Thursday, October 2, 2014

What type of Liposuction is the best?

Tumescent Liposuction
This is a question I get frequently. Some of the newer approaches have made great claims as to their superiority over the more traditional method, but these have yet to be proven and published in scientific journals. I always think that if those new techniques are really what they promote, then every plastic surgeon in the world would do them, and that is not the case. They have been around for a long time and they haven't substituted traditional liposuction, and probably never will. At any rate, the variable of highest importance when selecting liposuction surgery is the experience level and efficacy of the provider.

Tumescent Liposuction is the original mode of treatment and continues to be regarded the gold standard by which other methods are compared. It functions by applying a local anesthetic to the area, injecting a fluid to shrink the blood vessels and expand the fat cells, and then inserting through small incisions a long rod-like device called a cannula through which the targeted fat cells are removed by vacuum suction. Some temporary bruising and swelling are typical with this procedure.

Micro-fat Grafting
This is the method that my team and I employ in my practice most frequently. Done correctly, it provides the incredible results that liposuction is known for with minimal risk. Unlike all other types of liposuction, the fat tissue removed is still in tact enough that it may be inserted into different areas of the body where more volume is desired, such as the buttocks or facial deposits. This is a common procedure known as micro-fat grafting.

Laser (Smart-Lipo, Slim-Lipo), Ultrasound (VASER), Water (BodyJet), and Power Assisted Liposuction are the newer, more heavily marketed types of liposuction. They all act to liquefy the fat tissue more thoroughly than the traditional approach prior to its removal, which disallows the removed fat to be used elsewhere in the body. While it seems true that this liquification may lead to slightly less blood being extracted with the fat, the claims about producing less swelling and tissue trauma have yet to be proven and published in medical journals.

Because of the extreme measures taken to liquefy the fat and the precision required, these alternative methods also come with elevated risk for skin, nerve, and tissue damage, mostly depending on the skill level of the operator of the equipment. There is a much greater learning curve involved, so it’s crucial that the providing surgeon has been utilizing these techniques for a long time. They can also require more time in the operating room. I would say that the most important contributing factor to these techniques, which separates them from the traditional method is less bleeding. Besides that, I don't see any other true benefit. 

While I stand by the traditional tumescent approach in my practice, I do occasionally employ Laser Liposuction when dealing with cases of extreme skin flaccidity. This is because it does seem to provide a slight edge in times of loose skin needing to be kept as tight as possible. But I use this on an as needed basis only, and all of my liposuction clients are routinely thrilled with their results.