The improved safety and effectiveness of liposuction are largely due to newer and better equipment and procedures. It is true of any medical procedure that the better the technology is, the safer and more efficient that procedure becomes for the patient and doctor. Of course the cosmetic surgeon’s skill is another factor in safety and effectiveness, and you would always want to choose a fully qualified and experienced plastic surgeon who is certified by the American Board of Plastic Surgery.
The types of liposuction currently being performed are:
• Microcannula liposuction
• External ultrasound-assisted liposuction (XUAL)
Originally, liposuction was done without any fluid injected. This was traumatic for the patient, difficult for the doctor, and required substantial recovery time. As the years have gone by, fluid injection has gained more importance, with the amounts of fluid increasing in Wet Liposuction, then Super-Wet Liposuction, and then Tumescent Liposuction.
The fluid used is a saline solution (to match the salt content of natural body fluids), with two things added:
• Lidocaine – as a local anesthetic
• Epinephrine – to close off any blood vessels that might be damaged by the cannula
Why is fluid injected?
Mixed with fluid, the fat suctions out more quickly and smoothly. There has always been the question of: How much fluid? In tumescent liposuction, a larger amount is injected, as much as three or four times the amount of fat to be removed. All this fluid expands the area, creating more space for the cannula movements.
The cannula is used to break up the fat cells. Breaking their surfaces emulsifies (liquefies) the fat, again making it easier to remove. In the early days, the cosmetic surgeon broke up fat cells by vigorously moving the cannula back and forth by hand. To reduce the risk of broken blood vessels or perforated body organs, methods were sought to make cannula movement more subtle and controlled.
Power-assisted liposuction (PAL)
An electrical-powered cannula was developed to refine cannula movement. A PAL procedure does not inject much fluid, so this was a limited improvement.
A specialized cannula was developed which transmits ultrasound vibrations. This makes any manual movement unnecessary and reduces blood loss somewhat. It works well on fibrous areas like the male breast or the upper back. This cannula can be used in tumescent liposuction.
External ultrasound-assisted liposuction (XUAL)
In this method, the ultrasound is applied not through the cannula, but from a handpiece held against a special gel on the patient’s skin. It can help with one risk of UAL, namely the formation of seromas (pockets of fluid build-up which show as bumps on the patient’s skin). It’s the cosmetic surgeon’s judgment as to how much vibration to apply so its effectiveness is to some extent operator-dependent.
By using a more narrow cannula, incisions are smaller and fat can be removed from smaller areas than were first treated, such as the jawline.
Using a laser
SmartLipo™ is the name of a procedure which uses a laser to liquefy the fat. Lasers have been introduced to more and more medical and dental procedures because they are fast, precise, and safe. In SmartLipo, the laser directly dissolves the fat and can seal off any leaking blood vessels as it works, which reduces risk of infection. It is used with tumescent liposuction. Other lasers such as the CoolLipo and ProLipo lasers use different wave lengths to work on fat emulsification by heating the water inside the fat cells, which breaks the cell membrane.
The best cosmetic surgeons keep up with new technology through their professional memberships and various advanced-level seminars. But newest doesn’t always mean best, so if you’re considering liposuction for yourself, ask your potential cosmetic surgeon what he thinks of each liposuction variation, and choose one who has tested them and come to his own experience-based conclusions.