Define the waist
Reduce localized fullness around the abdomen, sides and lower back to reveal a clearer waistline.
Awake body contouring · New York City
Awake Lipo 360 in NYC
A 360° approach to contouring the abdomen, waist, flanks and back, using an awake, local-anesthesia approach when appropriate, with a treatment plan designed around your anatomy.
- Dr. Sergei Kalsow, MD
- 5,000+ awake liposuction procedures
- Madison Avenue, NYC
A considered, 360° approachDesigned around your anatomy
The surgeon behind the procedure
Meet Dr. Sergei Kalsow, MD
A New York plastic surgeon who has made awake liposuction, Lipo 360 and body contouring the center of his practice.
- 5,000+Awake liposuction proceduresAwake Lipo 360 and related liposuction under local anesthesia, planned around each patient's anatomy.
- 8,000+Awake procedures in totalEvery procedure performed with the awake, local-anesthesia approach.
- 10,000+Surgeries performedAcross all the procedures in his practice.
- Founder of Dreams Plastic SurgeryThe New York City practice he founded, where he is one of the surgeons.
- 635 Madison AvenueA private practice in New York City that also sees patients traveling in from across the U.S. and abroad.
- One surgeon, start to finishConsultation, standing markings, the procedure and every follow-up visit with Dr. Kalsow.
- Revision experiencePatients also come to him after liposuction elsewhere. Revision work follows its own strategy.
Liposuction is not a side service here. It is one of the procedures the practice is built around.
Real patients
Awake Lipo 360 Results
Each case shows the same patient before and after Awake Lipo 360, photographed from the same angle. More views of these and other patients are in the full gallery.
Case 01
Case 02
Case 03
Case 04
Case 05
Case 06Before-and-after photographs show individual outcomes and do not guarantee a particular result.
Scars and incisions
What about scars?
Liposuction does not require long incisions. Fat is removed through small access points, and where they go is part of the plan.
- A few millimeters eachAwake Lipo 360 is performed through small access incisions, typically a few millimeters long, rather than a continuous cut.
- Placed with clothing in mindWhere anatomy allows, access points are planned in natural creases or in areas usually covered by underwear.
- They fade over timeIncision marks are most visible in the first months and keep softening as they mature. Healing and final appearance vary by patient and skin type.
Video
More photographs of healed incisions can be reviewed during your consultation.
In detail
The procedure, in detail.
How Awake Lipo 360 works, who it is for, what recovery looks like and what to expect if you are traveling to New York.
Start with the procedure
What Is Awake Lipo 360?
Awake Lipo 360 is circumferential liposuction of the torso performed with local, tumescent anesthesia and an individualized comfort plan when an awake approach is appropriate.
Instead of treating the abdomen as a single isolated area, Lipo 360 approaches the midsection as one continuous contour, typically including the abdomen, waist, flanks and back.
The objective is body contouring, not weight loss. The exact treatment areas, anesthesia plan and amount of fat that can be removed safely are determined after an in-person or virtual evaluation.
Treatment goals
What Can Awake Lipo 360 Achieve?
The goal is to improve the shape and transitions of the torso, especially the waistline, while respecting the patient's natural frame.
Improve 360° proportion
Treat the torso as a connected shape so transitions between the front, sides and back look more balanced.
Personalize the contour
Adapt treatment areas to body frame, fat distribution, skin quality and realistic aesthetic goals.
Individual results vary. Lipo 360 is not a weight-loss procedure and may not be appropriate for every patient.
The how
How Awake Lipo 360 Works
“Awake” does not mean that comfort is ignored. The anesthesia and medication plan is individualized based on the procedure and patient.
Awake does not mean sensation-free. Patients can experience pressure, movement and periods of discomfort, and the procedure should not be described as pain-free.
Consultation and planning
Review anatomy, goals, medical history, skin quality and the areas that may benefit from contouring.
Standing markings
Dr. Kalsow maps the treatment areas and transitions before the procedure begins.
Local, tumescent anesthesia
The treatment areas are numbed according to the individualized anesthesia and comfort plan.
360° contouring
The torso is treated circumferentially, with attention to symmetry and transitions rather than isolated fat pockets.
Garment and follow-up plan
Patients receive individualized instructions for garments, activity, medication and postoperative visits.
A liposuction-first practice
The Kalsow Approach to Awake Lipo 360
Liposuction and body contouring are the center of Dr. Kalsow's practice, with 360° planning that treats the torso as one connected shape rather than a collection of isolated areas.
