Liposuction: To Ultrasound or Not To Ultrasound: Part II in the Liposuction Series

Liposuction has become sophisticated.  In the 1990s, I was like everybody else.  I performed liposuction with a little numbing medication and a vacuum tube--that was it!  While it worked well, I could not contour so easily or so completely.  Occasionally, I had contour irregularities.

However, I now employ pretty fancy technology for liposuction (and I almost never do traditional liposuction anymore.)  My preferred technique includes...

• tumescent anesthesia
• ultrasonic liposuction

Tumescent anesthesia involves injecting large quantities of fluid containing lidocaine (a numbing medication) and epinephrine (also known as adrenaline) into a patient's fat layer to provide comfort and to decrease bleeding before the fat is removed.  This technique maximizes comfort because the skin is so full of numbing medication that it becomes swollen.  (It has tumesced.)  Bleeding is minimized because the epinephrine constricts blood vessels, and the fluid volume itself compresses the blood flow in the smallest blood vessels (known as capillaries).

Ultrasonic liposuction adds an ultrasound, and does not rely on the vacuum itself for removing the fat.  The ultrasound energy is used first in order to break up and to emulsify the fat.  Then, the actual liposuction can be performed without as much force or fatique.  The end result is that surrounding tissue, such as nerves, blood vessels and connective tissue, are left relatively intact, but the removal of fat is more precise and more dramatic.

Incisions are small (less than one-quarter of an inch long) and are hidden in normal skin creases.  I use dissolvable sutures, and most of the resultant scars are virtually invisible. 

    

Patients almost always return home immediately after surgery, and pain is usually mild.  Expect to be back to work in a few days, and then return to the gym within 2-4 weeks.

    

Combining tumescent anesthesia and ultrasonic liposuction has led to significantly better results, with better precision, fewer complications, quicker recovery times, and greater satisfaction.  Small liposuction procedures can now be performed safely in as an out-patient procedure.

    

Next week, in Part III of the Liposuction series, I'll let you know where and when I commonly use liposuction.