Techniques of Liposuction
There are many techniques and technologies available to do liposuction. The important distinction between board-certified plastic surgeons is the liposuction technique they use, their experience and their attitude towards the safety of the patient. Various techniques of Liposuction include:
Suction Assisted Liposuction (SAL)
Suction-assisted liposuction (SAL), is the classical form of liposuction that removes the pockets of fat cells using a vacuum. In this traditional form of liposuction, cannulas are placed in the fat pockets through tiny incisions and the site is infiltrated with wetting solution. The surgeon then moves the cannula in a push/pull motion to penetrate the fat that loosens the fat cells which are then suctioned out of the body, using a vacuum. The disadvantages include being more difficult to use in fibrous areas, more physical work involved and more trauma to tissues.
Power Assisted Liposuction (PAL)/Microaire
Power-assisted liposuction uses an externally powered cannula, which is variable in size and flex and oscillates in a reciprocating motion at rates of 4000–6000 cycles/ min. Because the PAL cannula breaks up fibrous fat much more readily, the procedure is significantly faster and less labor intensive. Suction is still a major component of PAL, and both the power source and the suction are attached to the proximal end of the handpiece. With this technique, the tissues, vessels and nerves do not get damaged or tear apart making the recovery less painful and faster.
Ultrasound Assisted Liposuction
Ultrasound-assisted liposuction utilizes ultrasonic energy to break down fat and facilitate suction-assisted removal. Its mechanism of action is primarily mechanical and cavitation and some thermal effects which provide skin retraction owing to “stimulation” of the dermis of the treated areas. With this technique, fat is emulsified, which is then suctioned out with traditional cannulas.
Advantages of UAL include less surgeon fatigue, as well as improved results in fibrous areas and in secondary procedures, more uniform treatment of fat layers and improved contour with less revision. Disadvantages include slightly larger incisions, longer operative times, and the possibility of thermal injury to skin.
VASER (Vibration Amplification of Sound Energy at Resonance) is a third-generation ultrasound assisted device for body contouring. It works on the concepts of pulsed delivery of ultrasonic energy utilizing small-diameter solid probes. It emulsifies fatty tissue quickly and safely with the absolute minimum amount of energy, thereby achieving the desired result with little or no residual trauma to the remaining tissues.
Laser Assisted Liposuction
The treatment involves the insertion of a laser fiber via a small skin incision. The laser fiber purportedly acts to disrupt fat cell membranes and emulsify fat Once the fat is liquefied due to the heat of the laser, it is drained from the body by gentle suction. Due to its healing properties, it also results in good skin retraction. This procedure is very gentle, as it only targets the fat cells, protecting the vessels and nerve tissues. This also means, less pain and bruising and a faster healing process.
