The Different Types of Liposuction Techniques, Explained

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It’s the “gold standard” of fat reduction and the current top aesthetic procedure performed around the world. A recent International Society of Aesthetic Plastic Surgery (ISAPS) survey showed that liposuction treatments rose 24.8 percent in popularity over the last year. As the most effective treatment for fat removal, it does more than just take the fat out. Experts stress it’s not a weight-loss aid, but a body-reshaping treatment. Like a sculptor, a good physician will not just remove the stubborn fat, but shape the body as well. Here, experts explain the different approaches and tools used in the various types of liposuction treatments available now.

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Traditional Liposuction

This is the most common type of liposuction. It involves making small incisions in the skin and using a suction device to remove excess fat. “There is a lot of marketing that distorts the realities of liposuction,” says New York plastic surgeon Brad Gandolfi, MD. “All types of lipo start out the same. A small cut is made in the skin and the fat is suctioned out. From there, we can divide liposuction types into traditional, powered, and liposuction with energy additions.” Traditional liposuction is done less often now with the advent of power-assisted lipo, which improves surgeon fatigue says Dr. Gandolfi.

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Power-Assisted Liposuction 

This type of liposuction uses a cannula that moves in a rapid back-and-forth motion to loosen the fat before it is suctioned out. “Power-assisted liposuction, or PAL, uses a variety of tools that vibrates the tip of the liposuction cannula to help remove fat,” Dr. Gandolfi explains. “These come in different brands and are marketed under many names. There is no evidence that one is better than another.” This approach can make the procedure faster and more efficient, and may also reduce trauma to the surrounding tissues.

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Tumescent Liposuction

This type of liposuction involves injecting a large amount of a saline solution, along with a local anesthetic and sometimes epinephrine, into the area to be treated. Houston, TX plastic surgeon Olga Bachilo, MD says she performs tumescent liposuction in conjunction with power-assisted lipo. “I use epinephrine and lidocaine fluid to infuse into the tissue before doing liposuction with a vibrating hand tool,” she says. “This allows fat cells to be detached and allows me to remove them out of the body, yet they are still intact and viable and are able to be transferred to other areas of the body if desired.”

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Water-Assisted Liposuction 

This type of liposuction, also known as “water jet” or “hydro-jet” liposuction, involves using a jet of pressurized water to break up and remove the excess fat. This can make the procedure faster and gentler than traditional liposuction, and may also reduce the risk of complications. For patients who do not want to risk an internal burn using energy based devices, this is a viable option. “Energy tightens tissue through heat transfer, however, too much heat can cause a burn,” explains Nashville, TN plastic surgeon Daniel A. Hatef, MD. “Sometimes these burns are seen on the skin, and it is unsightly, but most of the time these burns are internal, and they manifest as strange contours and irregularities. This is why some surgeons are advocates of using no energy.” Dr. Hatef adds that some doctors prefer to perform traditional, power-assisted or water-assisted liposuction to remove as much of the fat as possible and let the skin retract on its own.

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Laser-Assisted Liposuction

This type of liposuction uses a laser to liquefy the fat before it is removed. This makes it easier to remove the fat, and may also help stimulate collagen production, which can improve skin tightness. You may hear Laser Lipo referred to as a brand name like SmartLipo, S.A.F.E. Lipo or AirSculpt. “The addition of energy has potential benefits that must be weighed with the risks of tissue injury from their use,” notes Glen Carbon, IL plastic surgeon Ryan Diederich, MD, who employs S.A.F.E. lipo at his practice. “We have also seen further development of the degree of contouring, learning that the body is not a static image, rather a dynamic structure and we need to evaluate it as an active, 360 structure. We continue to see refinements in liposuction with hi-definition liposuction for those wanting a more defined look, maximizing the body contour.” Recovery time is generally shorter than traditional liposuction.

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Ultrasound-Assisted Liposuction

This type of liposuction uses ultrasound energy to liquefy the fat before it is removed, making it easier to remove the fat. “VASER is the name of a device that uses Ultrasound energy to disrupt and liquify fat cells before they are suctioned out,” explains Dr. Bachilo. “This method kills fat cells, so they can no longer be transferred to another area.” When you hear the terms Hi-Def or 360, this just means etching is done to create contour and 360 refers to going all the way around the torso, adds Dr. Bachilo. 

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