Types of Liposuction can be described by the infusion technique, the power machine being used, or the philosophy followed by the surgeon.
Surgeons will use several techniques (Types) for each patient. By far the most common is the Tumescent technique. Tumescent Liposuction is used with the power cannulas (Vaser, BodyTite, MicroAire, Laser Lipolysis). The surgeon’s philosophy will determine how he uses all these things for each patient. Body Type Liposuction, 360° Liposuction, High Definition Liposuction, Traditional Tumescent Liposuction, Mega-Liposuction, Lipo-Lymphedema liposuction, Large Breast Reduction Liposuction and Gynecomastia Liposuction.
Infusion – Tumescent Liposuction
The volume of wetting solution used (Infused) is described as dry, wet, superwet, and tumescent. With true Tumescent liposuction the fat feels firm once it has filled with the solution (Tumesced). Anything less than this turgidity is said to be superwet, and even less solution is then described as wet. Dry liposuction does not use any fluid infiltrated into the fat. I am not aware of anyone using dry liposuction now.
The fluid that is infiltrated in liposuction serves two main purposes: stopping bleeding, and pain control during and after the procedure.
If you are having General Anesthesia then it is possible to reduce the amount of Lignocaine anesthetic that is added to the solution. If you have no lignocaine the general anesthesia will need to be deeper which is not as safe. You would also not have the post-operative protection that lignocaine gives.
You still need to add Adrenaline to the solution to control bleeding.
Liposuction Instruments
Since the work of Fischer in Italy everyone now uses blunt cannulas. Cannulas have become smaller in diameter because they give finer smoother results. They range in size from 1mm for small facial liposuction up to 5mm for mega-liposuction. They have been as big as 10mm.
Cannulas can be power assisted or manual.
MicroAire started with an air driven device which has been changed to an electric system. The advantages of power assisted devices is that they are faster and allow more complete extraction of fat. Faster means that the patient is not in theatre for as long and the surgeon is not so tired and will produce finer results.
Vaser
Vaser is the leading name in ultrasound liposuction and for good reason. The technology has been refined with several new generation machines bringing greater safety and efficiency.
Vaser works by using an ultrasound probe to selectively break fat cells and spare blood vessels. If the tissues are very fibrous such as in Gynecomastia then a more focused ultrasonic beam is used to break down more fibrous tissues. Vaser is able to clear away tough fibrous breast tissue that will not move with manual liposuction. With Vaser we are able to remove 100%, yes, all the breast tissue.
Gigantomastia (Macromastia) is the female version of male gynecomastia. The target here is not to remove all the breast tissue and is the fat is soft it will come out easily with tumescent liposuction. However if there is significant gland hyperplasia, Vaser will be extremely useful. Vaser has allowed us to achieve significantly better results for our patients with large breasts.
Vaser is also very effective for High Definition Liposuction. This is because it is able to remove all the tissue that is deep on the edge of muscle sheaths and that tissue that is just under the skin that would otherwise hide muscle definition.
Radio frequency Liposuction
BodyTite uses Radio Frequency to heat the deeper layers of tissues achieving better skin tightening than might be achieved with tumescent liposuction alone. It will not break down the dense fibrous tissues that Vaser is so good at. Some areas need Vaser and some are better with radiofrequency.
Laser Liposuction
Laser Liposuction arrived with great hope but has not delivered. Non-invasive Low Level Laser has found a niche with beauty therapists and seems to deliver some results. This does not involve liposuction.
Electric
MicroAire is the market leader. The early machines vibrated a lot and our arms and hands would tingle for a long time after surgery. Research and development have produced many refinements, several new models and the current microAire is a joy to work with. The main advantage is that the bulk of fat can be removed quickly leaving time for refinement and fine tuning.
Water Assisted
Body-Jet make a very nice and versatile machine. They have focused on using local anesthetic to loosen the fat as it is being sucked out. This removal of lignocaine reduces its accumulation in the blood stream and reduces the risk of toxicity. It also means that a greater volume of fluid can e used. The fat that is harvested has been washed and needs less processing prior to being used for fat grafting, SVF or Stem Cell collection
Electric
MicroAire is the market leader. The early machines vibrated a lot and our arms and hands would tingle for a long time after surgery. Research and development have produced many refinements, several new models and the current microAire is a joy to work with. The main advantage is that the bulk of fat can be removed quickly leaving time for refinement and fine tuning.