eMedicine Specialties > Plastic Surgery > Body Contouring

Liposuction, Techniques: Follow-up

Author: Charles Chalekson, MD, FACS, Chief of Plastics, Twin Cities Community Hospital
Coauthor(s): Bradon J Wilhelmi, MD, Professor and Endowed Leonard J Weiner, MD, Chair of Plastic Surgery, Residency Program Director, University of Louisville School of Medicine; Michael Neumeister, MD, FRCSC, Professor & Chairman - FACS - Director Hand/Microsurgery Fellowship - Division of Plastic Surgery, Southern Illinois University School of Medicine
Contributor Information and Disclosures

Updated: Nov 11, 2009

Outcome and Prognosis

Recent outcome studies show that 80% of patients were satisfied with their liposuction results, and 53% rated their appearance as excellent or very good. Interestingly, weight gain is common after liposuction and is seen in 43% of patients, with the abdomen serving as the most common location of recurrence. Three-quarters of patients rate discomfort as mild to moderate, with 60% indicating that the pain lasted less than 7 days.10

Future and Controversies

A relatively recent advance has been the development and use of ultrasonic-assisted liposuction (UAL) as a surgical technique to allow for body contouring through the liquefaction of fat. While initially used with solid probe devices, hollow cannulas are more frequently used as the mainstay of current therapy. Fat is eliminated through the process of cavitation, in which ultrasonic frequencies form microcavities or bubbles within low-density tissues (fat or water) that allow cell membrane disruption. Because this process can create significant amounts of heat, two concepts are essential in the treatment with this method of lipoplasty: (1) use only in the presence in a wet environment or solution (for control of temperature and the improvement of cavitation), and (2) apply ultrasonic energy to the cannula only while the cannula is in motion to avoid thermal burns/injury.

Many surgeons believe that UAL is best considered not as a replacement for suction-assisted liposuction (SAL) but rather as a compliment to decrease effort and surgeon workload during treatment, especially in fibrous areas or with large volumes. Some also feel that UAL results in improved feathering or contouring to allow for a smoother effect on surrounding fatty tissue to be treated.

Similarly, power-assisted liposuction (PAL) uses a small rotating blade at the tip of the aspiration cannula. As with UAL, this variant is designed to decrease the level of effort required to perform the procedure.

Laser-assisted liposuction (LAL) has various proprietary names, including Smartlipo, Slimlipo, and Coollipo. The principle is similar in that laser energy is introduced into the subcutaneous tissue and the deep portion of the dermis. Advantages are reported to include ease of procedure, increased fat removal and decreased recovery. Also, as with UAL, the energy is applied to the dermis to increase skin tightening. The efficacy of this continues to be studied, but skin tightening appears to be more reliably obtained with the use of the laser energy application.

Another new modality is water jet liposuction. This technique uses high pressure water jets to break down the fat tissue and facilitate aspiration.

For excellent patient education resources, visit eMedicine's Procedures Center. Also, see eMedicine's patient education article Liposuction.

 


More on Liposuction, Techniques

Overview: Liposuction, Techniques
Treatment: Liposuction, Techniques
Follow-up: Liposuction, Techniques
References
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References

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  2. Giese SY, Bulan EJ, Commons GW, Spear SL, Yanovski JA. Improvements in cardiovascular risk profile with large-volume liposuction: a pilot study. Plast Reconstr Surg. Aug 2001;108(2):510-9; discussion 520-1. [Medline].

  3. Kenkel JM, Lipschitz AH, Luby M, et al. Hemodynamic physiology and thermoregulation in liposuction. Plast Reconstr Surg. Aug 2004;114(2):503-13; discussion 514-5. [Medline].

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  5. Grazer FM, de Jong RH. Fatal outcomes from liposuction: census survey of cosmetic surgeons. Plast Reconstr Surg. Jan 2000;105(1):436-46; discussion 447-8. [Medline].

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Further Reading

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Keywords

liposuction, liposculpture, lipo, abdominal contouring, lipoplasty, liposuction techniques, ultrasonic liposuction, UAL, SAL, laser liposuction, superwet, tumescent, laser-assisted liposuction, power-assisted liposuction, water jet

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Contributor Information and Disclosures

Author

Charles Chalekson, MD, FACS, Chief of Plastics, Twin Cities Community Hospital
Charles Chalekson, MD, FACS is a member of the following medical societies: American Association for Hand Surgery, American Society of Plastic Surgeons, and Plastic Surgery Research Council
Disclosure: Nothing to disclose.

