Liposuction, also known as liposculpture, is a cosmetic surgery operation to improve your body shape by removing unwanted fat from areas of the body. Liposuction (lipoplasty) is particularly well-suited for women and men who are of relatively normal weight but have isolated pockets of fat that cause certain areas of their body to appear disproportionate. Liposuction is a procedure that can help sculpt the body by removing unwanted fat from specific areas, including the abdomen, hips, buttocks, thighs, knees, upper arms, chin, cheeks and neck. Many patients become discouraged at having lost unwanted pounds without seeing a flatter abdomen. The overall proportions of the body may be unbalanced, or the abdomen may simply have retained areas of fatty tissue that cause it to protrude.

These localized fat deposits may sometimes be an inherited trait and typically do not respond to dieting or exercise. Liposuction is often the only way to eliminate them. In these cases, liposuction can successfully trim excess fat in the abdomen for a flatter abdomen and more slender, balanced shape. Liposuction can be performed consecutively on many different sites; in fact, many patients choose to have several body parts treated during the same day. On average, liposuction takes 1-2 hours per area treated. With the Tumescent Technique, large volumes of saline solution, local anesthesia, and adrenaline are infused into the fatty area being treated to cause swelling. Liposuction is not a treatment for weight control or obesity and it cannot remove cellulite or stretch marks.

Liposuction carries greater risk for individuals with medical problems such as diabetes, significant heart or lung disease, poor blood circulation, or those who have recently had surgery near the area to be contoured. There are several types of liposuction procedures available, Tumescent liposuction involves the injection if a large amount of anesthetic into the area being treated. In ultrasonic assisted liposuction (UAL), sound waves are used to liquefy the fat before it is removed. LipoSelection uses the same concept without disturbing the surrounding tissue. Liposuction is not a very complicated plastic surgery procedure, as with all surgery, it has certain risks. The risk of drug reactions is possible in people who are allergic to certain substances.

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It is a conscious effort on the part of medical and health professionals to look for newer types of liposuction procedures to ensure safety and efficacy. While you can expect complications to arise with any surgery, there are certain choices that entail less risk on the patient’s health.

Tumescent Liposuction

This type of liposuction procedure is done by injecting a solution such as epinephrine, lidocaine, and saline into the fat within the body. Lidocaine serves as the local anesthetic, while epinephrine constricts the capillaries within the fat. This solution contributes to the swelling of the fat tissues and firms it up. Due to the constriction of the capillaries, it takes a while for the body to absorb the lidocaine.

The patient is no longer required to undergo general anesthetic before the procedure is performed. Some doctors would recommend this type of procedure due to the minimal loss of blood, as compared to other types of liposuction.

Wet Liposuction Technique

This type of liposuction procedure uses general anesthesia. By injecting local anesthesia that contains epinephrine to the specific area it reduces the amount of blood loss. As compared to the dry technique though, there is still a large amount of blood loss for this technique. This is because blood comprises 15 to 20% of the total amount of tissues removed from the patient’s body. After this procedure is done, blood transfusion is often required.

This used to be the most common technique used in liposuction. However, the implementation of this procedure has reduced over the years as safer methods are being developed.

Super-Wet Technique

The same with wet technique, this one also requires general anesthesia. Then, diluted local anesthesia solution is injected into the area of the body to be treated. Unlike wet technique though, blood consists of only about 8% of the total amount of tissues removed from the body.

Its main difference from the procedures mentioned above is the amount of solution injected into the fat tissues. The solution used for this technique is reduced as compared to the tumescent and wet technique, wherein there is very minimal lidocaine involved.

Ultrasonic Assisted Liposuction (UAL)

This type of liposuction procedure utilizes ultrasonic energy, which is delivered into the fat tissues of the body through a paddle or metal probe. This energy causes the fat to liquefy, thus making it easier to remove while also minimizing damage on the surrounding tissues and nerves.

Since this is a relatively new technique, surgeons proceed with caution when performing this technique. However, the introduction of this type of procedure has broadened the number of people who can now try liposuction.

Ultrasonic liposuction allows overweight individuals to undergo liposuction due to reduced level of blood loss. Meanwhile, patients who have undergone this procedure report less to no cases of post-operative pain.

Power Assisted Liposuction (PAL)

Just like Ultrasonic liposuction, power assisted liposuction is a new technique. As the name implies, it involves the use of power to create an oscillating movement on the cannula as it penetrates the body fats.

