In USA, the most common procedure performed is Vaser liposuction, or ultrasound assisted liposuction. Correct understanding of the history of liposuction, made one prefer new techniques such as Vaser for its safety and reduce the occurrence of side effects. As an example of a new generation liposuction technique, Vaser utilizes ultrasound to selectively liquefy fats without damaging surrounding nerves and vessels, producing less collateral damage than traditional liposuction techniques.
In addition, because latest techniques are becoming less and less invasive, liposuction has gradually evolved from an inpatient procedure to increasingly being done in the ambulatory/day surgery setting. This minimizing of downtime has made liposuction an increasingly popular procedure.
In addition to traditional liposuction which usually aims to reduce fat bulk, there are new applications to liposuction, such as Vaser Hi-Def sculpting. Vaser Assisted High Definition LipoSculpture, or Vaser Hi Def, is an advanced body sculpting technique.
The process creates an athletic, sculpted look in males and females by precisely removing the superficial and deep fat around muscle groups. This is in order to enhance the clarity of the underlying muscles. Similar to 3D Sculpture,
There are newer techniques on the horizon such as water jet assisted liposuction, which hold promise. However, patients should always be wary of the latest technologies that do not yet have extensive follow-up records and are not fully understood by the medical profession. Or even still being studied because they have been on the market for relatively short periods.
It is important to remember that liposuction is not a procedure to lose weight, rather, it is used more as a part of a complete weight loss program to address difficult to treat areas which are resistant to non-surgical weight loss methods.
Liposuction is one of the most commonly performed cosmetic procedures all over the world. And is in fact the commonest performed Cosmetic Surgery procedure in the United States.
It is a procedure by which fat is removed from the layers under the skin and through small cuts made in inconspicuous areas, using a vacuum suction cannula. It aims to remove local areas of fat, which are resistant to diet or exercise. And is meant to be a body-contouring procedure, and not for burn belly fat.
History of Liposuction
The history of liposuction is long, going back to the 1920s when surgeons obtained disastrous results with the first attempts to remove fat from the body. Over the years, the procedure evolved and improved in both safety and science. In 1974, Dr. Giorgio Fischer, a gynecologist from Rome, Italy, invented the liposuction procedure.
Subsequent developments in the technique of liposuction involved the use of blunt cannulas instead of sharp cannulas which were safer to use and had fewer complications of accidentally damaging blood vessels and nerves.
In recent times, the addition of different technologies to assist liposuction such as the use of lasers and ultrasound have greatly improved the safety profile of the procedure and driven the procedure further into the mainstream.
9 Types of Vaser Liposuction
- Different Injection Methods
- Dry liposuction
- The dry method does not use any fluid injection at all. This method is seldom used today.
- Wet liposuction
A small amount of fluid, less than the amount of fat which will remove from the area. It contains Lidocaine as a local anesthetic, epinephrine to contract the blood vessels and thus minimize bleeding, and a salt solution to make it saline, like bodily fluids. This fluid helps to loosen the fat cells and reduce bruising. Then the fat cells will suction out as in the basic procedure
1- Super-wet liposuction
In this method, the injection volume is the same as the volume of fat which will remove. This is the preferred technique for high-volume liposuction by many plastic surgeons as it better balances homeostasis and potential fluid overload (as with the tumescent technique). It takes one to three hours, depending on the size of the treated area/ areas. It may require either IV sedation as well as the local Lidocaine, or complete anesthesia.
2- Tumescent liposuction
Tumescent liposuction is the precursor of wet liposuction. The surgeon injects a solution containing a local anesthetic and vasoconstrictor (often Lidocaine and epinephrine respectively) directly into the subcutaneous fat which will remove. The volume of fluid creates a space between the muscle and the fatty tissue, allowing more room for the cannula. Despite a potentially large total volume of local anesthetics injected into the tissue, absorption by the body is spread over 12–36 hours because of the vasoconstrive effect, and systemic toxicity from Lidocaine is rare.
3- Laser assisted liposuction
Laser assisted liposuction which uses thermal energy to affect lipolysis has involved either of the Erchonia or powered devices.
4- Suction-assisted liposuction (SAL)
Suction-assisted liposuction is the standard method of liposuction. In this approach, a small cannula (such as a straw) will insert through a small incision. It attaches to a vacuum device. The surgeon pushes and pulls it carefully through the fat layer, breaking up the fat cells and drawing them out of the body by suction.
5- Ultrasound-assisted liposuction (UAL)
In ultrasound-assisted liposuction, surgeons use a specialized cannula to transmit ultrasound vibrations into the body. This vibration bursts the walls of the fat cells, emulsifying the fat (i.e. Liquefying it) and making it easier to suction out. UAL is a good choice for working on more fibrous areas, like the upper back or male breast area. It takes longer than traditional liposuction, but not longer than tumescent liposuction. There is slightly less blood loss. There appears to be slightly more risk of seromas forming (pockets of fluid) which may have to be drained with a needle.
