Liposuction - What Is the Best Technique For Me?

Author: Rodney Davis, Physician Assistant-Certified

There are several different techniques for achieving virtually the same results – despite all of the marketing claims. So what do you need to know before choosing which option is best for you? I have briefly outlined the three major methods that every prospective patient should be aware of before moving forward with liposuction.

Ultasound Assisted Liposuction (UAL)

This method was originally considered an advancement in liposuction methods in the 1990’s. Vaser is one of the main manufactures in this realm of UAL devices. ULA uses cannulas which send ultrasound energy through the fatty tissues, thereby liquefying the fat tissue. Most providers now agree that this method carries an increased risk of skin and tissue burns, permanent tissue damage, scarring, nerve damage, and localized fluid accumulation called seromas. There is insufficient proof of the safety of UAL devices therefore the FDA has never approved the marketing and advertising of UAL devices to be specifically used for liposuction.

Power Assisted Liposuction

Power Assisted Liposuction or PAL is a form of liposuction that uses vibrating straw-like cannulas of varying sizes, to break up and remove fat cells.  This method allows the practioner to use less force while suctioning out fatty deposits compared to manual liposuction. The use of less physical force during the procedure is not only a more efficient way for the provider to remove fat, but may also lessen the amount of swelling to the tissues and minimize the degree of trauma to the incisions.

Laser Liposuction

Most advertising would suggest that laser manufactures such as SmartLipo and its competitors have completely reinvented liposuction. However, in reality all of the basic steps involved with traditional liposuction are usually performed with laser liposuction including the frequent sedation of the patients, the injection of tumescent fluid (numbing solution), as well as the suction of fat. With laser lipolysis there is always an additional step which involves the burning of fat just before removal. Initially, the laser was intended to be used without liposuction of the fat. ‘Melted’ fat was to be resorbed by the body. This has generally been shown to be ineffective. Most liposuctionists now agree that fat must be removed after the burning. Ironically, this is achieved in the EXACT same manner as would be performed without the laser.

Some known disadvantages of the laser are that the act of burning fat makes this a more invasive procedure. Burning can lead to complications and permanent injuries to the skin and surrounding tissues. This procedure can sometimes be more expensive and is frequently used by non-experts.

SmartLipo was the first laser FDA approved for this procedure, many other “fat melting” lasers are now on the market and many others are being developed. Other lasers include CoolLipo and LipoLite. Proponents of laser assisted liposuction claim that lasers have the ability to emulsify fat and tighten skin. Reportedly, skin tightening occurs due to laser energy which breaks collagen bonds in the dermis stimulating new collagen to form. This process is call neocollagenesis.

Before and After Liposculpture by Rod Davis, PA-C at Pacific Lipo

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No certain brand of lipolysis laser at this point has been proven to be superior to any other. In my opinion, it is actually the skill of the provider in proper tumescent liposuction technique that is the best predictor of outcome.

For more information on Liposuction in San Diego, please contact Pacific Lipo at (858) 427-8899. To ask Physician Assistant Rod Davis a liposuction question – email rod@pacificlipo.com.