Liposuction Techniques
We have compiled in brief the various categories of liposuction techniques here on in this page. The major features that distinguish the various liposuction techniques are:
- the amount of solution that is injected under the skin before liposuction
- the use of any additional technological devices to assist routine liposuction
It is important to do your own research regarding the specific techniques, as well as ask your surgeon about their experience with a particular technique and any unique customizations they may have with the technology they possess. Below are a list of techniques currently on the market today:
Dry Technique (no longer used)
This is the old method which did not use injections of local anesthesia into the fat before liposuction. This technique was abandoned because of the excessive blood loss it caused (~30% blood in drawn out fluid).
Wet Technique
Wet Technique requires general anesthesia and the injection of approximately 100 milliliters of local anesthesia containing epinephrine. Although the wet technique caused less blood loss than the dry technique, blood loss with the wet technique was still excessive and dangerous with blood composing approximately 15% to 20% of the tissue removed by liposuction.
Super Wet Technique
In this method, the infused volume is in about the same amount as the volume of fat expected to be removed. This is the preferred technique for high-volume liposuction by many plastic surgeons, as it better balances homeostasis and potential fluid overload.
The super wet technique requires the injection of a volume of dilute local anesthesia that is less than half the volume used for the tumescent technique. Surgical blood loss with the super wet technique is greater than the tumescent technique but significantly less than the wet technique. Approximately eight percent (8%) of the fluid removed by super wet liposuction is blood.
Tumescent Technique
Tumescent Technique (Tumescent Liposuction) requires an injection of a large volume of very dilute solution of local anesthesia containing lidocaine and epinephrine.
The volume of dilute local anesthesia is usually sufficient to cause the targeted fat to become tumescent (swollen and firm). The tumescent technique is the only technique that permits liposuction totally by local anesthesia. Approximately one percent (1%) of the fluid removed by tumescent liposuction is blood.
Mechanisms of liposuction
Ultrasonic Assisted Liposuction (UAL)
Ultrasonic Assisted Liposuction (UAL) requires the use of a large volume of tumescent fluid and uses either a metal probe or metal paddle to deliver ultrasonic energy and heat into subcutaneous fat, essentially melting and cutting away the fat in the skin.
According to Wikipedia, currently there is insufficient proof of the safety of UAL devices and the FDA (Food & Drug Administration) has never given approval for marketing and advertising of UAL devices to be specifically used for liposuction.
Power Assisted Techniques (PAL)
Power Assisted Liposuction (PAL) devices use power supplied by an electric motor or compressed air to produce a rapid in-and-out movement or a spinning rotation of an attached liposuction cannula.
Advocates of PAL assert that it makes liposuction easier for the surgeon. However there are no objective scientific publications to support the enthusiastic claims made by manufacturers of PAL devices.
Suction-assisted liposuction (SAL)
Suction-assisted liposuction is the standard method of liposuction. In this approach, a small cannula (like a straw) is inserted through a small incision. It is attached to a vacuum device. The surgeon then pushes and pulls it carefully through the fat layer, breaking up the fat cells and drawing them out of the body by suction.
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.
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. This method presents possibilities to avoid such complications by having the ultrasound applied externally as opposed to inside the skin. As this technique is relatively new compared to the others, it is not widely used and the studies done are not conclusive as to its effectiveness.
Water-assisted liposuction (WAL)
WAL involves the use of a thin fan-shaped water beam, which loosens the structure of the fat tissue so that it can be removed by a special cannula. During the liposuction procedure water is continually added and almost immediately aspirated via the same cannula. This technology is also relatively new and is under study and therefore not as widely used.