Where Do Liposuction Scars Appear, and How Many Are There?

Hello, I'm Dr. Jaeho Cho, Director of TheLINE Plastic Surgery.

"How many scars will liposuction leave? I'm worried they'll show when I wear shorts."

Liposuction scars form at the incision sites where the cannula (the thin tube used to remove fat) is inserted. Each incision is small, usually around 2mm, so what really determines scarring is not the size but how many incisions are made, where they are placed, and how well the entrance is protected during surgery. A long cannula can reach a wide area through fewer incisions, which makes it possible to gather the incisions in places hidden by creases or clothing: two near the armpits for the arms, and three around the hips and tailbone for the abdomen and thighs. Incision sites usually look red at first and fade over several months, though this can take a year or more. The exact placement and number of incisions depend on the treatment area and body shape.

Where Are Liposuction Incisions Placed for Each Area?

Liposuction can only remove fat within the range the cannula can reach. With a short cannula, treating a wide area evenly requires incisions at several points, which means more scars and scars in more visible places. A longer cannula reaches further from a single point, so fewer incisions are needed and they can be moved to hidden spots.

Arm liposuction is done through two incisions: one at the front of the armpit and one at the back. Because the incisions slightly overlap the armpit crease, they often blend into the crease and become hard to see over time. These two incisions allow liposuction all the way around the arm, a full 360 degrees.

The abdomen is usually treated through three incisions: one on each side of the pelvis and one near the tailbone. When the abdomen and thighs are treated together, the same three incisions can be used to reach the thighs, so adding an area does not mean adding as many incisions.

These are typical placements. Incision sites and number may vary with the treatment area, fat distribution and skin condition.

Do Fewer Liposuction Incisions Mean Less Fat Removed?

Many people assume that bigger incisions let more fat come out, but that is not the case. In fact, more incisions make surgery more complicated. For every incision, the surgeon has to keep track of how much fat was removed in which direction from that point and balance it all across the whole area. The more factors there are to consider, the more variables come into play, and in my clinical experience, more variables make an uneven result more likely.

That is why treating a wide area through few incisions requires a long cannula. At TheLINE, we mainly use 70cm long cannulas and have lengths of up to 100cm. The longer the cannula, however, the harder it is to feel where the tip is, so handling a long cannula naturally takes clinical experience.

Can Thigh and Calf Liposuction Be Done Without Knee Scars?

When the thighs and calves are treated all the way around, incisions are often placed at the inner knee or ankle to give the cannula enough angle of access. These spots are easily exposed in shorts or skirts, so patients often ask about them during consultations.

One study reported a way to reduce these incisions. Researchers at the Plastic Surgery Hospital of the Chinese Academy of Medical Sciences and Peking Union Medical College used custom-made long cannulas bent before use, a "bent cannula" technique, to reduce thigh and calf liposuction to three incisions[1]. All three were placed within the bikini area: one in the pubic area and one in each lower buttock crease[1].

The study followed 40 patients (mean age 25.9, range 18 to 42) who had this procedure with the same surgeon between January 2020 and December 2022, for 12 to 39 months, and no patient reported serious complications[1]. Both the surgeon and the patients were reported to be satisfied with the long-term results, and the authors noted that two patients (5%) had slight pigmentation on the upper inner thigh, which was still acceptable[1].

However, this was a case series of 40 patients from one hospital and one surgeon, not a randomized comparison with other methods, and the results are limited to the thighs and calves. Using long cannulas to reduce incisions at TheLINE follows the same principle, but incision placement for the legs is decided in consultation based on the treatment area.

What Matters During Surgery for a Fainter Liposuction Scar?

Liposuction incisions are 2mm or smaller, so in most cases the size of the incision itself is not a major concern. What makes a scar darker is the damage that small entrance takes during surgery. If the cannula is forcefully twisted to reach in several directions from one incision, the skin at the entrance can be crushed and torn, and a wound damaged this way tends to leave a scar even when it is stitched well.

So during surgery we pay attention to three things. First, we keep the pressure on the incision entrance to a minimum. Second, we place a protective device in the entrance so the cannula does not rub directly against the skin as it moves in and out. Third, we prevent friction heat from the repeated cannula movement from raising the temperature at the entrance. After surgery, rather than stitching only the outer skin, we close the incision in two layers, first the inner layer and then the outer, so the wound heals evenly.

One study looked at the effect of protecting the entrance. It reviewed the records of 60 consecutive patients who had liposuction or fat grafting at a hospital in the United States: the first 30 had surgery without protection, and the next 30 had a silicone tube placed in the incision[2]. Complications at the incision site, such as scarring, wound opening and pigmentation, occurred in 10 patients (33.3%) without protection and 2 patients (6.7%) with protection[2]. However, because this was a retrospective study comparing two time periods rather than randomly assigned groups, the influence of other factors that changed in between cannot be fully ruled out.

How Should Liposuction Scars Be Cared For After Surgery?

As incision sites heal, they often look red and slightly raised at first, then flatten and fade over several months. For some people this takes a year or more, so the early red appearance is not what the final scar will look like. How scars form and fade is covered in "Why Do Scars Form and How Do They Fade?"

Right after surgery, it is best to avoid strenuous movements that put stress on the incisions. If a wound opens and then heals again, the mark can last longer. When to return to exercise is covered in "When Can I Start Exercising Again After Liposuction?" Smoking and alcohol can also slow wound healing, so it is best to be careful with both.

Problems with liposuction incisions are uncommon. Still, if something seems unusual, such as the wound opening or oozing, it is better to visit the clinic right away than to wait and hope it gets better. A wound needs to be seen in person to be assessed, and the longer a problem is left, the longer the mark may last.

Frequently Asked Questions About Liposuction Scars

Individual Differences and Precautions for Liposuction Scars

• Incision sites and number may vary with the treatment area, extent of treatment, fat distribution and skin condition.
• How well a scar heals and how quickly it fades varies from person to person with constitution and skin condition.
• The study figures above come from specific studies and patient groups and do not apply equally to every patient.
• If an incision opens, becomes red, warm or starts oozing, have it checked by a doctor rather than judging it yourself.

Three Key Takeaways

1. What matters most for liposuction scars is how many incisions are made and where, not their size, and a long cannula can reach a wide area through few incisions.

2. Incisions can be gathered in hidden places: two near the armpits for the arms, and three around the hips and tailbone for the abdomen and thighs.

3. A fainter scar depends on protecting the entrance and careful stitching during surgery, and on avoiding strain on the incisions afterward.

Incision placement and number depend on the treatment area and individual condition. Please visit us for a consultation to confirm your plan.

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--- Sources

1. Wang C, Zhang G, Gu T, Han X, Li F, Wang Y. "Bent Cannula" Liposuction Technique Using Only 3 Incisions in Asian Lower Limb Shaping. Plast Reconstr Surg Glob Open. 2025;13(12):e7348. PubMed 41415596
2. Moyer HR, Sisson KM. Liposuction Port-Site Protection: Necessity or Needless Expense? Aesthet Surg J Open Forum. 2024;6:ojae098. PubMed 39691861

This article summarizes questions about liposuction scars and incision placement based on Dr. Jaeho Cho's clinical experience and published peer-reviewed studies. Individual conditions should be assessed by a specialist in person.

By Dr. Jaeho Cho (Ph.D. in Surgery)