Coauthor(s)

Bradon J Wilhelmi, MD, Professor and Endowed Leonard J Weiner, MD, Chair of Plastic Surgery, Residency Program Director, University of Louisville School of Medicine
Bradon J Wilhelmi, MD is a member of the following medical societies: Alpha Omega Alpha, American Association for Hand Surgery, American Association of Clinical Anatomists, American Association of Plastic Surgeons, American Burn Association, American College of Surgeons, American Society for Aesthetic Plastic Surgery, American Society for Reconstructive Microsurgery, American Society for Surgery of the Hand, American Society of Plastic Surgeons, Association for Surgical Education, Plastic Surgery Research Council, and Wound Healing Society
Disclosure: Nothing to disclose.

Michael Neumeister, MD, FRCSC, Professor & Chairman - FACS - Director Hand/Microsurgery Fellowship - Division of Plastic Surgery, Southern Illinois University School of Medicine
Michael Neumeister, MD, FRCSC is a member of the following medical societies: American Association for Hand Surgery, American Association of Plastic Surgeons, American Burn Association, American College of Surgeons, American Medical Association, American Society for Reconstructive Microsurgery, American Society for Surgery of the Hand, American Society of Plastic Surgeons, Association of Academic Chairmen of Plastic Surgery, Canadian Society of Plastic Surgeons, Illinois State Medical Society, Illinois State Medical Society, Ontario Medical Association, Plastic Surgery Research Council, Royal College of Physicians and Surgeons of Canada, and Society of University Surgeons
Disclosure: Nothing to disclose.

Medical Editor

Rodrigo Santamarina, MD, Attending Plastic Surgeon, Berkshire Medical Center, Assistant Professor of Surgery, Plastic and Hand Surgeon, Division of Plastic Surgery, University of Massachusetts Medical School
Rodrigo Santamarina, MD is a member of the following medical societies: American College of Surgeons, American Medical Association, American Society of Maxillofacial Surgeons, American Society of Plastic Surgeons, Massachusetts Medical Society, New York Academy of Sciences, and Society of American Gastrointestinal and Endoscopic Surgeons
Disclosure: Nothing to disclose.

Pharmacy Editor

Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, eMedicine
Disclosure: eMedicine Salary Employment

Managing Editor

Alan Matarasso, MD, FACS, PC, Clinical Professor of Plastic Surgery, Albert Einstein College of Medicine; Immed Past President of New York Regional Society of Plastic and Reconstructive Surgery
Alan Matarasso, MD, FACS, PC is a member of the following medical societies: American Association of Plastic Surgeons, American College of Surgeons, American Medical Association, International College of Surgeons US Section, New York Academy of Medicine, New York County Medical Society, Pan American Medical Association, and Pan-Pacific Surgical Association
Disclosure: Nothing to disclose.

CME Editor

Nicolas (Nick) G Slenkovich, MD, Director, Colorado Plastic Surgery Center
Nicolas (Nick) G Slenkovich, MD is a member of the following medical societies: American Academy of Otolaryngology-Head and Neck Surgery, American College of Surgeons, American Medical Association, American Society of Aesthetic Plastic Surgery, American Society of Plastic Surgeons, and Colorado Medical Society
Disclosure: Nothing to disclose.

Chief Editor

Jorge I de la Torre, MD, FACS, Professor of Surgery and Physical Medicine and Rehabilitation, Residency Program Director, Division of Plastic Surgery, University of Alabama at Birmingham; Director, Center for Advanced Surgical Aesthetics
Jorge I de la Torre, MD, FACS is a member of the following medical societies: American Association of Plastic Surgeons, American Burn Association, American College of Surgeons, American Medical Association, American Society for Laser Medicine and Surgery, American Society for Reconstructive Microsurgery, American Society of Maxillofacial Surgeons, American Society of Plastic Surgeons, Association for Academic Surgery, and Medical Association of the State of Alabama
Disclosure: Nothing to disclose.

 
 
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