Liposuction Techniques
All About Liposuction Techniques & Guidelines
Liposuction is a term that encompasses a variety of surgical procedures involving the removal of fat deposits from under the skin using a hollow stainless steel tube (otherwise known as a “cannula”) in conjunction with a powerful vacuum.
The cosmetic benefits of liposuction include improving one’s body shape in areas where dieting and exercise have not shown results. Such problem areas typically include the hips, thighs, buttocks, abdomen, and face. There are numerous liposuction techniques available ranging from those that are no longer considered safe (such as Dry Liposuction) to those that meet more current industry standards (such as Tumescent Liposuction).
Liposuction Techniques & Guidelines
Depending on the liposuction technique chosen and the amount of fat removed, the performing surgeon may choose to use either local or general anaesthetic. Patients removing smaller pockets of fat can have the procedure performed in a doctor’s office or clinic and return home on the same day, whereas a stay overnight may be in order for those removing larger amounts. Age is not typically a consideration in choosing a liposuction technique, although older patients may have less skin elasticity and consequently may not experience the same results as a younger person. Results are most often measured in terms of patient happiness as a function of safety, comfort (before and after surgery), finesse, and visible cosmetic improvement(s).
The fat cells are permanently removed during liposuction. Consequently, the weight gained following the procedure will typically not gather in the area performed. However, to maintain optimal results, patients should maintain a healthy diet and exercise regimen, as liposuction does not prevent future weight gain. Like any surgical procedure, liposuction carries certain risks, although these are minimized when it is performed by a specially trained, board-certified plastic surgeon.
Tumescent Liposuction
Tumescent liposuction uses a solution that is infused into the fatty tissue before the fat is removed. The solution typically contains saline, epinephrine and a local anaesthetic such as lidocaine. Epinephrine helps constrict blood vessels and reduce bleeding, while the solution causes the targeted tissue to become swollen and firm, making it easier for the surgeon to remove with a cannula. The term “tumescent” refers to this swollen or firm state.
The development of tumescent and other wetting techniques represented an important improvement over older dry liposuction methods because the infused solution helps reduce blood loss and surgical trauma. The amount and composition of the solution, as well as the type of anaesthesia used, depend on the treatment area, extent of liposuction, patient health and surgical plan.
After the solution has been introduced, a thin hollow tube called a cannula is inserted through small incisions to loosen and remove the targeted fat. Smaller cannulas may be used depending on the treatment area and technique. Your surgeon will determine the most appropriate approach based on your anatomy, treatment goals and the amount of fat being removed.
Ultrasonic Assisted Liposuction (UAL)
Ultrasonic Assisted Liposuction (or UAL) is a liposuction technique involving the use of a large amount of tumescent fluid (causing swelling in the tissue) in conjunction with a metal probe that delivers ultrasonic energy and heat into targeted subcutaneous fat. This technique utilizes the high-pitched sound waves of the ultrasonic energy to liquefy fat cells, making them easier for the surgeon to remove. This technique is particularly effective at aiding in the excavation of undesired fat from more difficult body areas such as the chin, neck, cheeks, knees, calves, and ankles. It is also popular for more conventional locations such as the back, sides, and abdomen. Ultrasonic Assisted Liposuction is often performed alongside Tumescent Liposuction, “tummy tucks,” and Body Lift Surgery for patients seeking more precise body contouring. Like other liposuction techniques, UAL is meant to help patients shape body areas not responsive to diet and exercise; UAL is not a method of weight control or a solution for obesity.
During UAL, surgeons first inject a tumescent fluid consisting of anaesthetic, saline solution, and epinephrine into the targeted area. This helps prevent fluid loss along with making the chosen fat deposits easier to remove. Following this, a thin metal tube (known as the cannula) is inserted through an incision to deliver the ultrasonic energy. The cannula liquefies fat cells on contact, making them easier to remove. It should be noted, however, that Ultrasound-Assisted Liposuction carries a high risk of full-thickness skin burns and scarring compared to other liposuction techniques because of the heat generated by the ultrasonic energy.
