Too much fat is a near ubiquitous problem. The sheer number of weight loss diets, medications, and exercise programs that we are inundated with each day is a testament to their ‘popularity’. Accompanying these fat concerns, to no surprise, is the desire for liposuction as a surgical fat removal method. Liposuction is by both number and surface area the most common cosmetic plastic surgery procedure in the United States.
Contrary to the perception of some is that most liposuction patients are not trying to use it as a weight loss method. Almost every liposuction patient that I have ever seen in my Indianapolis plastic surgery practice has come in with a history of diet and exercise efforts. Whether it is the 35 year-old mother who can’t get that stomach pouch off after her second child or the very trim 42 year-old male who just can’t get rid of those stubborn love handles, liposuction is usually sought out for the right reason…as a spot method of body contouring.
As potential patients seek out liposuction today, they are surrounded by an array of technology that did not exist just ten years ago. And such information is freely available for their assessment on the internet. Between marketing ads and alleged patient testimonials, every manufacturer and many doctor’s practices tout one liposuction method over another. Whether it is tumescent, ultrasonic, laser, water jet or cold liposuction, they all seem to be the ‘best’. At the least, many are relatively new and after all newer is better…isn’t it?
To understand this maze of liposuction technology, it is important to appreciate how the liposuction process actually works. Essentially, it is a two-part process. Simplistically, the first part of liposuction requires that the fat be loosened by some method. The second part is that the loosened fat is then suctioned out. All the different liposuction techniologies need to use the second phase, suctioning. The difference between all of them is in the first part, the method they use to loosen up the fat.
In traditional ‘old-style’ liposuction, good old elbow grease is how the fat is gotten free. Most everyone has a good vision of how that is done by the in and out motion of a cannula that looks like a good beating up, to quote quite a few patients. In ultrasonic liposuction, it is the high intensity sound waves that do it. With laser, it is the heat and melting of the fat. With water jet, it is the high pressure of water. With cold, it is the reverse thermal effect of heat that does it.
I have left out the tumescent method as it is not really a liposuction method per se. Every liposuction technique first infuses a fluid to make the suctioning part easier, to make the treated site numb, and to lessen bleeding. It is called tumescence because it inflates or tumesces the planned treated area. It is necessary to do this first for all liposuction methods. While this may have been a liposuction advance by the late 1980s and early 90s, it is standard today and not a novel liposuction approach.
While great and appealing arguments can be made for each of these liposuction technologies, the reality is that none of these methods have been proven or shown to be better than another. They are accepted techniques that can make for an acceptable liposuction outcome. The most important technology or technique, however, remains that of the hands and the experience of the plastic surgeon wielding the device. The greatest tool ever made is only as good as the person using it. Conversely, skill and experience can make an average tool do a great job. More focus should be placed on that assessment by potential patients, if possible, than the allure of the next great liposuction wand.
Dr. Barry Eppley