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Liposuction in Standing: “The True Liposculpture” 


Dr. Ziya Saylan 

Many patients visit us having undergone unsuccessful liposuction procedures elsewhere with unhappy results. This usually occurs when the patient’s body fat is marked in the standing position. After laying down on the operating table gravity vectors will change the position of the fat and the original place marked for suctioning will be displaced. As the inventor of the orthostatic liposuction technique Dr Giorgio Fisher describes during our personal talks, “Everybody looks healthier and slimmer on the beach as they lay down on the sand. While sitting or standing you can see all the fat again.” 


Dr. Ziya Saylan’s orthostatic “The Stand-Up Liposuction procedure” provides better results because it suctions against the gravity targeting the fat where it actually is. Moreover, patients can look at themselves in the mirror during the surgery to let me know if they would like any additional areas to be treated. 

The Procedure - Liposuction in the year 2022 does not require general anesthesia. Light IV sedation is sufficient. Experienced surgeons usually work with a combination of medicals, in which two medications are administered through the vein for pain and reassurance. After the additional ingestion of a pain pill, the insertion the tumescent solution (Klein solution) into the marked fat deposits vasoconstricts, numbs and dilutes the tissue for the treatment. The new procedure involves fewer incisions, smaller cannulas (3mm Saylan Liposuction Cannulas) and operates with the patient standing up (for the Lower half of the body including the belly and love handles). Local anesthesia of the entrance wounds of the cannulas and Tumescent Solution to loosen the fat reduces bleeding to a large degree. Following a superficial local anesthesia, the tumescent solution is filled into the marked fat pads via small stitches. With the help of a body mirror placed in the operating theater the patients will look at themselves in the mirror and let the surgeon know if they would like any additional areas to be treated and to what degree. This allows the patient in the stand-up position to be in better control of the liposuction and evaluate the results of the surgery. 

However, the “liposuction while standing” is only possible with fat pads on the legs and hips. The patient should be informed in advance that a liposuction in standing can only be realized for small amounts of fat on the legs and hips. 

With a much faster recovery time, optimal fat removal results and dramatic reductions in complications, the Stand-Up Lipo approach can give patients the chance they have always dreamed of. 

Some Plastic surgeons who are also advocates of Stand-up Lipo (like me) call this treatment of body fat reducing as The Smarter Liposuction". 


Depending on the area, the treatment can last up to 2-3 hours. The increased time required for the tumescent process as the sole disadvantage is reflected in the costs  – these depend on the scope of the procedure. 

In 1992, my master Dr. Fischer from Italy, Rome has  developed an orthostatic liposculpture operating table that permitted the patient to be moved from the horizontal to the vertical position during the liposuction procedure. By 1993, the table was improved to provide electronic control of the table movement, a rotating safety sling to secure the patient, and a footrest to sustain the patient’s weight. Fischer 3 had already lectured on the orthostatic technique.


In 1996, I have stated to perform the liposuction in standing position. The table  (Reverse Trendelenburg Operating Table) was not available all over that time. Now the Emirates Speciality hospital has bought this table for liposuction purposes in standing and I am ready to perform better liposuctions to my patients. 


An important aspect of using the orthostatic technique is understanding the seriousness of hypotension (low blood pressure) and the need for immediate treatment. Our stand up (orthostatic) table promptly allows the patient to be placed supine, without the need for increased fluids or epinephrine. When large amounts of tumescent solution are used, increasing intravenous fluids for treatment of a vasovagal reflex may result in fluid overload.


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