Each patient is evaluated individually for anatomy, skin quality, fat distribution, goals and the anesthesia approach that may be appropriate. Dr. Kalsow stays directly involved in planning, surgery and postoperative care.
- 360°The abdomen, waist, flanks and back planned as one continuous contour
- AwakeLocal, tumescent anesthesia with an individualized comfort plan when appropriate
- 1 surgeonPlanning, markings, procedure and follow-up with Dr. Kalsow himself
Candidacy
Is Awake Lipo 360 Right for You?
Awake Lipo 360 may be considered for adults who want to improve localized torso contour and who are appropriate candidates for liposuction and the proposed anesthesia plan.
Final candidacy is determined after medical evaluation. Some patients may be better suited to another procedure, a staged plan, or a different anesthesia approach.
- You are in appropriate overall health for the procedure.
- Your weight is reasonably stable.
- You have localized fat that has not responded as desired to diet and exercise.
- You understand that liposuction contours the body; it is not a substitute for weight loss.
- You have realistic expectations about shape, skin retraction and recovery.
- You can follow preoperative and postoperative instructions.
Set expectations early
Recovery After Awake Lipo 360
Recovery varies with the extent of treatment, the patient's health, the amount of liposuction performed and individual healing.
Compression
Compression garments may be recommended to support the early recovery period.
Swelling and bruising
These are expected during early healing and improve gradually over time.
Activity
Walking is often encouraged, while strenuous activity is restricted until cleared.
Final contour
Results evolve as swelling resolves and tissues settle; final timing varies by patient.
Trust through clarity
Safety, Limits and Informed Decision-Making
Every surgical procedure has risks, and the safest plan is the one built for the individual patient.
Risks are reviewed openly
The right plan depends on the patient, the treatment areas, the total procedure, medical history, the facility and the anesthesia approach.
No promises on volume, comfort or shape
No specific amount of fat removal, pain-free experience, guaranteed skin tightening or predetermined shape can be promised.
Decided in consultation
Dr. Kalsow reviews the expected benefits, limitations, alternatives, recovery plan and procedure-specific risks so the decision is individualized.
Optional combined planning
Can Fat Transfer Be Combined With Lipo 360?
In selected patients, fat collected during liposuction may be considered for contour enhancement in another area. Whether this is appropriate depends on anatomy, available donor fat, goals and safety considerations.
Awake Lipo 360 remains the primary procedure. The exact treatment plan is individualized after consultation, and not every patient is a candidate for combined fat transfer.
Destination patients
Traveling to New York for Awake Lipo 360
Patients traveling to New York need more than a procedure description. They need to understand how consultation, arrival, postoperative visits and clearance to travel home fit together.
- Virtual consultation before travel when appropriate.
- Pre-arrival instructions and required medical documentation.
- Guidance on where to stay and how long to remain in New York.
- Transportation planning for the day of the procedure.
- Postoperative visits before returning home.
Questions
What patients ask us.
What does “awake” Lipo 360 mean?
It refers to performing Lipo 360 with a local, tumescent anesthesia approach and an individualized comfort plan when appropriate, rather than automatically using general anesthesia.
What areas are treated with Lipo 360?
Lipo 360 commonly includes the abdomen, waist, flanks and back. Exact treatment boundaries depend on the patient's anatomy and goals.
Is Awake Lipo 360 painful?
The numbing process and parts of the procedure can be uncomfortable. Patients may feel pressure or movement. Comfort varies, and the procedure should not be described as pain-free.
Is Lipo 360 a weight-loss procedure?
No. Lipo 360 is a body-contouring procedure designed to reduce localized fat and improve shape. It is not a substitute for weight loss.
How long is recovery?
Recovery varies based on the extent of treatment and individual healing. Swelling and bruising are expected early, and activity is gradually increased according to postoperative instructions.
Can I travel to NYC for surgery?
Potentially, yes. Destination patients need a plan for consultation, preoperative clearance, local accommodation, transportation, postoperative visits and safe timing for travel home.
How much does Awake Lipo 360 cost?
Pricing depends on the treatment plan, number of areas, complexity and other clinical factors. A consultation is needed for an individualized quote.
Can fat transfer be combined with Lipo 360?
In selected patients, harvested fat may be used for contour enhancement. Whether fat transfer is appropriate depends on anatomy, goals, available donor fat and safety considerations.
Start with a conversation.
Request a consultation with Dr. Sergei Kalsow in New York City, in person or by FaceTime. Your anatomy, goals and medical history come first; the plan follows.