Liposuction St. Petersburg

Traditional Liposuction

Liposuction has been performed by plastic surgeons for over 30 years. First performed in Europe, liposuction was first performed in the United States in the early 1980’s. These early procedures were done using the dry technique which has now been abandoned due to bleeding and other complications. Safer techniques arose including wet, superwet, and tumescent techniques. Ultrasound technology was developed in the mid 1990’s and became very helpful in removing fibrous fat with less effort. As the years passed, technology improved and VASER was developed. It’s because of the existence of new technology in liposuction that we now refer to the “old” methods as traditional liposuction.

Traditional liposuction refers to the liposuction typically performed under general anesthesia and if deemed safe by a plastic surgeon, can allow volumes in excess of 5 liters to be removed. This technique is most commonly done using the superwet technique as this technique minimizes bleeding without the watery mess associated with the tumescent technique. Due to some unfavorable outcomes by overzealous physicians, large volume (exceeding 5 liters) can no longer be done in an outpatient facility and must be perfomed in a hospital. Traditional liposuction can only be done by a residency trained plastic surgeon because it must be done in an accredited facility.

In addition to traditional and ultrasound assisted liposuction, second generation ultrasound assisted liposuction, laser assisted liposuction, water assisted liposuction, and other nonsurgical methods have been developed to remove unwanted fat. In fact, it was during the 1990’s that liposuction became the most popular procedure performed by plastic surgeons.

Ultrasound Assisted Lipectomy (UAL)

Ultrasound assisted lipectomy (Liposuction) became popular in the 1990’s in the removal of fibrous fat. Fibrous fat is sometimes found for genetic reasons; other times it may be present in certain areas of the body, such as love handles or the back. UAL is frequently used to treat gynecomastia because gynecomastia tissue is frequently fibrous from the presence of breast tissue. The older UAL cannulas treated tissue at the tip of the cannula much like you would expect a laser, in a straight line. As a result, “end on hits” were problematic in inexperienced hands which could result in skin burns and ineffective liquification of fat. Ultrasound energy is delivered to separate the fat cell to cell bonds turning solid fat into liquid fat, while leaving the fat cell intact and viable. The liquified fat is then removed with a suction cannula. This technology continues to be used by plastic surgeons in all environments but is inferior to the currently technology found in VASER.

VASER

VASER is the latest generation of ultrasound assisted lipectomy technology and received FDA approval in 2002 to be used for liposuction. VASER, like the older ultrasound technology, uses ultrasound waves to emulsify fat cells turning them into a liquid form to be removed. Because it uses ultrasound energy, fat cells are selectively treated leaving blood vessels, muscle, skin, and other tissues unharmed. This has led to the term LipoSelection because the final result is only fat is being treated. VASER is considered one of the safest technologies available and can be used in both general and local anesthesia patients. Using this technology in liposuction results in less bleeding, less pain, and fewer contour irregularities. Additionally, the ultrasound energy stimulates the skin causing greater contraction than traditional liposuction resulting in better cosmetic outcomes.

Laser Lipolysis (Slimlipo, Coollipo or Smartlipo)

Laser lipolysis utilizes laser energy to destroy fat cells which then are removed with a suction cannula. This is similar to VASER in that there are 3 steps to the procedure: 1 Infiltration of wetting solution 2 lipolysis or treatment of the fat and 3 suction of the fat or fat cells. Where this technology differs is that the laser treats the cell(s) immediately before the cannula. Therefore, only the area at the tip of the cannula is treated. VASER cannulas treat a volume of tissue at the end of the cannula, much like a ball at the top of a microphone. To treat the superficial part of the deep fat with laser technologies, one must bring the cannula closer to the skin increasing the risk of skin burn and contour irregularity. Additionally, the laser does not selectively treat fat, as VASER does leading to increased risk of damaging blood vessels, muscle and other tissues. All in all, the laser technologies are more dangerous. The ideal technology would be a laser specific to fat, but this has not been developed yet.

Aqualipo (Water Assisted Lipo)

The most recent of technologies available is now water assisted liposuction. This technology utilizes low volume high pressure to emulsify fat for removal much like pressure washing the fat out of your body. Experience among plastic surgeons is limited as it is a new technology.

Don’t leave without reading the Bottom Line . . .

VASER is a safe technology for liposuction that can be done in the office or hospital setting, with general OR local anesthesia. There is less downtime than traditional liposuction and fewer risks/complications. The only limitation is that VASER under local anesthesia has limitations on how much fat can be removed in one setting. This is because there are limits to how much local anesthetic can be used safely in one setting. VASER liposelection under local anesthesia is appealing however because there are no general anesthesia risks, no breathing tube down the throat, and lower costs associated with the procedure.

While many liposuction options exist, one must find the right surgeon. Unfortunately, most physicians offering anything other than traditional liposuction are NOT plastic surgeons. They are family doctors, ER doctors, and internal medicine doctors trying to cash in on the cosmetic surgery specialty. These fly by night physicians take weekend courses, buy a machine, and hang a sign offering liposuction to unsuspecting patients seeking legitimate procedures. When a complication arises, the non plastic surgeon can’t admit the patient and take the patient to surgery because THEY AREN’T PERMITTED TO OPERATE IN AN ACCREDITED HOSPITAL OR SURGERY CENTER. Why? Because they are not residency trained in plastic surgery. The only place they can do their procedures is in a private office setting because there are no regulations or standards enforced there. Most patients aren’t even aware that those physicians are not plastic surgeons. Those physicians use phrasology like, “board certified specialist” or “board certified physician” to redirect the focus from plastic surgeon to whether or not a physician is board certified. Weekend courses are no substitute for the training a surgeon receives during an accredited residency in plastic surgery. Ask your potential liposuction surgeon if he or she is in fact a residency trained plastic surgeon.