After ultrasonic liposuction, it is necessary to perform suction-assisted liposuction to remove the liquified fat. Ultrasound-assisted liposuction techniques used in the 1980s and 1990s were associated with cases of tissue damage, usually from excessive exposure to ultrasound energy. The Vaser Lipo system, a third-generation UAL device, prevents this problem by using pulsed energy delivery and a specialized probe that allows physicians to safely remove excess fat.
A 40-year old woman undergoing a combination liposuction and abdominoplasty. Power-assisted liposuction: Approximately 80% of the cannula enters its full length
6- Power-assisted liposuction (PAL)
PAL uses a specialized cannula with mechanized movement, so that the surgeon does not need to make as many manual movements. Otherwise, it is similar to traditional UAL.
7- Twin-cannula (assisted) liposuction (TCAL or TCL)
Twin cannula (assisted) liposuction uses a tube-within-a-tube specialized cannula pair, so that the cannula which aspirates fat, the mechanically reciprocated inner cannula, does not impact the patient’s tissue or the surgeon’s joints with each and every forward stroke. The aspirating inner cannula reciprocates within the slotted outer cannula to simulate a surgeon’s stroke of up to 5 cm (2 in) rather than merely vibrating 1–2 mm (1/4 in) as other power assisted devices, removing most of the labor from the procedure. Superficial or subdermal liposuction is facilitated by the spacing effect of the outer cannula. And the fact that the cannulas do not get hot, eliminating the potential for friction burns.
8- External ultrasound-assisted liposuction (XUAL or EUAL)
XUAL is a type of UAL where the ultrasonic energy is applied from outside the body, through the skin, making the specialized cannula of the UAL procedure unnecessary. It was developed because surgeons found that in some cases, the UAL method caused skin necrosis (death) and seromas, which are pockets of a pale yellowish fluid from the body, analogous to hematomas (pockets of red blood cells).
XUAL is a possible way to avoid such complications by having the ultrasound applied externally. It can also potentially cause less discomfort for the patient, both during the procedure and afterwards; decrease blood loss; allow better access through scar tissue; and treat larger areas. At this time, however, it is not widely used and studies are not conclusive as to its effectiveness.
9- Water-assisted liposuction (WAL)
WAL uses a thin, fan-shaped water beam, which relaxes the adipose tissue structure, so that it will remove by a special cannula. During the liposuction the water is continually added and almost immediately aspirated via the same cannula. WAL requires less infiltration solution and produces less edema from the tumescent fluid. The utility of this technology is under study and is currently not widely used.
Subsequent developments in the technique of liposuction involved the use of blunt cannulas instead of sharp cannulas which were safer to use and had fewer complications of accidentally damaging blood vessels and nerves.
In recent times, the addition of different technologies to assist liposuction such as the use of lasers and ultrasound have greatly improved the safety profile of the procedure and driven the procedure further into the mainstream.
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9 Considerations Before Your Procedure of Vaser Liposuction
Here are some important considerations to think about before your operation.
1- Techniques
No one liposuction technique is best suited for all patients in all circumstances. Discuss with your plastic surgeon which technique is appropriate for you, depending on your overall health, body mass index and the amount of fat to be removed.
2- Anesthesia
Discuss with your doctor which anesthesia or anesthetic combination is right for you. Also, a physician should have the primary responsibility for providing and/or supervising your anesthesia.
Patient Selection – You should receive a thorough preoperative history and physical examination from your surgeon before having liposuction. Even though liposuction is generally an elective procedure, you must be assessed using the same standards as those used for anyone undergoing any type of surgery.
3- Multiple Procedures
Having multiple procedures done at the same time increases the potential for complications, particularly with large-volume liposuction. Patients having large-volume liposuction should discuss with their plastic surgeon about having one surgery at a time to limit their risk for serious complications.
4- Postoperative Care
Attend every one of your follow-up appointments. During these appointments your plastic surgeon will assess your postoperative recovery and satisfaction, as well as wound healing and scar maturation.
5- Facility Selection
In Singapore, according to MOH guidelines, liposuction for small volumes less than 1 liter can be done in clinic settings. For liposuction requiring the removal of more than 1 liter of fat, the operation must be done at least in an ambulatory/day surgery setting. A handful of clinics offer day-surgery services as part of their facilities. It is advisable to check with the surgery before your operation.
6- Training and Qualifications
Patients should understand that liposuction is a surgical procedure. In Singapore, all graduates from medical school are qualified as Bachelor of Medicine and Bachelor of Surgery (MB, BS). However, the specific training in liposuction requires that the physician be trained in the specific procedure according to the technique he is using (e.g. A doctor using VASER Liposelection should be trained in VASER operations).
