LIPOSUCTION 101 The Clinic for Plastic Surgery

So you are thinking about getting liposuction and you are confused? That is not surprising, given the overwhelming amount of information about the subject in the media and on the Internet. The purpose of this article will be to get you up to speed with the pertinent terminology, technology available, and equipment as well as the advantages and disadvantages of each system. In addition, new, exciting techniques will also be reviewed. I have been in private practice for about 10 years and have used all of the systems available and feel very qualified to give a thorough, accurate evaluation on this subject.

While there are many differences between the various liposuction technologies and modalities available, you may be surprised to learn that all liposuction procedures have many common features which I will outline for you.
There are three main phases to most if not all liposuction procedures – infiltration phase, fat preparation phase, and fat aspiration phase. The infiltration phase consists of infusing a saline solution containing numbing agents (lidocaine), and epinephrine to shrink the blood vessels to minimize bleeding. When awake liposuction is performed, bicarbonate is also added to decrease the stinging sensation as the fluid is infiltrated.

The second phase of liposuction involves preparation of the fatty tissue for extraction. The way this occurs is dependent on each unique technology and it’s effectiveness also varies. For example, ultrasound energy is used to soften the fat with ultrasonic liposuction (Vaser), whereas a laser is used to soften the fat with laser liposuction (Smartlipo). Traditional and power assisted liposuction utilize mechanical energy to prepare the fat.

The last phase of liposuction is aspiration of the fat. This is the phase that ultimately determines your result and is dependent on the skill and artistry of the surgeon performing your procedure. When the fat has been prepared adequately, the fat comes out easily and with minimal trauma, whereas with no fat preparation it may be difficult to extract and the amount of trauma required to do so may be more extensive.

A good surgeon should be able to deliver a nice result utilizing the technology that they are the most comfortable and experienced with. It remains controversial as to what system is the best or gives the best result, but I will offer a few observations based on my experience with all of the main liposuction technologies.

I no longer perform traditional liposuction as I consider it too traumatic and less controllable with regards to fat extraction. I have utilized power-assisted liposuction since 2003 and continue to use it as it minimizes surgeon fatigue and allows for more expeditious fat removal. I recently replaced my microaire pal system with a newer, advanced system called powerX and am very excited with the implementation.

Since late 2009, I have also utilized ultrasonic Vaser liposuction in my practice. It is very effective at removing large deposits of fat.

In addition to this technology, I was also concurrently trained in Vaser HI DEF liposculpture, which is a technique. This has revolutionized my results and allowed me to transition from a suctioner of fat to a sculptor of fat.

The best analogy that I like to use to explain the concept of vaser technology is to liken the fat to a stick of frozen butter. Vaser is able to turn the frozen butter (fat) into a malleable state that allows it to be manipulated and shaped, much like a sculptor works with clay. This is crucial, because now the fat liposuctioner who has been trained in The HI DEF technique can literally sculpt his result much like Michelangelo created the statue of David. Obviously, this requires a bit of artistry and is a very exclusive technique, meaning that the vast majority of doctors do not even know what it is, much less how to perform it.

These concepts can confuse some patients, so I will elaborate further to better explain. Vaser is what I call an enabling technology, whereas HI DEF liposculpture is a technique. Just because one has a Vaser, does not mean he has the ability to perform HI DEF liposculpture. The technique requires extensive training and experience. Likewise, it is also possible to perform HI DEF liposculpture without the Vaser, but without the Ultrasonic enabling technology, it is exceedingly difficult.

In 2010, I added Smartlipo laser lipolysis to my armamentarium of equipment. I feel that it plays a role in smaller areas where some skin tightening is desired. A new exciting development has just been released with the approval of the Cellulaze Smartlipo laser 2 weeks ago. Its indication and FDA approval are for the permanent treatment of cellulite. I will be training on this next week in Toronto.

So perhaps you are now more confused than when you started. Suffice it to say that when a patient sees a hi def result, most will choose this as the desired outcome they would like to have. It is a mistake, however to assume that everyone is doing liposculpture and delivering these kinds of results, because they are not. How do I know this, you might ask? Because I used to be a fat suctioner before I evolved into a fat sculptor. My results were good and my patients were happy. When the HI DEF technique was introduced in 2007, it became quickly apparent that what we once thought was not possible, was now achievable. Initially, many of the results were scrutinized and the photos were declared to be doctored. At the present time, those of us who know how to perform the technique are in some ways ostracized and the NaySayers continue to suction fat in the traditional manner.

A recently departed entrepreneurial spirit encouraged us to THINK DIFFERENT. I choose to do so and the personal satisfaction gained from helping to literally reshape and sculpt the human form back to the beauty that god intended is immense. Once you see the magic, you can’t go back!

I encourage you to continue to educate yourself about body contouring procedures. I see my experience in this field as a tool for you to rely on to help answer your questions.We will continue to try and educate our patients and separate what is hype from fact. If there are other topics that you would like to see discussed, contact us or call us at (281) 940-1535.