Liposuction Techniques
Clinic 360All About Liposuction Techniques & Guidelines
The cosmetic benefits of liposuction include improving one’s body shape in areas where dieting and exercise have not shown results. Such problem areas typically include the hips, thighs, buttocks, abdomen, and face. There are numerous liposuction techniques available ranging from those that are no longer considered safe (such as Dry Liposuction) to those that meet more current industry standards (such as Tumescent Liposuction).
Liposuction Techniques & Guidelines
The fat cells are permanently removed during liposuction. Consequently, the weight gained following the procedure will typically not gather in the area performed. However, to maintain optimal results, patients should maintain a healthy diet and exercise regimen, as liposuction does not prevent future weight gain. Like any surgical procedure, liposuction carries certain risks, although these are minimized when it is performed by a specially trained, board-certified plastic surgeon.
Tumescent Liposuction
In the past, liposuction often required blood transfusions because of the significant amount of blood loss. The dry technique, for instance, which does not inject fluids into the tissues, resulted in 20-45% blood loss. The wet technique, which injects 100-300 ml of saline into the tissues, helped mitigate the blood loss, reducing it to between 15-30%. This was still, however, a fairly high amount of blood loss. The tumescent technique is now the method of choice for liposuction, as it has reduced blood loss to as little as 1%. (Studies show that with the tumescent technique, blood loss generally ranges between 1-7.8%.) This surgery, therefore, marks a large improvement in safety standards compared to older methods.
The improvement in safety in this technique owes itself largely to the dilution of the lidocaine and epinephrine, a method that delays the rate at which the drugs are absorbed into the bloodstream. As such, the body processes the substances over a period of 24 to 36 hours, reducing potential toxicity. In the majority of cases, the localized anesthesia eliminates pain during the surgery. In a small percentage of instances, however, patients may experience varying degrees of discomfort during and following the procedure. Similar to other liposuction techniques, surgeons employ highly efficient tools called microcannulas to remove localized fat. These are stainless steel tubes possessing a diameter ranging from 1 mm to 3 mm. Since the microcannulas enter through incisions in the skin, patients benefit from their minute size, which minimizes the formation of large scars.
Ultrasonic Assisted Liposuction (UAL)
During UAL, surgeons first inject a tumescent fluid consisting of anaesthetic, saline solution, and epinephrine into the targeted area. This helps prevent fluid loss along with making the chosen fat deposits easier to remove. Following this, a thin metal tube (known as the cannula) is inserted through an incision to deliver the ultrasonic energy. The cannula liquefies fat cells on contact, making them easier to remove. It should be noted, however, that Ultrasound-Assisted Liposuction carries a high risk of full-thickness skin burns and scarring compared to other liposuction techniques because of the heat generated by the ultrasonic energy.
Ultrasonic Assisted Liposuction should not be confused with Ultrasound Fat Reduction, which is a nonsurgical technique involving the application of a metal paddle to deliver ultrasonic energy to the fat layer below the skin, causing the breakdown (or lipolysis) of the targeted fat cells. In the latter procedure, fat cells release triglycerides that are expelled naturally by the body, causing a visible reduction of fat in the treated area.
Laser-Assisted Liposuction (SmartLipo)
Similar to other liposuction techniques, laser-assisted liposuction begins with the application of a tumescent solution (consisting of anesthesia, saline, and epinephrine), followed by the breakdown of fat, a process referred to as “laser lipolysis.” The surgeon will typically move onto standard liposuction in order to vacuum up or “aspirate” the liquefied fat, although suction is not employed in all surgical cases.
Proponents of laser-assisted liposuction claim that it involves less bruising and a quicker recovery time compared to other liposuction techniques. Surgeons will often apply lasers engineered to coagulate small blood vessels; this strategy has been proven to help bruising. Lasers may also stimulate the production of collagen and elastin, tissues that help firm and tighten skin. Further advancements in laser-assisted liposuction are emerging as a wider range of wavelengths are becoming available.
It is important to note, however, that while the laser energy of this procedure is designed to exclusively target fat cells, it may also apply heat to the surrounding tissues. This exposure may cause side effects such as swelling, bruising, burns, numbness, and minimal bleeding.