Redefining Shape

Cosmetic Surgery Magazine article, posted 2005

Ultrasonic Liposuction (UAL) has been performed on thousands of patients outside the United States since 1989. A number of peer review articles about UAL have been published in Europe, Asia and South America as well as in the US.

The following observations comparing the two techniques have been compiled from these journals.

Traditional Tumescent Liposuction:

  • Best suited for women and men close to their ideal weight.
  • Best suited for women and men with good, i.e. youthful skin tone and texture.
  • May require multiple procedures to achieve ideal proportions.
  • Requires surgeon’s strength and dexterity to manipulate cannulas to “shear” fat for suctioning. This method can be referred to as “mechanical” liposuction as opposed to “ultrasonic”.

Ultrasonic liposuction:

  • Ultrasonic waves delivered through the cannula emulsify or liquify the fat while traditional liposuction requires manual effort to pulverize adipose tissue.
  • Ultrasonic waves actually target fat cells specifically, causing them to “implode” and liquify for suction removal. Because fat cells alone are selected, blood and tissue loss is minimal.
  • Ultrasonic techniques make difficult fibrous areas easier to treat than traditional methods. These fibrous areas include the male breast, upper abdomen and fatty deposits on the back.
  • Traditional liposuction causes more tissue trauma and bruising than ultrasonic techniques due to tissue destruction necessary to manually break up the fat. Ultrasound emulsifies fat without damaging adjacent tissues.
  • ”Wavy” areas of fat that are sometimes side effects of traditional liposuction are minimized by ultrasonic liposuction. Ultrasonic techniques preserve skin retraction and contraction. Because ultrasound is so precise, this means smooth and even contouring is more achievable.
  • Ultrasonic liposuction may be performed on patients who are overweight. This is possible due to decreased blood loss and skin tightening observed with ultrasonic liposuction.
  • Less postoperative pain has been reported by patients undergoing ultrasonic liposuction.
  • Ultrasonic liposuction produces better skin retraction and may improve cellulite.

No procedure is without risk. Surgical training on ultrasonic liposuction is critical, even when the surgeon is familiar with traditional or tumescent liposuction. Most plastic and cosmetic surgeons are not yet familiar with the use of ultrasound. Plastic surgeons agree that one procedure will not replace another. Ultrasonic techniques will serve to broaden the number of candidates now suitable for liposuction.

Frequently Asked Questions About Ultrasonic Liposculpture

How do I know whether or not I am a candidate for ultrasonic liposculpture?

Traditional tumescent liposuction has been very effective in young patients with mild to moderate amounts of fat. Ultrasonic liposuction expanded the number of patients suitable for body sculpting.

This includes patients with larger amounts of fat and less elastic skin tone. It also allows us to treat areas not easily or effectively treated in the past. This would include fibrous areas such as the back, male breast and upper abdomen. A physical examination is required in order to verify whether you are a candidate for this procedure.

What sets ultrasonic liposuction apart from traditional tumescent liposuction?

What makes this so unique is the ability to gently liquify or emulsify the fat without injuring the adjacent structures. This is a non-mechanical method of dissolving the fat that also appears to tighten the skin. There has been less blood loss, less bruising and decreased tissue trauma observed. Ultrasonic liposuction allows us to also remove fat in areas that were previously unable to have liposuction such as the back, upper abdomen and male breast.

How long has this procedure been available?

Ultrasonic liposuction has been performed on thousands of patients outside the United States since 1989. Recently, ultrasonic liposuction has been introduced into this country.

What are the possible risks and complications of ultrasonic liposuction?

As with any surgical procedure, there are risks and complications. The specific risks and complications that are unique to ultrasonic liposuction include skin burns and unknown long term effects. A detailed list of the risks and complications is contained in the informed consent and your doctor will explain each one to you.

What medical conditions might exclude me from being a candidate?

A patient needs to be in good medical condition in order to undergo this or other elective procedures. A patient should have the ability to heal incisions and adequately fight infections, and no medical contraindications such as a heart or lung disease. Heavier patients are now candidates for this type of procedure; however, obese patients with medical contraindications are not candidates. Patients with excessive amounts of redundant skin are not candidates for this procedure.

Is camera equipment utilized with this procedure? If not, how can you ‘see’ what you are doing?

The ultrasonic liposuction equipment is highly sophisticated. The fat is dissolved by the ultrasonic waves that are emitted from the end of a cannula. This liquified fat is then gently aspirated away. While endoscopic techniques have been utilized to inspect the area in which the fat has been removed, it is not necessary on a routine basis. This is because the results are immediately visible, just as when ice or snow melts in the sun.

Does ultrasonic liposuction cost more than traditional tumescent liposuction?

Yes, ultrasonic liposuction does cost more than traditional liposuction. Because more areas can be treated in one setting and because it takes more time, the cost is necessarily greater. The ultrasonic equipment is also much more costly than traditional tumescent liposuction devices. The benefits of ultrasonic liposuction justify the additional time it takes to perform the procedure and the additional financial expense. Often the additional cost is offset by the reduction in the number of procedures required.

Cosmetic Surgery Magazine Issue 3 pages 32 & 33