June 29, 2026 | Body Contouring
A patient sat down in my office last year and told me she was less afraid of surgery than of walking out with a bad lipo. She had spent weeks watching recovery videos. She knew the words lumps, dents, and fibrosis before I said any of them. I told her that was a smart fear, and that almost every answer to it comes down to two things: how much I take out, and how disciplined we are about aftercare.
These questions come straight from consultations like hers, anonymized.
What Does a Lipo 360 Actually Cover?
Three-sixty means we treat all the way around the trunk, not just the front. That is the full abdomen including the waistline, a little blending into the mons (the area just above the pubic bone), the lateral chest, the upper and lower back, and the flanks (your sides, the soft area above the hip).
For arms, it is essentially circumferential, the same idea applied to a limb. The point is a contour that looks right from every angle.
How I Prevent Lumps and Fibrosis
Two things matter most, and I build both into your plan before you ever go to sleep.
First, lymphatic massage, which is gentle, directed massage that moves trapped fluid out of the tissue. We have an in-house tech, and I want you in two or three times a week for about four weeks. That breaks up fibrosis (the firm, scar-like tissue that can form after lipo) before it becomes a problem you can see or feel.
Second, I leave a small drain in the abdomen. When you do your massages, any trapped fluid comes out fast. Lumpiness almost always comes from fluid getting stuck, so clearing it early prevents most of it.
How I Keep You From the Over-Done Look
By not removing too much fat. That is the whole secret, and it is harder than it sounds. I leave enough healthy fat so the contour still looks natural.
A bad lipo is one where you can tell at a glance that someone had liposuction. The contour is irregular and the belly button looks off. On top of careful removal, J-Plasma, a skin-tightening technology, helps the surface smooth back down, though how tight it gets depends on how your skin responds.
Will Lipo Flatten the Bulge When I Relax?
Not entirely, and I tell every patient this honestly. What I remove is what we can pinch. If you have a bulge when your muscles relax, that is usually the abdominal muscles having separated, often during pregnancy, and the only thing that repairs that is a tummy tuck.
A tummy tuck makes everything flat and tight and repairs the muscle, like a built-in corset. It is significantly more improvement than lipo alone, but it comes with a scar. I would rather you understand the trade-off than feel disappointed later.
Should I Do the Fat Transfer or Skip It?
Consider keeping it. Once we discard your fat, we cannot get it back, and adding volume later with a product like Sculptra gets very expensive.
We do not have to do a dramatic Brazilian Butt Lift. Sometimes just filling the hip dips gives a smoother curve from waist to hip without much projection. I tailor it to you, from very subtle to dramatic, working from a photo of what you like. I always place a little extra because about thirty percent reabsorbs, so it looks slightly full at first and then settles. The same fat transfer principle applies anywhere we move your own tissue.
How Bad Is the Recovery?
Honestly, easier than people expect. I have had liposuction myself. The pain is like going back to the gym after a long break, sore with movement but tolerable. If you have had a C-section, this is easier than that.
You see a difference almost immediately, but you will be swollen, and it keeps improving with the massages and the compression garment. We provide two Marena fajas with clips so we can size you down as the swelling drops, worn for four weeks, off twice a day to shower. You can shower the next day, and my nurse visits to help with that first shower. Most swelling is gone by two weeks, with improvement continuing for up to six months. One week to get back to normal, four weeks for full exercise.
Am I a Good Candidate?
This is a fair question to ask before you fall in love with a result. The best candidates for liposuction 360 have localized fat they can pinch, reasonably good skin tone that will snap back over the new contour, and a stable weight that is not swinging up and down.
Liposuction is not a weight-loss tool, and I will tell you so directly. If you are still actively losing weight, settling it first usually gives a better, longer-lasting result. And if your main issue is loose skin or separated muscle rather than fat, lipo alone is the wrong answer, which is exactly the kind of thing we sort out at your consultation before any plan is set.
How I Plan Your Contour Before Surgery
I do not improvise this. We talk through which areas bother you, I assess your skin and what we can pinch, and for the fat transfer we work from a photo of the shape you actually like, so we are aiming at your goal rather than mine.
I also walk you through the honest limits of each piece. What liposuction will do, what it will not, where J-Plasma skin tightening helps, and whether a tummy tuck belongs in the conversation. The plan we build together is specific to your body, which is the whole point.
Why I Do This Carefully
I am double board-certified by the American Board of Plastic Surgery and the American Board of Surgery, a Fellow of the American College of Surgeons, and I completed my plastic surgery fellowship at the Mayo Clinic. I am also a Clinical Associate Professor of Plastic Surgery at Texas Tech University Health Sciences Center Paul L. Foster School of Medicine. Body contouring is a large part of my practice, and the difference between a smooth result and a lumpy one is judgment about how much to leave plus a disciplined aftercare plan.
Ready to Talk?
If you want contour without the over-done look, bring your goals and a photo of the shape you like, and let us map it together. For the surgeon’s editorial take, see the companion essay on drworldwide.com. For the recovery and massage menu, see the version on swplasticsurgery.com.
Call (915) 590-7900, text 1-866-814-0038, or book online at agulloplasticsurgery.com. #StayBeautiful.
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