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.

• Liposuction Surgery Techniques in Body Contouring
• Liposuction Surgery Information – Technique Variations
• Tumescent Liposuction: Brigitte Nielsen Plastic Surgery

Liposuction is a way to remove fat quickly and can help sculpt your body. Specific areas may include the abdomen, hips, buttocks, thighs, knees, upper arms, chin, cheeks and neck. Although no type of liposuction is a substitute for dieting and exercise, it can remove stubborn areas of fat that do not respond to traditional dieting and exercise.

Over the last 10 years, surgical liposuction (also known as lipoplasty or suction lipectomy) has undergone some refinements. New techniques in the market now include ultrasound-assisted lipoplasty (UAL), the tumescent technique, and the super-wet technique.

Surgical Liposuction

During liposuction, localized fat deposits are removed to re-contour certain areas of the body. Through a tiny incision, a narrow tube or cannula is inserted and used to vacuum the fat layer that lies beneath the skin. The cannula breaks up the fat cells, suctioning them out. The suction action is provided by a vacuum pump or a large syringe, depending on the surgeon’s preference.

The problem with liposuction plastic surgery is that fluid is lost along with the fat, and it is vital that this fluid be replaced during the procedure to prevent shock. For this reason, patients need to be carefully supervised and receive intravenous fluids during and immediately after this procedure.

Fluid injection: a medicated solution is injected into fatty areas before the fat is removed. The fluid is a mixture of intravenous salt solution, lidocaine (a local anesthetic) and epinephrine (a drug that contracts blood vessels). The fluid helps to remove fat easily, helps reduce blood loss and provides anesthesia pre and post surgery and also helps reduce bruising.

Tumescent liposuction: a technique used on patients who only need a local anesthetic. This procedure can take up to 5 hours. Large volumes of fluid, often as much as three times the amount of fat to be removed are injected in this technique. The injected fluid contains an adequate amount of anesthetic, which could cut the anesthetists costs.

The Super-Wet technique: 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 removed. This technique often requires IV sedation or general anesthesia and typically takes one to two hours of surgery time.

Non-surgical Liposuction
A new breakthrough in non-invasive body technology is Body Contouring, which removes excess fat cells without surgery, focusing on the hips, stomach, thighs, bottoms and flanks.

This non-surgical liposuction is a safe, painless, surgery-free body contouring treatment. The process sends ultrasound beams into the problem area to destroy fat cells. The entire procedure is guided by innovative tracking technology that ensures smooth, uniform contouring.

Body Contouring is the latest successful technology for the effective removal of excess fat. Together with Ultrashape, a scientific breakthrough which redefines the contours of your body, it is a great alternative to surgery. There are no side effects to this treatment that takes between 1 and 2 hours, and it is possible to resume your daily routine immediately thereafter.
Liposuction can give you the body you so desire, but do remember to know all about the procedure before you decide to take the plunge.

• Liposuction Techniques
• Liposuction Surgery Techniques in Body Contouring
• Liposuction Surgery Techniques and Information

Tumescent Liposuction

Developed about 15 years ago, this is the most common, and safest, method. 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 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.

Once the area has been sufficiently plumped up, the surgeon removes these fat cells through the insertion of a cannula, a tiny wand like instrument that suctions and removes the loosened fat cells via a high-power suction machine. The fat then glides through transparent vacuum-like tubes as fat and fluid are suctioned from your body. Because of the fluid loss, you need to be monitored carefully by an experienced anesthesiologist who can balance your fluid intake and output throughout the procedure.

There is nothing arbitrary about this process. A skilled surgeon, like a sculptor, has to use his sense of sight and touch to assess the areas of fat buildup and to contour and sculpt these areas into an ideal form. It also requires a great deal of arm movement and exertion by the surgeon, as he or she both suctions and sculpts. The tumescent technique has a low complication rate in and of itself, yet is also used as preparation for other kinds of liposuction techniques.

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.

What is Large Volume Liposuction?

What person today has not heard of gastric bypass surgery, more commonly known as “stomach stapling?” The news stories about musicians, new anchors and other celebrities who have undergone this procedure are frequent. Yet, only twenty years ago, the mere mention of gastric bypass would have elicited a declaration of “that would be malpractice!” In much the same way, our assessments about the safety of Large Volume Liposuction are progressing.

