Liposuction Surgery Types

There are several different techniques used in liposuction today and new ones are being developed frequently. Liposuction is also being done safely on more areas of the body. The procedure can be very effective in removing stubborn areas of fat that do not respond to dieting and exercise.

Liposuction can be performed on almost any part of the body where there are areas of fat you want removed. However, most liposuction surgeons are more experienced with certain parts of the body. Common locations for liposuction include the abdomen, waistline, hips, buttocks, inner and outer thighs, the area above the knees, the upper arms, under the chin and the neck.

Many areas of the body can be the site of a couple of pounds of fat that will not leave no matter how much you diet or exercise. Liposuction can be performed on several areas during one session, but there is a limit to how much fat can be removed safely and how long you can be under anesthesia without an overnight stay in the hospital. Liposuction is recommended only for people who are already within 20% of their ideal weight; this translates to about 20 to 30 pounds for an average sized woman. It is not a quick fix weight loss solution.

The most common types of liposuction are:

Liposuction Techniques

There are several different liposuction techniques. All of them are variations and refinements on the same theme. Basically, liposuction consists of the insertion of a narrow tube called a cannula through a small incision in the skin. The tip of the cannula is worked back and forth through the pocket of fat to be removed, breaking it up. As the fat is broken up, a vacuum device sucks it out of the body through a tube connected to the cannula. If a large area is being treated, the surgeon may use several incision sites to keep the incisions inconspicuous, to reach a larger area, and to help prevent rippling or contour irregularities.

The history of liposuction is a story of continuous development and improvement. Since liposuction started, in the 1980s, it has evolved and several different techniques have spun off. These include:

Traditional (or Dry) Liposuction: This was the original form of liposuction. It was done by inserting a cannula and suctioning excess fat out of the body under very high levels of negative pressure, without adding any fluid or adding very little. It sometimes caused excessive trauma to the tissues, extensive blood loss, nerve damage, and tissue death in the early days of liposuction. The dry technique is not widely used anymore.

Wet Technique: The wet technique is similar to the traditional technique, but a small amount of fluid is injected or infused into the area being treated. The fluid is usually a solution of saline (sterile salt water) and two drugs, lidocaine and epinephrine. Lidocaine is a numbing agent and epinephrine constricts blood vessels and minimizes bleeding. The amount of fluid infused is less than the amount of fat the surgeon expects to remove, so if your surgeon estimates that he or she will be removing 1000 ml of fat, less than that amount of fluid is infused.

Super-Wet Technique: The super-wet technique is an extension of the wet technique. In super-wet liposuction, the surgeon injects an amount of fluid that is about equal to the amount of fat to be removed. There is less trauma to the tissues with the super-wet technique than with either the dry or wet technique.

Tumescent Liposuction: This liposuction technique involves injecting large amounts of fluid during the procedure. Typically, there is two to three times as much fluid injected as the amount of fat to be removed. The area to be treated becomes engorged with fluid or swollen, and the medical word for swelling is tumescence. The large amount of fluid creates more room between the skin and subcutaneous tissue and helps separate the fat cells, allowing the cannula to move more easily through the fat. Tumescence also helps limit the amount of tissue damage during the procedure. This version of liposuction does not require general anesthesia, although you may be given a sedative to keep you calm and relaxed. The main risk with tumescent liposuction is lidocaine toxicity, which is caused by too much lidocaine entering the bloodstream and which can cause a dangerous drop in blood pressure or an irregular heartbeat. However, this happened more often in the early days of the technique and is a rare occurrence now.

Ultrasonic-Assisted Liposuction (or lipoplasty) (UAL): In this technique, the surgeon uses high-frequency sound waves, which are either applied to the treatment area through the skin or through the cannula as it is passed through the fat to be removed. The ultrasonic energy liquefies fat cells, which are then removed by suction. But ultrasonic liposuction has risks not associated with other types of liposuction. Although it is not heat energy, ultrasonic energy can heat tissue to the point that it can cause burns.

Power-Assisted Liposuction (PAL): This liposuction technique uses tumescent technique and a cannula with a rapidly vibrating tip. The vibrating tip is said to loosen fat cells with less trauma than traditional techniques and without the burn risks associated with UAL.

Laser-Assisted Liposuction and Laser Lipolysis: In this technique, a laser is used to assist in the liposuction process. Laser lipolysis differs from laser liposuction in that fat is liquefied and it is then drained out of the treatment area through small incisions or is simply broken down by the body, rather than being sucked out using a vacuum device. This type of liposuction is considered to be less invasive than other techniques. Because the laser also seals blood vessels as it breaks up the fat cells, there is less bleeding and bruising than with other liposuction techniques. The laser also is said to tighten up the skin in the treatment area because it causes the formation of collagen, an important protein in skin that gives it elasticity.

High-Volume Liposuction: Liposuction procedures where a large amount of fat is being removedmore than 5000 ml of fat (10 pounds)are referred to as high-volume liposuction. However, the greater the amount fat that is removed during liposuction, the greater the risk of complications from the procedure. Since most liposuction procedures infuse a large amount of saline, epinephrine, and lidocaine into the treatment area, there are greater risks of throwing off the bodys fluid levels and causing lidocaine toxicity in high-volume liposuction. There is also the risk of the loss of very large amounts of blood. Because of the much higher risks, most high-volume liposuction procedures, when they are done at all, is performed in a hospital with an overnight stay.

The final results of any liposuction procedure depend on factors such as the elasticity of your skin and how well you heal. Because the procedure involves breaking up pockets of fat, the area treated may not be completely smooth afterward. Discuss the possibility of bumps and rippled areas with your surgeon. You should also look at before-and-after photos of patients who have had liposuction with your surgeon.

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