Liposuction is a popular cosmetic procedure meant to reshape an area of the body where there is a bulge of fat that does not respond to diet and exercise. In recent years, different methods for performing liposuction have been developed, and patients’—and doctors’—options for treatment have expanded.
Traditionally, liposuction involved making an incision, placing tumescent fluid in the skin, inserting the cannula—thin, hollow, tubes with blunt tips—under the skin, and suctioning out the fat being targeted. In the late 90’s, a newer technique emerged, called ultrasonic-assisted lipoplasty (UAL). UAL employs high-frequency sound waves to liquefy the fat being removed before it is suctioned out with the cannula. Since first hitting the plastic surgery scene over 10 years ago, UAL has undergone several modifications & updates to improve its safety & efficacy profile. The “newest kid on the block” is the laser lipolysis (a.ka. smart lipo). This is another way to melt fat before retrievals with cannulas.
There are some differences between traditional liposuction and UAL. In the past, complications for UAL include burns and seromas (pockets of fluid under the skin). Now, with newer machines and surgeon expertise, these complications are negligible. Lastly, UAL can take longer—two to four hours—than traditional liposuction to perform, which can be a factor in the decision-making process, especially since it is generally an outpatient procedure.
Traditional liposuction and UAL are not entirely different, however—they share many factors in common. For one, the same qualities that make someone a good candidate for traditional liposuction also make them a good candidate for UAL: they should be of average (or possibly slightly above average) weight; in general good health; and the fat they are targeting should be fat that has not gone away despite exercise and diet.
Traditional liposuction and UAL are also similar in that, for the most part, the same risks are involved with either method. Complications are rare, but in both cases there is some possibility of infection, blood/fat clots, and changes in skin pigmentation or texture.
Further, the American Society of Plastic Surgeons (ASPS) does not recommend removing more than 5,000 mL (11 pounds) of fat at one time in an outpatient liposuction treatment, regardless of the technique being used.
The benefits in UAL lie primarily in the way in which liquefying the fat ultrasonically can facilitate suctioning it out—especially in areas like the back and sides, where fat tends to be more solid or fibrous. If you are planning to have a high volume of fat removed, especially if it’s from a particularly fibrous area, UAL can make fat removal easier, and may be a good option.
In the end, the most important factor for the patient to take into consideration is not what technique is used but who is doing the liposuction. The best surgeon will produce the best results. Patients should feel free to ask their doctor about their credentials and training (making sure to choose a board certified surgeon), as well as how many lipoplasties they’ve performed, before undergoing treatment.
About the author
Dr. Rajagopal is a board certified plastic surgeon with over 15 years of experience specializing in plastic surgery for men & women in the San Francisco Bay Area.