There are several different types of liposuction procedures, each of which has a different level of effectiveness and safety. Many plastic surgeons have their own favorite method, or at least one that they feel most comfortable with, and will often exclusively perform that procedure.
Basic Types of Liposuction Surgery
Basic liposuction is done by sucking the fat from under the skin using a tube called a cannula, which is attached to a hose through which the fat travels. The cannula is inserted through small incisions in the skin, and loosens the fat by scraping it before sucking it out. The patient is sedated using general anesthesia, and in the “dry” method, which is seldom used today, no fluid is injected.
This is an improvement over the dry method, and involves the injection a small amount of a solution, made up of a local anesthetic, a vasoconstrictor to reduce bleeding, and saline, into the areas of fat to be removed. This fluid helps loosen the fat cells and prevent bruising.
Super Wet Liposuction Technique
Another version of this method is “super-wet” liposuction, and involves a greater amount of fluid injected - about the same volume as the fat that is expected to be removed. This technique is said to better control the patient’s bleeding, and provides a better balance of fluids in the body during the procedure. With the super-wet technique, the patient may still need general anesthesia, but can sometimes get away with IV sedation, combined with the local anesthetic in the injected solution.
This method, which is widely considered the best and safest technique, involves a much larger amount of solution that is injected into the fat. This volume is typically three to four times the amount of fat that is to be removed, and it serves to create a large space between the fat and the muscle tissue, which makes it easier for the surgeon to manipulate the cannula to break up the fat cells.
Local anesthetic and IV sedation are typically all that is needed to make the patient comfortable during the surgery. This is a huge improvement over earlier types of liposuction in that it takes away much of the risk of the procedure, the basis of which is the use of general anesthetic.
Tumescent liposuction surgery can take four or more hours, which is significantly longer than basic and wet liposuction, as care must be taken when injecting the solution into the patient’s body. In addition, after the solution is introduced, the surgeon must wait an hour to start working to allow the solution to penetrate the tissue and expand the affected areas.
Ultrasound-assisted liposuction came into being in the early 1990s and consists of the use of ultrasonic waves to emulsify the fat cells, so they are easier to remove. There are two ways that this energy can be transferred – internally through the cannulae, and externally through paddles which are passed over the fat deposits.
The internal method has shown to be effective, especially in fibrous areas of the body, such as the male breast area, or the upper back. However, this technique has had a higher rate of complications than others have.
To date, the Food and Drug Administration has not approved an ultrasonic device for the use of ultrasound-assisted liposuction. The external method has proven to be ineffective unless the ultrasonic energy is turned up so high that it burns the patient’s skin. Because of this, external ultrasound-assisted liposuction has not been widely used.
Different techniques are widely used around the world, with different success and complication rates. It is up to consumers to educate themselves about the different types of liposuction surgery so they can choose which one is right for them.