Because the device used is easy to control, it enables surgeons to precisely remove the unwanted fat. The vibrations caused by the oscillating movement of the tube enables fat to break up and suction out easily. When using this technique, the entire procedure generally takes lesser time to complete.

In a recent study by the Tulane University Health Sciences Center, it was revealed that using the PAL technique leads to 30% more fat removal as compared to manual liposuction. On the other hand, there is also a reduced period of recovery time for the patient.

But, as with any other surgery, there are certain risks involved with this procedure. Therefore, patients are advised to opt only for skilled doctors who have enough expertise and knowledge on using the PAL technique.

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There are three major techniques of liposuction, involving different kinds of suction equipment.

Tumescent Liposuction

Developed about 15 years ago, this is the most common, and safest, method of liposuction. The term “tumescence” refers to the swelling and firming of fatty tissues by the means of infusing fluid into the tissue. After tiny incisions are made where the patient’s skin covers fatty tissue, the area is soaked with a saline solution that contains an anesthetic (Lidocaine) and adrenaline to reduce blood loss and bruising. This reduction of blood loss through the shrinking of capillaries has been a great advance, enabling plastic surgeons to remove much fat with little blood loss.

Tumescent liposuction involves swelling the areas to be suctioned with a solution that equals two to three times the amount of the fat and fluid that will be suctioned out. In the Super-Wet technique of liposuction, however, the tissues are infused with an amount of fluid that equals the fat and fluids that will be suctioned. Super-wet involves the use smaller amounts of, or no, Lidocaine, thereby reducing the risk of Lidocaine toxicity.

Power Assisted Liposuction

In essence, this is liposuction hastened by a vibrating suction cannula. Developed by a German surgeon, this technique employs an electric-powered cannula, which like a jackhammer sucks out the fat faster. In my opinion, while it might help the surgeon to do his or her job faster, it takes away from the surgeon’s ability to feel the contour and the topography of tissue as this machine vibrates. Also, this machine might not be safe to be used in delicate or potentially dangerous areas such as the neck and face.

Ultrasonic Assisted Liposuction (UAL)

This method was first used in the 1990′s, and was considered an advance in treating especially fibrous areas, such as the male chests, back, and flanks. It uses cannulas that bombard subcutaneous fatty tissues with waves of ultrasound, thereby liquefying them through ultrasound energy and heat. An external method also delivers this energy by applying a paddle-shaped instrument to the skin. The higher general complication rate of this technique as compared to other conventional techniques has recently drawn surgeons away from this fad.

Specifically, ultrasonic assisted lipoplasty (UAL) carries an increased risk of skin and tissue burns, permanent tissue damage and scarring, nerve damage causing lasting skin irritation or pain, and fluid buildup or formation of seroma cavities of fluid beneath the skin. Because there is insufficient proof of the safety of UAL devices, the Food & Drug Administration (FDA) has never approved the marketing and advertising of UAL devices to be specifically used for liposuction.

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Liposuction, also known as Liposculpture, is the most commonly performed plastic surgery in the United States where more than 400,000 men and women annually undergo this procedure. A cosmetic surgery that contours and sculpts your body into a slimmer profile, Liposuction removes unwanted and excess fat. By reducing total body fat, it can help to lower cholesterol, and reduce the risk of diabetes and heart disease.

Liposuction Candidates

Three categories of men and women seek Liposuction to achieve their ideal appearance, after trying unsuccessfully to do so through diet and exercise.

The first category of patients includes those who wish to reduce their size, including women who have gained weight due to pregnancy, hormonal fluctuations or medications. This category also includes men and women who undergo Large Volume Liposuction. Normally, Liposuction involves the removal of about two litres of fat, about the size of a “Coke” bottle. During Large Volume Liposuction, however, five or more litres of fat are removed resulting in a dramatic reduction in size.

The second category includes those who have disproportionate areas of fat in their abdomen, hips, thighs, buttocks, knees, cheeks and neck. These problem areas are commonly known as “saddlebags,” “thunder thighs,” “love handles” and “double chins.” Often, these stubborn areas of fat have genetic origins, and cannot be reduced by diet and exercise.

The third category of patients includes men who suffer from Gynecomastia, excessive breast growth due to the enlargement of breast glands, and excess fatty tissue.

In all cases, men and women who undergo Liposculpture should have had a stabilized weight for at least six months. Liposuction is not a solution for ridding of stretch marks or of cellulite.

