What kind of liposuction is best?

The Feb. issue of Dermatologic Surgery, lead article is entitled: Laser Assisted Lipolysis: A Review. It’s very interesting in that they find no advantage to Lipo-assisted lasers, ultrasound, radio-wave, etc. over the tumescent technique and traditional liposuction with small cannulas. After using an ultrasound liposuction unit for several years, I agree. It did add to the complication list, however. With energy producing lasers, ultrasounds, etc., we have heating and sometimes burning the tissues. Theoretically, they make the skin tighten, but the skin tightens with traditional lipo also. Should heating (or burning) the tissues reduce the recovery? I don’t think so.

When I first started liposuction (we didn’t even have a name for it at that time) in 1982, the cannulas were as big as my index finger, and I ordered them from Germany. The big advancement was the tumescent solution which allows local anesthesia and liposuction of much larger areas. In the old days, 2,000 ml of fat removal was the max and much of it was blood. Now we remove 4,000 ml and more with virtually no blood loss. The other advance is in the size and design of the cannulas. Now they are 2 mm or less instead of 10 mm or more. The first ones had a cutting edge as well and the new ones rely simply on the negative pressure of the suction machine to vacuum the fat.

However, there is a marketing advantage using the latest advance in liposuction with catchy names such as Cool or Smart Lipo, and now Tickle lipo.

E. Ronald Finger, MD, FACS