During the past decade, liposuction, which is also known as "lipoplasty" or "suction lipectomy," has benefited from several new refinements. Today, a number of new techniques, including ultrasound-assisted lipoplasty (UAL), the tumescent technique, and the super-wet technique, are helping many plastic surgeons to provide selected patients with more precise results and quicker recovery times. Although no type of liposuction is a substitute for dieting and exercise, liposuction can remove stubborn areas of fat that don't respond to traditional weight-loss methods.
1- Tumescent Liposuction
The word "tumescent" means swollen and firm. By injecting a large volume of very dilute lidocaine (local anesthetic) and epinephrine (capillary constrictor) into subcutaneous fat, the targeted tissue becomes swollen and firm, or tumescent. The tumescent technique is a method that provides local anesthesia to large volumes of subcutaneous fat and thus permits liposuction totally by local anesthesia. The tumescent technique eliminates both the need for general anesthesia and need for IV narcotics and sedatives. The tumescent technique for liposuction 1) provides local anesthesia, 2) constricts capillaries and prevents surgical blood loss 3) provides fluid to the body by subcutaneous injection so that no IV fluids are needed.
2- Dry Technique
Dry Technique Dry Technique (no longer used) required general anesthesia. The dry technique derived its name from the fact that it did not use injections of local anesthesia into the fat before liposuction. This technique was abandoned because of the excessive blood loss it caused. Blood composed approximately thirty percent (30%) of the tissue that was removed by liposuction using the dry technique.
3-Wet Technique
Wet Technique also required general anesthesia. The wet technique required the injection of approximately 100 milliliters of local anesthesia containing epinephrine. Although the wet technique caused less blood loss than the dry technique, blood loss with the wet technique was still excessive and dangerous. Blood composed approximately 15% to 20% of the tissue removed by liposuction using the wet technique.
4-Ultrasonic Assisted Technique
Ultrasonic Assisted Liposuction (UAL) requires the use of a large volume of tumescent fluid and uses either a metal probe or metal paddle to deliver ultrasonic energy and heat into subcutaneous fat. Internal UAL is the term used to describe the technique where a long metal probe, which may be solid or hollow, is inserted into fat through a large incision. Among those surgeons who do internal UAL, most rely on the use of general anesthesia or heavy IV sedation. Internal UAL has largely been abandoned because of the risk of full-thickness skin burns and severe scaring.
5-Power Assisted Technique (PAL)
Power Assisted Liposuction (PAL) devices have recently become available. PAL devices use power supplied by an electric motor or compressed air to produce either a rapid in-and-out movement or a spinning rotation of an attached liposuction cannula. Advocates of PAL assert that it makes liposuction easier for the surgeon. While some liposuction surgeons have expressed enthusiasm about PAL, many others remain skeptical about any advantages of PAL. There are no objective scientific publications to support the enthusiastic claims made by manufacturers of PAL devices.
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