during liposuction.

Patients who belong to category number 2 are more knowledgeable than patients in category number 1 because they know what muscles are, and they have seen muscles. They also know how muscles are shaped. However, for some reasons, they are not comfortable showing their muscles to the world, hence they want to “hide” them.

Can you hide your muscles? Yes, you can! By not removing the superficial fat during liposuction, and by not removing fat in all the “grooves” and “dents” of normal muscles definition, you can hide those muscles. However, leaving significant fat behind in order to hide muscles really defeats the purpose of getting liposuction done. One may still appear flabby after liposuction, if one chooses to do so.

For those who are not familiar with the shape of muscles and where the normal “grooves” and “dents” are, may refer to human anatomy charts readily available on the internet, such as these:

Human Anatomy - Female Body

Anatomy of female muscular system

Or, perhaps, make friends with healthy and fit people and hang around with them, instead of hanging around with fat people, so that you know what normal arms look like!

female toned arms 1

Video 1: Pre-op assessment of a “skinny-fat” body.

Video 2: Pre-op marking of the arms.

Video 3: Awake syringe liposuction under local anesthesia by Dr Arthur Tjandra.

Video 4: Completion of left arm liposuction. Comparison between right and left arms, before and after liposuction.

Video 5: Completion of non-high-definition arms liposuction.

Video 6: Result of non-high-definition arms liposuction, the next day.


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:


3 Comments on “Patient No.502: Arms liposuction, high-definition or not?

  1. Pingback: Patient No. 481: You call the result of this arms liposuction your masterpiece? Damn you! I want a refund! – L'Elixir de Vie, by Arthur Tjandra (曾华浚), M.D., FICS (Plastic Surgery)

  2. Pingback: Patient No. 481: Result of autologous fat grafting to buttocks to correct botched liposuction in Taipei, 6 months later – L'Elixir de Vie, by Arthur Tjandra (曾华浚), M.D., FICS (Plastic Surgery)

  3. Pingback: Patient No. 481, Session 2: Touch-up upper back liposuction and autologous fat grafting to buttocks - L'Elixir de Vie, by Arthur Tjandra (曾华浚), M.D., FICS (Plastic Surgery)

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