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Liposuction Techniques

 Liposuction Procedures and Techniques – Different Types of Liposuction

Liposuction procedures and techniques help eliminate the fat existing between the inner layer of the skin and muscles. This adipose deposit is stubborn, is excess, and can be found on any part of the body.

Fundamentally, the procedure involves removing fat with the help of a narrow, hollow stainless steel pipe called a cannula. One end of this pipe is connected to a hose or plastic tube. The hose  is attached to a suction device (usually a vacuum pump or large syringe) called an aspirator and then to a deposition canister. The cannula loosens body fat, which the aspirator sucks out into the deposition vessel. This process is called Suction Assisted Lipectomy (SAL). The different types of liposuction vary by the amount of fluid and the cannula technique employed. Lipo may be conducted in a hospital or as an outpatient case at the doctor’s surgery center. Usually the patient can go home a few hours after the  operation, but sometimes may need to stay overnight in the hospital.

Liposuction Procedure

The greater the number of adipocytes (fat cells) to be extracted, the greater the health risk involved. Liposuction is basically a five-step process, and its duration may vary with the quantity of fat to be removed. The surgery usually lasts for a couple of hours or so with a total stay of 4-7 hours in the hospital. Here are the steps:

  • Marking: The target area(s) is marked with a pen on the patient’s body.
  • Anesthesia Administration: Local or general anesthesia is injected into the patient depending upon the quantity of fat to be extracted. For small adipose packets, regional (local) anesthesia is preferred. To evacuate a large quantity of fat, to tone down the body circumference in one procedure, and/or when a combination of techniques is needed, general anesthesia may have to be administered.
  • Incision:  After administering anesthesia, small linear cuts or tiny holes (around  1/7″ or less in diameter) are made in the marked body region(s). The number of incisions varies according to the body part involved and its size. If just a few cuts, say 2-7, are made, then they are approximately ¼” long and are stitched after the operation. If the microcannulae (outer diameter as small as 2.2 mm) are used, 4-12 very tiny holes are made.  Therefore, stitches are not required.
  • Lipo Suction:      The cannula is inserted into the fat and is moved back and forth to loosen up the surplus adipose deposits. This cannula movement can be manual or motorized depending upon the specific technique and instruments used. The dislodged fat is then removed using a suction device. In some techniques a laser is used to break (or melt) the fat bodies.
  • Intra Venous (IV) Fluids Infusion: In some liposuction surgeries, a lot of body fluid is lost. IV fluids are administered during and after the plastic surgery to compensate for the loss. In some of the newer techniques, the anesthetic  liquid is diluted enough to decrease the need for IV fluid.
  • Sealing the Incisions: The surgeon may suture the incisions or may leave them open. The decision depends upon the type of liposuction surgery and the situation. Doctors prefer to let the minor incisions heal on their own. This reduces the swelling and bruising post procedure.

Types of Liposuction Surgery

Each procedure and technique has its unique risks and benefits. Various body areas, fat quantity, and the patient’s health condition are the key factors which influence the liposuction type selection.

Your plastic surgeon (preferably board-certified) will determine the most suitable method for you. Following are the current types of liposuction:

  • Dry Technique:  Though nearly abandoned now, this process used general anesthesia. Neither local anesthesia, nor additional fluids were infused into the area to break and loosen fat cells. This led to a lot of bleeding & bruising and required a great deal of physical effort for the surgeon. Moreover, accuracy was compromised, and the results were not maximal.
  • Wet Technique:  This procedure also used general anesthesia along with an injection of  local anesthesia in the target body region. The blood loss was significant in this technique, and it is seldom used now.

 

  • Tumescent Technique:  A large amount  of medicated liquid is injected into the targeted body area. This fluid is a mix of local anesthesia, epinephrine and intravenous (IV) salt solution.      Epinephrine is a vaso-constrictor. That is, it contracts the blood vessels to lower the blood flow in the affected body area. This helps reduce  blood loss during the surgery, while also relieving the pain significantly. This enables the surgeon to remove the fat more easily. Tumescent is the least painful, safest, and therefore, the most employed  of all the lipo methods.
  • Super Wet Technique: This is similar to the tumescent technique. The volume of dilute local anesthesia required in the super wet method, however, is less than half of what is used in tumescent.

 

  • Water Jet Assisted Liposuction: Instead of cannula or manual extraction, a slightly  pressurized saline fluid stream helps displace the fat cells gently. This subtlety results in less swelling or bruising during and after the operation. The recovery period is also short.

 

  •  Ultrasonic Assisted Liposuction (UAL): A newer liposuction procedure, UAL uses ultrasonic vibrations to liquefy fat. A metal paddle is used to introduce the vibrations and heat into the fat cells. The dislodged fat is later vacuumed out of the body. UAL can be performed both externally (above the skin’s surface) or internally (below the skin’s surface, with a heated cannula). This technique particularly helps eliminate dense fiber fat from body parts like male breasts and the upper back. A major disadvantage of this technique is that it can cause skin burns. UAL is sometimes used with the tumescent technique for better accuracy or as a follow-up procedure.

 

  • VASER Liposuction: Also called LipoSelection, Vaser liposuction employs  high frequency ultrasonic waves to help loosen the fat. Bleeding and bruising are less in this technique than in the more traditional ones.

 

  •  Power Assisted Liposuction (PAL): Here, PAL devices use compressed air or power from an electric motor to move the attached cannula during the surgery. The      technique reduces the surgeon’s manual labor. It has the following variation:
  • Twin-Cannula Assisted Liposuction (TCAL or TCL): This method requires a tube-within-a-tube cannula pair. The cannula’s inner part suctions out fat cells and the outer part replicates the surgeon’s movements of breaking them. The fat displacement and suction happen simultaneously in TCL.

 

  • Laser Liposuction: Here, laser beams are used to liquefy the fat bodies, especially in small areas. The rays can be administered externally or internally. In the external process, the laser is employed on the body  surface, while in the internal method the laser device is attached to the end of the cannula, for insertion in the body. This is an alternative to      the manual methods like tumescent. Laser liposuction procedures and technique has the following types:
    • SmartLipo:       One of the most popular methods presently, SmartLipo uses high quality and very powerful laser beams to break fat. It helps hit even the  smallest of targets precisely.
    • CoolLipo:       This gentle method rejuvenates and firms up the sensitive skin of face, chin, and neck.
    • ProLipo PLUS: This enables surgeons to use variable beam strengths during a liposuction procedure to deliver focused results.
    • Lipolite Laser: This is capable of aiming the body areas containing even  fibrous fat, which is usually resistant to the rest of the laser liposuction techniques. The method destroys even the adipocyte membranes for an optimal effect.
    • LipoControl and LipoTherme: Mostly applied in combinations, they are great laser techniques for the smallest and the most stubborn fat bodies.

The patient  satisfaction index, medical safety and speedy recovery define the excellence and success of any liposuction procedures and techniques. These factors in turn depend upon the surgeon’s experience and skill.

Patients should regularly exercise and consume the right, balanced diet to maintain the new contours and decreased fat.  Failure to eat properly and / or to exercise can result in a return of fat tissues.