Liposuction, Laser Liposuction, Liposculpting
Liposuction has rapidly marched into the 21st century since the first case I performed in 1984. The French get credit for getting the liposuction snowball moving forward. Liposuction was first performed with fairly large suction cannulas (blunt metal tubes with side holes) to suction out fat. Once it was clear how worthwhile this technique was for body contouring better developments in suction devices, smaller cannulas with specific pruposes and aesthetic refinements were rapidly brought forward.
Today, terms like Tumescent technique, Liposculpture, Power Assisted Liposuction, Ultrasonic Liposuction and Laser Liposuction are tossed out there left and right so it’s tough to tell what is real, what is hype and what is marketing. My personal bias is it’s not the individual device type that is so important, it is the surgeon’s attention to detail and aesthetic judgment that is going to make the most impact. That being said, some of our technical refinements have their advantages.
Tumescent liposuction essentially means we fill the tissues with fluid, numbing drugs and medication to shrink down blood vessels to decrease bruising and blood loss. This may permit surgery under local anesthesia or full sleep. Most surgeons “tumesce” the tissues these days. While as plastic surgeons we may give different formal names to how much we “tumesce”, the bottom line is most surgeons will always tumesce to some degree. While the term liposculpting has a nice ring to it all liposuction is a form of liposculpting and experienced surgeons really liposculpt on every case. Ther term really focuses more on good technique, attention to detail, occasional reinjection of fat if appropriate and the use of varying plans of treatment and finer (smaller) cannulas.
Ultrasonic liposuction was very popular in the ‘90’s but never had full broad appeal. This special instrumentation can be helpful in denser tissue or reoperative areas, but has some more specific risks and expenses that make it uncommonly used today.
Laser liposuction is the current media craze in body contouring. Perhaps “Smart Lipo” is the name the public has heard the most but there is also “Cool Lipo”, “Slim Lipo” and others. The science behind these techniques is to use an internal small laser cannula that allows the surgeon to heat and rupture fat cells internally and then use standard suction to remove the fat and material or in small zones let the body reabsorb the cellular debris. The different competing devices use different laser wavelengths and energy levels to accomplish similar goals. Care must be taken to avoid over heating or burning patients and the technique is inherently slower than conventional liposuction. Of course the lasers represent a significant expense and possibly a higher cost to the patient, but in the right hands there is solid science behind the technique. Many surgeons are not convinced that final results are superior to standard liposculpting and therefore not worth the expense. Every meeting in plastic surgery, different sides still argue about which is the best option so the jury is still out on the internal laser question vs. just good technique.
Power Assisted Liposuction
Power Assisted Liposuction (PAL) uses mechanically driven oscillating cannulas during liposuction. This mostly is transferring the work load to a handle that oscillates rather than the surgeon using his or her arm and wrist to do the work. Some surgeons don’t like the bulk of the handles or the vibration to the arm, yet some like not having to exercise too much during a case. The PAL technique, like ultrasonic can be beneficial in denser tissues.
Zerona body contouring is a form of external low energy laser treatment that decreases body contour in a completely non-invasive way. This very low level of laser energy doesn’t heat or injure fatty tissues but makes fat cells decompress free fatty acids into the extra cellular areas that the body clears, uses as energy and possibly redistributes diffusely throughout the body. The Zerona is perhaps most beneficial when smaller contour correction is needed and the patient desires no surgical down time. Tucson plastic surgeon Dr. Nelson has also found this type of low level laser therapy beneficial in the recovery phase of standard liposuction.
Hopefully this has been a nice primer on current techniques in liposuction body contouring. Please go to www.jnelsonmd.com or call us to schedule your Free consultation! (520-575-8400)