Not a week goes by that a patient seeing me for a liposuction consult does not ask…what type of liposuction do you do? Or….do you use tumescent liposuction? With the many different liposuction techniques that are available, and the media propaganda that often surrounds them, it is no wonder why many patients want one liposuction technique over another. And as patients seek non-surgical, or less invasive, alternatives to more invasive liposuction methods, these questions will continue to be asked.

First and foremost, it is important to understand that almost all current liposuction techniques use the tumescent method. Tumescent, a word meaning inflated, is the preparatory step of infusing a large amount of fluid prior to actually suctioning out fat. Besides making the liposuction cannula flow more easily amidst the fat, medication in it helps numb the treated ares and also control any bleeding that would occur if it was not used. Therefore, tumescing the area is always done with any invasive liposuction method. In essence, it is a universal liposuction principle and there really is nothing ’special’ or unique about it per se. Basically, it has to be done.

How the fat is extracted is another story. Whether liposuction is done by traditional (good old elbow grease, so to speak), ultrasonic (external or internal), pulsed light, or laser methods, these are all ways to loosen up the fat and then suck it out. The reality is….none of these newer methods has yet to be conclusively shown to be better than another…no matter what the manufacturers or advertisements say. The newer methods, such laser (Smartlipo), are definitely cooler and are easier for the plastic surgeon to perform, but thzt doesn’t necessarily translate into a better outcome for the patient although there may be less associated recovery. In my opinion, recovery after liposuction can only be improved so much, after all it is a surgical procedure. The real benefit of newer liposuction technology would be if it was faster, more efficient, or was more effective at removing fat evenly. In other words, can you get a better result? That is where the real benefit of new liposuction techniques lies…..and is of most interest to patients. The evidence for this at present is emerging but more clinical studies are needed. The evidence for the benefits of Smartlipo will be better known in another year or so.

The greatest advance ever made, to date, in the lipoaspiration of fat (beyond tumescent fluid) is the use of small cannulas in tradiional liposuction. This is the most likely method to have the lowest probability of having uneven areas or dimpling after liposuction. While it is a bit more time-consuming for the plastic surgeon, the end result is always worth it. The best liposuction technique…..is still the skill, experience, and eye of the plastic surgeon performing the procedure. The tools used do not overcome poor surgical technique.

Dr Barry Eppley
http://www.eppleyplasticsurgery.com
http://www.ologyspa.com
Claria North Medical Center, Carmel, Indiana
Clarian West Medical Center, Avon, Indiana
Indianapolis