Richard A. Baxter, M.D.

The Art Behind Plastic Surgery


What other techniques are available and how can I decide which is most appropriate for me?

It is important to make your decision in consultation with a plastic surgeon who has extensive experience in state-of-the-art techniques. There are several new technologies in liposuction, and these are often introduced with so much marketing hype that it can be difficult to separate truth from fiction. Remember that all of the current methods use the tumescent technique. So in and of itself, the tumescent technique is not really a specific method.

"Traditional" method: With the traditional or standard method, suctioning is done with a small instrument called a cannula. This is a blunt-tipped instrument about the diameter of a cocktail straw, with holes near the tip. After the area is infused with tumescent fluid, the cannula is connected to suction and the tip is inserted through a small incision in the skin. The cannula is moved continuously until the desired amount of fat has been removed and the planned contour change has been achieved.

Ultrasonic-assisted liposuction (UAL): Ultrasound is high-frequency sound waves, which can help to soften and liquefy fat cells, making it easier to achieve good results in areas where the fat is more dense (such as abdomen, hips, back, and chest.) The internal UAL method uses a specially designed probe to deliver the ultrasonic energy directly into the fat compartment. The most widely used type of UAL is called VASER. Most UAL procedures employ a combination of ultrasonic and traditional techniques.

Laser-assisted liposuction: Out of all the new procedures that have appeared over the last several years, this one has undoubtedly received the most hype. But does it really offer any advantage over traditional techniques including ultrasound? The procedure still involves injection of anesthetic fluid and requires the use of a suction cannula just like regular liposuction. The only difference is the use of a laser, which is supposed to soften up the fat and stimulate the skin so that it might tighten better. Although some studies show a measurable increase in skin shrinkage, it is not likely to be clinically significant and the use of laser adds expense and the risk of burns and scarring. Paradoxically, laser lipo has been advertised as being less invasive and safer.


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