The Available Liposuction Surgery Techniques

Many techniques have been introduced since liposuction surgery was first invented. The procedure has become safer and more accurate, giving good aesthetic results. New liposuction techniques, or refinements of older techniques continue to be created.

There are several commonly used  liposuction techniques for fat removal. There are also other techniques that are rarely used, but that are still discussed or that you may hear about.

Dry Liposuction Procedure

This method of liposuction surgery is rarely used anymore and stems from the original suction-assisted lipectomy procedure. It is done by inserting a standard cannula into the area to be treated and injecting no fluid. The fat is broken up and is suctioned out of the body under very high levels of vacuum pressure. 

Dry liposuction can cause a lot trauma to the tissues, extensive blood loss, nerve damage, and tissue death because it can cut through important blood vessels that supply the skin. This technique has fallen out of favor.

Wet Liposuction Techniques

What is the difference between wet and dry? Right – fluid! The wet technique added an infusion of fluid to the area to be suctioned, which helped in removing the fat.

The solution used is saline (sterile salt water) with epinephrine, a drug that constricts the blood vessels (called a vasoconstrictor), and lidocaine, a topical anesthetic. The epinephrine reduces the amount of bleeding and the lidocaine increases the comfort for the patient. If your surgeon is using a wet technique if he or she injects less solution than the amount of fat being removed. 

Super-Wet LiposuctionTechnique

What is the difference between wet and super-wet? Right – more fluid. With a super-wet technique, the surgeon infuses about the same amount of fluid as the amount of fat to be removed. Originally, lidocaine was not used in the super-wet technique, but now the solution is saline with epinephrine and lidocaine. Super-wet can be a slight less risky technique than the tumescent technique, since there is less risk of lidocaine toxicity, but both are quite safe.

Tumescent Liposuction

The tumescent technique is the type of liposuction most commonly used today.  In this technique, the area to be treated is infused with a lot of saline/epinephrine/lidocaine solution. With the tumescent technique, the surgeon usually infuses twice or even three times as much of the solution as the amount of targeted fat to be removed.

When tumescent liposuction was first being done, some doctors caused their patients to overdose on lidocaine and there were fatalities due to lidocaine toxicity. Cosmetic and plastic surgeons who perform liposuction now are far better at making sure they use the right amount of lidocaine.

Ultrasonic-Assisted Liposuction

Ultrasonic-assisted liposuction (UAL) is a liposuction technique that involves the use of high-frequency sound waves called ultrasound. The ultrasound waves energize the fat cells and they literally liquefy. The liquefied fat is then removed through a cannula, but under less suction force than in standard liposuction. The surgeon may also use a solution of saline, epinephrine, and lidocaine as in tumescent liposuction to help with postoperative discomfort and to help with delivery of the ultrasound.

Ultrasonic liposuction can be aimed at the treatment area in either of two ways. The surgeon may pass a paddle or pad that emits the waves over the skin over the area of fat to be treated, which is called external UAL. Or the waves can be emitted from a special type of cannula right into the area of fat, which is called internal UAL.

UAL can potentially cause burns if care is not exercised in the use of the ultrasonic cannula and paddles. The cannula or paddles have to be in constant motion to prevent overheating or causing burns. The ultrasonic energy can burn tissues that are not targeted for removal as well as superficial tissue or skin. Using a tumescing solution can also help cool the tissues to reduce the chance of burns.

Power-Assisted Liposuction

Power-assisted liposuction (PAL) is a newer technique in which the cannula eases through the fatty tissue with less trauma than traditional techniques and with no burn risks as with UAL. The surgeon uses a special high-speed linear-reciprocating suction cannula, which essentially vibrates rapidly back and forth and helps break up the fat. Some surgeons report that they are able to perform more effective high-volume liposuction in a shorter time, without as much trauma, especially areas where the fat is more fibrous, such as the buttocks, saddlebags, and back and the male breast.

Laser-Assisted Liposuction

Using the laser-assisted liposuction technique, fat is emulsified with a cold laser in a way that leaves the fat cell membrane unharmed. Laser-assisted liposuction is most commonly used in conjunction with tumescent liposuction, but has also been used for smaller fatty areas without suction to remove the emulsified fat.  The body can eliminate a small amount of fat on its own with no problem. The device is held over areas to be treated for several minutes and then small incisions are used to drain the fluid. The laser used in this device does not create heat there is no risk of burns or thermal wounds. 

Laser Lipolisis

Laser lipolisis (sometimes referred to as Laserlipolisis) is a newer procedure invented in Italy. It is not being done in the United States yet, but is routinely performed in South America, and Europe. This procedure uses injections similar to the tumescent technique and involves the insertion of a fiber optic laser through very small incisions. The laser used affects only the yellow material in the body, the fat. Amounts up to 500 ml (a little over 1 pint) of fat are emulsified and can be absorbed by the body. 

Nonsurgical Fat Removal

Surgical fat removal does not have to be suction-assisted.  See our Nonsurgical Fat Removal Section for more information.

 
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