Tumescent Liposuction



Developed about 15 years ago, this is the most common, and safest, method of liposuction. The term "tumescence" refers to the swelling and firming of fatty tissues by the means of infusing fluid into the tissue. After tiny incisions are made where the patient's skin covers fatty tissue, the area is soaked with a saline solution that contains an anesthetic (Lidocaine) and adrenaline to reduce blood loss and bruising. This reduction of blood loss through the shrinking of capillaries has been a great advance, enabling plastic surgeons to remove much fat with little blood loss.

Tumescent liposuction involves swelling the areas to be suctioned with a solution that equals two to three times the amount of the fat and fluid that will be suctioned out. In the Super-Wet technique of liposuction, however, the tissues are infused with an amount of fluid that equals the fat and fluids that will be suctioned. Super-wet involves the use smaller amounts of, or no, Lidocaine, thereby reducing the risk of Lidocaine toxicity.

Power Assisted Liposuction

In essence, this is liposuction hastened by a vibrating suction cannula. Developed by a German surgeon, this technique employs an electric-powered cannula, which like a jackhammer sucks out the fat faster. In my opinion, while it might help the surgeon to do his or her job faster, it takes away from the surgeon's ability to feel the contour and the topography of tissue as this machine vibrates. Also, this machine might not be safe to be used in delicate or potentially dangerous areas such as the neck and face.

Ultrasonic Assisted Liposuction (UAL)

This method was first used in the 1990's, and was considered an advance in treating especially fibrous areas, such as the male chests, back, and flanks. It uses cannulas that bombard subcutaneous fatty tissues with waves of ultrasound, thereby liquefying them through ultrasound energy and heat. An external method also delivers this energy by applying a paddle-shaped instrument to the skin. The higher general complication rate of this technique as compared to other conventional techniques has recently drawn surgeons away from this fad.

Specifically, ultrasonic assisted lipoplasty (UAL) carries an increased risk of skin and tissue burns, permanent tissue damage and scarring, nerve damage causing lasting skin irritation or pain, and fluid buildup or formation of seroma cavities of fluid beneath the skin. Because there is insufficient proof of the safety of UAL devices, the Food & Drug Administration (FDA) has never approved the marketing and advertising of UAL devices to be specifically used for liposuction.