Ultrasonic Assisted Liposuction should not be confused with Ultrasound Fat Reduction, which is a nonsurgical technique involving the application of a metal paddle to deliver ultrasonic energy to the fat layer below the skin, causing the breakdown (or lipolysis) of the targeted fat cells. In the latter procedure, fat cells release triglycerides that are expelled naturally by the body, causing a visible reduction of fat in the treated area.
Liposuction Techniques FAQ
What are the most common techniques for liposuction?
Common liposuction techniques include tumescent liposuction, ultrasound-assisted liposuction (UAL), and laser-assisted liposuction. Tumescent liposuction uses an injected solution to help reduce bleeding and make the fatty tissue easier to remove. Ultrasound-assisted liposuction uses ultrasonic energy to liquefy fat before it is suctioned out, while laser-assisted liposuction uses laser energy to help break down fat before removal.
The technique used will depend on the treatment area, your anatomy, the amount of fat being removed, and your surgeon’s treatment plan.
What is Tumescent Liposuction?
Tumescent liposuction involves the injection of a solution containing saline, epinephrine, and a local anaesthetic such as lidocaine into the targeted fatty tissue before fat removal. The solution causes the tissue to become swollen and firm, or “tumescent,” which helps reduce bleeding and makes the fat easier for the surgeon to remove with a cannula
What are the benefits of going with Tumescent Liposuction?
Tumescent liposuction uses a diluted solution containing saline, epinephrine, and local anaesthetic before fat removal. The solution causes the fatty tissue to become swollen and firm, which can make it easier for the surgeon to remove with a cannula.
Epinephrine helps constrict blood vessels and reduce bleeding, while the local anaesthetic helps numb the treatment area and support patient comfort. The use of diluted local anaesthesia also helps reduce tissue trauma during liposuction.
The specific solution, amount of anaesthetic, and overall anesthesia plan are determined by the surgeon based on the treatment area, amount of liposuction, patient health, and surgical plan.
What is Ultrasound-Assisted Liposuction (UAL)?
Ultrasound-Assisted Liposuction (UAL) is a liposuction technique that combines tumescent fluid with ultrasonic energy to help break down and liquefy targeted fat cells before they are removed with a cannula. The ultrasonic energy can make fat easier for the surgeon to remove, particularly in areas where the tissue is denser or more difficult to treat.
What is Laser-Assisted Liposuction (SmartLipo)?
Laser-Assisted Liposuction uses a thin laser fibre inserted through a small incision to deliver laser energy to the targeted fat. The energy helps liquefy the fat cells, which are then removed using a small cannula.
Laser-assisted liposuction may be used for body contouring in areas such as the abdomen, arms, hips, thighs, chin, neck, and other localized areas of unwanted fat. The suitability of this technique depends on the treatment area, your anatomy, and your surgeon’s treatment plan.
What liposuction technique is right for me?
The most appropriate liposuction technique depends on factors such as the treatment area, the amount and type of fat being removed, your skin quality, overall health, and the surgeon’s treatment plan. Tumescent liposuction is commonly used, while ultrasound- or laser-assisted techniques may be considered in selected cases depending on the tissue and area being treated.
Your surgeon will recommend the technique that best matches your anatomy, goals, and the specific areas being treated.
Are more experienced surgeons more expensive?
Surgeon fees can vary based on factors such as experience, qualifications, the complexity of the procedure, the technique used, and geographic location. Cost is important, but it should not be the only factor when choosing a surgeon. Experience, qualifications, and your comfort with the surgical team are also important considerations.
How long will does it take for liposuction incisions to heal?
Liposuction incisions are small and usually begin healing within the first couple of weeks after surgery. The incision lines may remain pink, red, or slightly raised for a period of time as the scars mature and gradually become less noticeable. Full scar maturation can take several months and, in some cases, up to a year or longer.
Answer:
The incisions are usually closed up within a week or two. They should be fully healed with no scabs 2 to 4 weeks following surgery and become progressively less visible over the subsequent 3 to 12 months, except for patients with darker skin (in which case the incision sites may stay visible for a year or two).
This answer should be updated. The current version is too specific about exact healing timelines and makes an unnecessary generalization about darker skin tones.
What is the safest technique for liposuction?
There is no single liposuction technique that is safest for every patient. Tumescent liposuction is commonly used because the injected solution helps reduce bleeding and tissue trauma while providing local anaesthesia to the treatment area.