7- Facility Accreditation
Patients should make sure plastic surgery performed under anesthesia, including liposuction, is performed in a surgical facility that is accredited by the Ministry of Health, Singapore as an Ambulatory/Day Surgery facility.
8- Patient Selection
You should receive a thorough preoperative history and physical examination from your surgeon before having liposuction. Even though liposuction is generally an elective procedure, you must be assessed using the same standards as those used for anyone undergoing any type of surgery. If you are overweight and your body mass index (BMI) > 28, the procedure cannot be performed in a clinic setting in view of the higher risk of operative complications. Discuss with your surgeon to have the procedure done in an environment with adequate close monitoring.
9- Liposuction Volume
Most liposuction involving the tummy or thighs or back will result in the removal of more than 1 liter of fats. If your surgeon agrees to perform large-volume liposuction consisting of more than 1 liter of total fat, the procedure should be performed in an Ambulatory Day Surgery Centre or Hospital setting recognized by the Ministry of Health (MOH). It is unethical to have more than 1 liter of fat removed in a clinical setting as the surgeon would be exposing you to unnecessary health risk and potential life threatening situation which a regular clinic is not equipped to handle. As to emphasize the gravity of the matter, MOH has informed all doctors that parties who fail to comply with requirements”…. Shall be guilty of an offence and shall be liable on conviction” and subjected to disciplinary action.
3 Considerations After Vaser Liposuction
As with any cosmetic surgery, liposuction carries potential side effects. Scars, bruises, and swelling may be apparent following surgery. It may take a few months for the lumpiness to completely disappear after the liposuction procedure. It will also take some time for your body to get used to the new shape. But most patients are pleased with the results despite the adjustment time.
1- Liposuction Swelling
Some post- liposuction swelling is inevitable. During follow-up visits with your doctor, it is important that you inform him or her of any changes in the amount of post- liposuction swelling or other side effects that you are experiencing. After liposuction, the swelling should be on a gradual recovery. If the swelling is not recovering or getting worse, inform your doctor immediately.
Swelling in the ankles and treated areas is common. This may be accompanied by a lumpy appearance in the area from which fat was removed, which will settle and appear more natural within six months after surgery.
If the upper thigh has been treated with liposuction, patients may experience thrombophlebitis, or inflammation of the veins, in this area. Within a few weeks, this should go away. Discuss your expectations with your cosmetic surgeon before the procedure. And be aware of the possible complications that may arise as a result of the surgery.
2- Liposuction Bruises
One of the more minor complications of liposuction is bruises. These tender areas may cause some pain, but bruises are frequently short-lived and usually disappear after approximately one month.
Bruising can be expected during any type of invasive medical procedure, but can be minimized depending on the technique that the cosmetic surgeon uses. Newer techniques like Vaser are associated with less post-operative bruising due to the fat-selective effect of the treatment.
Be sure to discuss with your doctor before the surgery to address all your concerns about post-liposuction bruising. Post- liposuction side effects, including bruises and scars, may be minimized with proper care.
3- Sutures and Scars
There will be small scars at the regions where the liposuction cannulae are inserted. These scars are typically small and heal well. Sometimes, the doctor will leave the incisions open in order to allow fluid to drain out.
Since the incisions are small, and the amount of fluid that must drain out is large, some surgeons opt to leave the incisions open, the better to clear the patient’s body of excess fluid. They find that the unimpeded departure of that fluid allows the incisions to heal more quickly.
Others suture them only partially, leaving space for the fluid to drain out. Others delay suturing until most of the fluid has drained out, about 1 or 2 days. In any case, while the fluid is draining, dressings need to be changed often. After one to three days, small self-adhesive bandages are sufficient.
As with any cosmetic surgery, liposuction carries potential side effects. Scars, bruises, and swelling may be apparent following surgery. It may take a few months for the lumpiness to completely disappear after the liposuction procedure. It will also take some time for your body to get used to the new shape. But most patients are pleased with the results despite the adjustment time.
Vaser Lipo Cost
Robles Clinic:
Argentina
Cost: 1670-2980 €
Shanghai United Family General Healthcare HOSPITAL
ShanghaiCost: From € 1728
Dr. Manuel Gutiérrez Romero Plastic Surgical Clinic
Tijuana, Mexico
Cost: 0-400 €
Rose Private Clinic Budapest
Budapest, Hungary
Price: 1670-2980 €
Adonis Clinic
Kyiv, Ukraine
Cost: 1600-1950 €Ktop Clinic
Krung Thep Maha Nakhon 10110
Thailand
Cost: 2500 €
Premier Clinic
Nové Město, Czech Republic
Cost: 1798-3350 €
Estetik International
Osmangazi / Bursa, Turkey
Cost: 2290-3900 €
TDS Clinic Tunis
Tunis, Tunisia
Cost: From € 1850
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Areas & Photos
