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Liposuction


Liposuction is one of the most requested cosmetic procedures worldwide. Essentially, we remove fat selectively from the different areas of the body, revitalizing an aesthetically pleasing contour, akin to the word "sculpturing."


During the 1970's until the 1980's, liposuction was performed under a dry technique which produced surmountable bleeding and morbitidy.  It was until in 1987, when Dr. Klein described the tumescent technique wherein large volumes of saline with diluted lidocaine and epinephrine were injected into the subcutaneous and fat tissues prior to suctioning.  The lidocaine provided local anesthesia while the epinephrine provided vasoconstriction of vessels. Lidocaine decreased the total required general or regional anesthesia which decreased morbidity while the vasoconstriction caused by the epinephrine allowed us to aspirate large amounts of fats without significant amount of blood loss.  This tumescent technique coupled with our understanding of physiology allowed us to perform liposuction safely.


Read more about Lipoplasty in "My Views and Finer Details" at arnoldangeles.blogspot.com 


There are numerous machine assisting devices that help us perform a good liposuction, but regardless of what device or machine you use, the end result will still be determined by the doer, your plastic surgeon.  I have included some brief discussion on the machines and tools that we use in doing liposuction.  One may have an advantage over the other.  Just read through it, and probably some procedures may be more appealing for your own personal needs and objectives.


Truths about liposuction include:

  1. Liposuction is not a weight reducing procedure
  2. Skin tightening after liposuction may depend on the client's age, skin redundancy and newly developed machines (Pls see SlimLipo below).
  3. Skin and abdominal ptosis will remain and is better addressed with concomittant abdominoplasty


Suction Assisted Liposuction (SAL)

Suction-Assisted Lipoplasty (SAL)


Relies on mechanical avulsion through suctioning of fat to remove adopose cells. Cannulas are usually made of steel. Bigger cannulas remove fat faster but results are more traumatic and may result in irregularities.  This does not mean we cannot change into smaller cannulas after removal of the bulk and proceed with body contouring without the troublesome bumps and humps after surgery.


Advantages

  • Ease of use
  • No skin burning
  • Malleable and variety of cannulas available
  • Less seroma formation

Disadvantages

  • Difficult in fibrous areas requiring more effort by the surgeon
  • Large areas takes longer time
  • Physically more tiring for the surgeon


SlimLipo

SlimLipo® which is created by Palomar™ is another machine which is similar to the laser concept of Smart-Lipo®.  The power of the laser is fine-tuned to melt only the fats, nothing else.  This has increased safety and efficiency in the body sculpturing armamentarium of plastic surgeons. An additional advantage of this machine is its ability of fine tune its lasers to stimulate skin tightening.  This allows us to have an efficient body contouring result and at the same time enjoy its skin tightening benefits.  Bruising and contour deformities are also minimal. 


Ultrasound Assisted Liposuction (UAL) and VASER

Ultrasound-Assisted Lipoplasty (UAL)


Relies on ultrasound energy to emulsify fat (“cavitation”). From the beginning of its use during the early 1990's, the cavitation phenomena has resulted in the excitement of plastic surgeons in their ability to aspirate larger amounts of fats and enabling them to "thin-out" their patients.  Unfortunately, this excitement died quickly because of the considerable morbidity that occurred.  The ultrasound energy caused superficial or even deep burns to the dermis and skin.


But the concept of ultrasound liposuction did not disappear.  It has been developed further to enhance application in liposuction.  The ultrasound energy is more controlled to cavitate and emulsify fats while preserving the important vessels and fibrous tissues.  Even the cannulas were further developed to deliver precise energy to the target fats only.  This is the concept of the VASER® Lipo System developed by Sound Surgical Technologies. This Vibration Amplification of Sound Energy at Resonance (VASER) surmountably eliminated the complications that resulted from the traditional ultrasound liposuction.


To Date, the VASER® 2.0 Lipo System enables a more safe and improved liposuction sculpting experience.  This system also increases the aspirated fat viability, allowing us to do fat grafting and therefore enhancing our overall body contouring results.


The only disadvantage of the VASER® lipo system is the cost and availability of the machine.  There are occassions when seroma formation persists for a longer period of time, but it has always been manageable.






Power Assisted Liposuction (PAL)

Power-Assisted Lipoplasty (PAL)


The PAL system is similar to a SAL but produces a forward and backward movement that is powered by a mechanical or pneumatic device.  This facilitates movement of cannula within tissues and mimics movements made by the surgeon. 


Advantages

  • This is effective in removing large volumes of fat and in working in fibrous or “re-do” (repeat liposuction) areas.
  • Ideal for shaping the back and wings (normally, these areas are tough and fibrous)
  • Requires less physical effort from the surgeon

Disadvantages

  • The handle is heavier and is sometimes noisy.
  • There is a minimal charge fee for the use of machine



Laser Assisted Liposuction (LAL)

Laser Assisted Lipoplasty (LAL)


This procedure is also similar to a SAL or PAL.  The laser is applied externally, producing radiowaves that emulsifies the fat internally before the actual aspiration is performed.  The fat becomes for "liquified" and easier to aspirate.The aspiration can be done using a SAL or a PAL.  This procedure must not be confused by SmartLipo which is discussed below.


This external laser has also the advantage of decreasing post-operative pain and bruising.



Before and After Liposuction
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Smart-Lipo®


SmartLipo is technically a machine rather than a procedure.  After tumescent fluid infiltration, a fine probe with a laser tip "melts" the fats directly, hence, the term "smart." This procedure allows proper contouring especially in difficult areas. The fats are more efficiently melted and suctioned resulting in a good and natural contour.


This is one machine that increases the efficiency of fat removal because of the laser tip that directly or "smartly" melts the fats away, making it easier to suction and contour.


This machine is also locally distributed by Spectrumed™