Notions of what is attractive are constantly evolving. The voluptuous actresses of the 1950’s would today be considered overweight. However, while we can’t really define what an “ideal” weight is, it is widely accepted that a significant portion of Americans today are overweight. This is both a health issue, and a self-esteem issue. More than half of American women wear a size 10 or more, and are unhappy with their size.

Just as the safety of gastric bypass surgery was once questioned, so is the acceptability of Large Volume Liposuction. However, in the hands of a skilled and experienced plastic surgeon who takes all of the usual precautions that are observed during any major surgery, a patient can successfully and safely have large amounts of fat removed.

When approximately two liters of fat (about the size of a Coca-Cola bottle) are removed, this is considered Small Volume Liposuction. This is successful when smaller localized “problem” areas of the body are being contoured. However, the removal of this quantity of fat will not make a difference in a large person whose goal is significant size reduction. In the latter case, large volumes of fat, five or more liters are removed, with the dramatic outcomes- 2 to 5 size reduction in cloth size. The surgeon removes the fat with an eye towards contouring the area as well. In this procedure, it is a good practice to combine the Tumescent with the Super-Wet Technique, as the latter does not use Lidocaine (or uses less), thereby avoiding the risk of Lidocaine toxicity.

If you are considering liposuction you should seek a plastic surgeon who has very extensive experience in performing this procedure in an optimal surgical facility. A minority of qualified plastic surgeons specializes in this.

• Liposuction Surgery Techniques and Information
• Liposuction Information – Body Contouring
• Tumescent Liposuction: Brigitte Nielsen Plastic Surgery

 

Liposuction techniques vary by certain distinguishing features. Some of the older techniques have been replaced by more advanced and safer methods. The volume of solution injected under the skin and the use of additional mechanical devices differentiate today’s procedures.

Common techniques used in liposuction surgery today include:

Tumescent Liposuction
Ultrasonic Assisted Liposuction (UAL)
Power Assisted Liposuction (PAL)
Super Wet
Wet
Dry

It is important to consult a qualified and skilled cosmetic surgeon and discuss each of these techniques in detail. Factors such as medical history, general health, desired results and your surgeon’s recommendations will determine the best procedure for you.

What does each technique involve?

Tumescent Liposuction – This procedure is considered the safest of all liposuction techniques due to some unique characteristics. These are:

The patient does not need to be under general anesthesia.
Fluid loss is reduced.
An IV is unnecessary in most cases.
The patient experiences little discomfort.
An injection containing lidocaine, epinephrine and saline is used.

A large volume of the solution is injected into the fatty areas to be removed. This solution is a local anesthetic, so the patient is awake during the procedure. The fatty tissue becomes swollen and firm and the amount of blood removed during the procedure is greatly reduced.

Ultrasonic Assisted Liposuction (UAL) – This procedure is performed by using a large amount of tumescent fluid along with a metal probe or paddle. The device delivers ultrasonic energy and heat into the subcutaneous fatty areas, breaking down the fat so it can be removed. The patient is required to be under general anesthesia or heavy IV sedation during this procedure.

This method is becoming less common due to the risk of severe scarring and full-thickness burns.

Power Assisted Liposuction (PAL) – This procedure moves a cannula (small, hollow tube) rapidly in-and-out or in a spinning motion. This constant, quick motion separates and removes the fat cells from targeted areas of the body. The power is supplied by an electric motor or compressed air. The PAL procedure allows for less manual movement by the surgeon for a quicker procedure. This method uses the anesthesia technique employed in tumescent technology.

Super Wet Technique – Requires general anesthesia. This procedure requires the injection of diluted local anesthesia. It uses less than half of the volume that the tumescent technique uses. There is significantly more blood loss that with the tumescent technique, but less than with the wet technique.

Wet Technique – This procedure also requires general anesthesia. A large amount of local anesthesia containing epinephrine is injected into the fatty areas. Excessive blood loss is common with this technique so it is rarely used in today’s liposuction procedures.

Dry Technique – This procedure is no longer used for two main reasons. No local anesthetic was injected into the surgery locations. Also, there was more blood loss during this surgery than any other liposuction procedure.

Board certified cosmetic surgeons employ the latest techniques available to them. During your consultation, ask as many questions as possible about your elected procedure. Be sure all of your questions have been answered thoroughly and clearly before making any decisions.

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