Liposuction Techniques

There are three techniques for performing Liposuction, which vary in safety and effectiveness. All involve the insertion of a cannula — a small wand-like instrument connected to a high-powered suction machine — into tiny incisions made by the plastic surgeon into the targeted area. It is through this instrument that the plastic surgeon draws fat from beneath the skin.

Tumescent Liposuction refers to the commonest, and safest, method. “Tumescence” is the swelling and firming of fatty tissues through the infusion of a saline solution that contains Lidocaine, an anesthetic with adrenaline, which reduces blood loss and bruising.

Your plastic surgeon will soak the area with a solution that is two to three times the amount of fat and fluids to be removed. In Super-Wet Tumescent Liposuction, however, tissues are infused with fluids equal to the amount of fat and fluids to be removed. Super-Wet Liposuction uses a solution that has smaller amounts of, or no, Lidocaine, reducing the risk of Lidocaine toxicity.

Once the area is sufficiently plumped up, the plastic surgeon removes the loosened fat cells, suctioning fat and fluid through transparent vacuum-like tubes.

Power Assisted Liposuction hastens the process by an electronic-powered cannula which, like a jackhammer, suctions fat more quickly. While it lessens the plastic surgeon’s exertion, it also reduces the ability to contour with precision, especially in delicate areas like the neck and the face. Likewise, Ultrasonic Assisted Liposuction, which bombards subcutaneous fatty tissues with waves of heat and energy and was developed for use in more fibrous areas, has a high rate of risks and complications such as burns, and is not a patient’s best option.

Liposuction Results

For optimal results, Liposuction should be performed by a plastic surgeon who has a honed aesthetic sense, as well as excellent surgical skills. The surgeon must work diligently to locate the appropriate areas of subcutaneous fat in order to successfully sculpt and contour those areas. It is therefore of the utmost importance to select a cosmetic surgeon who has the highest credentials, a fine artistic sense and who is highly experienced in performing Liposuction.

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Fluid Injection, a technique in which a medicated solution is injected into fatty areas before the fat is removed, is commonly used by plastic surgeons today. The fluid — a mixture of intravenous salt solution, lidocaine (a local anesthetic) and epinephrine (a drug that contracts blood vessels) — helps the fat be removed more easily, reduces blood loss and provides anesthesia during and after surgery. Fluid injection also helps to reduce the amount of bruising after surgery.

The amount of fluid that is injected varies depending on the preference of the surgeon.

Large volumes of fluid — sometimes as much as three times the amount of fat to be removed — are injected in the tumescent technique. Tumescent liposuction, typically performed on patients who need only a local anesthetic, usually takes significantly longer than traditional liposuction (sometimes as long as 4 to 5 hours). However, because the injected fluid contains an adequate amount of anesthetic, additional anesthesia may not be necessary. The name of this technique refers to the swollen and firm or “tumesced” state of the fatty tissues when they are filled with solution.

The super-wet technique is similar to the tumescent technique, except that lesser amounts of fluid are used. Usually the amount of fluid injected is equal to the amount of fat to be removed. This technique often requires IV sedation or general anesthesia and typically takes one to two hours of surgery time.

Ultrasound-Assisted Lipoplasty (UAL). This technique requires the use of a special cannula that produces ultrasonic energy. As it passes through the areas of fat, the energy explodes the walls of the fat cells, liquefying the fat. The fat is then removed with the traditional liposuction technique.

UAL has been shown to improve the ease and effectiveness of liposuction in fibrous areas of the body, such as the upper back or the enlarged male breast. It is also commonly used in secondary procedures, when enhanced precision is needed. In general, UAL takes longer to perform than traditional liposuction.

Power Assisted Liposuction

Lipoplasty (liposuction) has proven to be a very popular surgical cosmetic procedure; see current American Society for Aesthetic Plastic Surgery (ASAPS) statistics. Power-Assisted Lipoplasty (PAL) is a relatively new technique, approved for general use by the FDA in December 1998, and is not yet widely used. Most lipoplasty procedures are performed using traditional suction-assisted lipoplasty (SAL) and certain procedures can benefit from ultrasound-assisted lipoplasty (UAL).

Technique:

In PAL, a reciprocating cannula, or hollow tube (powered by gas or electricity) powers through tissue and vacuums out fat and fibrous or scarred tissue reportedly with minimal effort. The back and forth motion of the tip of the cannula facilitates passage through tissue.

Benefits:

Procedure may be gentler for the patient, possibly causing less bruising, swelling and discomfort.

May provide a more rapid recovery, with quicker return to work and activities.

Patients may spend less time in the operating room and under anesthesia than with other lipoplasty techniques.

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