Liposuction: Here's the situation

Who doesn't have some stubborn areas that they wouldn't love to sucked out? Liposuction is nothing new, but the media has brought to light different techniques that have the same endpoint-removing fat.

Almost all doctors performing liposuction use tumescent fluid as the first step. This is poking a few small holes in the area and fill up the fatty area with fluid. This fluid is a mixture of saline, lidocaine (for pain control), and epinephrine (to minimize bleeding and to prolong the effect of the lidocaine).

There are 5 types of liposuction

1. SAL (suction assisted liposuction): through small holes different sized cannulas connected to a suction source are placed within the fatty areas. In a back and forth sweeping motion the fat is sucked in to canisters.

2. PAL (power assisted liposuction): same as SAL but instead of the doctor moving the instrument by hand, the machine goes back and forth.

3. UAL (ultrasound assisted liposuction): an instrument is used first that vibrates at speeds of 4,000 strokes per minute. This emulsifies the fat. The fat is then removed with the same cannulas in in SAL. Advertisements about VASER liposuction or Lysonx liposuction are types of UAL.

4. WAL (water jet liposuction): claims no tumescent anesthesia is needed. It breaks up fat by high powered water pulsations and the water is immediately sucked out with the fat.

5. LAL (laser assisted liposuciton): a fiber optic laser is used and placed within the body and the laser ruptures the fat and the fat is then removed with suction cannulas. The thought process is it causes skin tightening, and minimizes downtime, bruising, and pain. There are dozens of different laser liposuction units, the most popular being Smartlipo, Cool Lipo, Lipotherme etc.

6. Ultrasonic assisted liposuction: Body Tite

Here's the skinny.

1. SAL: the original technique still works. Results in good hands are just as good as any other modality.

2. PAL: the same as SAL (for the lazy surgeon)

3. UAL: fell out of favor because the high incidence of seromas. The technology has advanced so, that they claim there are less seromas. I have used it a few times and had seromas in the majority of the cases. Seromas are not a terribly big deal, but just a nuisance to deal with. The instruments for UAL do get hot. In order to avoid burning the skin a plastic portal is sewed into the entry point to protect the skin. This sometimes results in a larger than normal puncture wound. UAL is good at treating fibrous fatty tissue such as: re-do liposuctions, and gynecomastia (male breasts).

4. WAL: I have not tried this treatment but have seen lectures about it and has seen photos within the body of what happens after WAL. Didn't look too atraumatic to me, almost looked like TAL (tornado assisted liposuction)

5. LAL: There is NO histological evidence that laser liposuction causes dermal skin tightening. These are antecdoctal claims. I have on the other hand seen terrible burns from doctors using laser liposuction on patients. I personally used it on a few patients (with their permission of course), treating half their body with LAL and the other half with SAL. SAL came out slightly better, and the pain and swelling was less on the SAL side.

6. Ultrasound assisted liposuction: I do believe this is very good treatment. It is not FDA approved yet but has seen results from doctors in South America and Israel using this. This shows skin tightening and fat removal. It is ideal for people who could possibly need a tummy tuck

Regardless to the type of liposuction you get done aftercare is just as or perhaps more important than the surgery. The right type of garment after surgery and eating right is important. Got questions, we got answers...feel free to contact the office.