The safest approach depends on factors such as your health, the areas being treated, the amount of fat being removed, the liposuction technique, and the type of anaesthesia required. Your surgeon will recommend the approach that is most appropriate for your individual treatment plan
What’s the difference between Ultrasound-Assisted Liposuction and Ultrasound Fat Reduction?
Ultrasound-Assisted Liposuction (UAL) is a surgical procedure. A probe or cannula delivers ultrasonic energy beneath the skin to help liquefy targeted fat, which is then removed through liposuction.
Ultrasound fat reduction is non-surgical. It uses externally applied ultrasound energy to target localized fat without incisions or surgical suction. It is one of several nonsurgical fat-reduction technologies and is not a substitute for liposuction when more significant fat removal or contouring is required.
Neither treatment should be considered a weight-loss procedure.
Does liposuction use local or general anaesthetic?
Liposuction may be performed using local anaesthesia, intravenous sedation, general anaesthesia, or a combination of these approaches. The type of anaesthesia used depends on factors such as the areas being treated, the amount of fat being removed, your health, and the overall surgical plan.
Your surgeon will recommend the most appropriate anaesthesia option for your procedure.
Will I have to stay overnight at the hospital?
Liposuction is typically performed as an outpatient procedure, so most patients return home the same day. However, if a larger amount of fat is removed or your surgical plan requires additional monitoring, your surgeon may recommend an overnight stay for observation and recovery.
What’s the difference between a cannula and a microcannula?
A cannula is a thin, hollow stainless steel tube inserted through small incisions and used to loosen and remove unwanted fat during liposuction. Cannulas are available in different diameters and designs depending on the treatment area and surgical technique.
A microcannula is a smaller-diameter cannula used for more precise fat removal, particularly in smaller or more superficial treatment areas. Published liposuction techniques have used small cannulas in the range of approximately 2–3 mm, although the exact size selected depends on the procedure and surgeon’s technique.
Smaller cannulas require smaller access incisions and can allow the surgeon to remove fat gradually and precisely. However, the final contour depends on more than cannula size alone, including surgical technique, treatment area, skin quality, and the amount of fat being removed.
Does any liposuction technique permanently remove fat?
Yes. Fat cells removed during liposuction are permanently removed from the treated area. However, liposuction does not prevent future weight gain. If you gain weight after surgery, the remaining fat cells in treated and untreated areas can enlarge, which may change your results.
Maintaining a stable weight through healthy eating and regular physical activity can help preserve your results over time.
Do all liposuction techniques carry the same risks?
No. Most liposuction techniques share some general surgical risks, including swelling, bruising, soreness, infection, changes in sensation, contour irregularities, scarring, fluid collections such as seroma, anesthesia-related complications, and the possibility of revision surgery.
Some techniques also have additional risks related to the equipment or medications they use. For example, ultrasound- or laser-assisted liposuction involves energy that can create heat, which introduces a risk of thermal injury or skin burns.
Tumescent liposuction uses lidocaine and epinephrine in the injected solution, so the amount of medication and fluid must be carefully calculated and monitored.
The overall risk also depends on factors such as your health, the amount of fat being removed, the number of areas treated, the type of anesthesia, and whether liposuction is combined with other procedures. Your surgeon will recommend the technique and surgical plan considered most appropriate for you.
Will my age determine the liposuction technique chosen?
Age alone does not usually determine which liposuction technique is most appropriate. Your surgeon will also consider your overall health, skin quality and elasticity, the areas being treated, and the amount of fat being removed. Because skin elasticity can decrease with age, some patients may experience less skin retraction after liposuction and may benefit from additional skin-tightening or contouring procedures.
Can liposuction be combined with other cosmetic procedures?
Yes. Liposuction may be combined with other cosmetic procedures when it is appropriate for the patient and surgical plan. Common combinations may include tummy tuck, breast surgery, or other body contouring procedures.
Liposuction is also commonly included as part of a Mommy Makeover, where it may be combined with procedures such as tummy tuck, breast augmentation, or breast lift to address several areas within one treatment plan. Whether procedures can be safely combined depends on your health, the extent of surgery, and your surgeon’s assessment.