With all of the new lipo procedures out there - tumescent, laser-assisted, ultrasound-assisted, and even fat-dissolving injections - is there still a place for traditional liposuction?
Is Traditional Liposuction Outdated?
Doctor Answers (13)
Liposuction options can be confusing- be careful
Liposuction Devices and Techniques... Is one really better than another?
Traditional liposuction still lives!
Traditional liposuction combined with a modified tumescent technique is still the gold standard for liposuction. Do not be deceived by all the cleverly named "newer" techniques promising more than they can deliver.
No "new" technique can beat properly performed traditional liposuction and make a marginal candidate for liposuction have a great result. The key to obtaining a great result is to go to a real plastic surgeon who has excellent artistic sculpting skills and ask for a realistic evaluation of how well your skin will shrink after liposuction. If you don't have good elasticity, they should tell you because you won't get a great result no matter what technique is used.
Just yesterday, I evaluated a patient destroyed by Smart Liposuction done by a general surgeon (the kind of doctor who would remove your appendix or gall bladder). He told her he was a national trainer for Smart Lipo but he had NEVER been trained in plastic surgery himself at all.
"Buyer beware!!" holds true more in liposuction than in almost any other cosmetic surgical arena because so many non-qualified physicians are tempted to do it because it looks simple and often these are the people promoting the "latest and greatest" lipo techniques.
Traditional liposuction is still the gold standard of...
Traditional liposuction is still the gold standard of treatment.
There are many good scientific studies comparing traditional liposuction with some of the newer techniques. In one study published by Fodor and Watson (Plast Reconstr Surg. 1998 Apr;101(4):1103-16; discussion 1117-9.), ultrasound assisted liposuction and traditional liposuction were used in the same patients. Using several different analysis techniques (including blinded patient and observer analysis) they were unable to find a difference in the two techniques. One study of laser assisted versus conventional liposuction by Prado's group (Plast Reconstr Surg. 2006 Sep 15;118(4):1032-45) showed no significant difference in clinical indicators between the two groups.
To determine the merits of a procedure, visit the link below and search for peer reviewed scientific articles to determine if a procedure is good. Companies will produce studies which only show the best part of a product, not the down side. The best peer reviewed scientific articles will have double blinded controlled studies. This means that the participant and the evaluator will not know what procedure is done. In this way, an unbiased decision can be made as to the results.
The underlying principles of laser and ultrasound assisted liposuction are sound. With advances in technology, differences may become evident. For now, the use of additional technologies is a physician-dependent decision. The key is to find a physician who is comfortable performing liposuction, is trained and experienced in the procedure, and is able to produce reproduceable desired results.
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"Traditional" Liposuction = Regular / Tumescent Liposuction
In these tough economic times, like mushrooms after the rain, the ranks of Plastic surgeons are rapidly filling with mass defection of doctors who trained in other fields.
Putting power and tax revenues first and the interests of patients a very distant seconds, in all states in the USA, ANY licensed doctor, regardless of his/her actual training, can PRACTICE any field in Medicine. With declining reimbursements and huge insurance hassles thousands of ER, Family Practice, Gynecologists, General Surgeons and other have become cosmetic surgeons.
As the competition for cosmetic patients has heated up so have the claims of the participants and of the companies supplying them. Now, every cream is the ULTIMATE wrinkle eraser. Every Laser is THE BEST wrinkle tightener with no down time. There is no shame. Every dinky hole in the wall medical office has been magically transformed either into a "CENTER" or an "ADVANCED INSTITUTE" regardless of the preposterous nature of such claims. PT Barnum and other mount-back snake oil salesmen would be truly proud.
In such an atmosphere, the aim by many of these under-qualified physicians is to confuse and make sales. Few fields lend themselves more to confusion than Liposuction.
Few Facts: There is NO "traditional" liposuction. Traditional liposuction IS tumescent liposuction. But -don't tell that to those who try to convince you otherwise.
TUMESCENT Liposuction / Regular / Traditional Liposuction - the areas of fat and infiltrated with a TUMESCENT (swelling) solution of Ringer's lactate, dilute adrenaline and a local anesthetic. After allowing the adrenaline to cause shrinkage of the blood vessels, liposuction is carried out with minimal blood losses EITHER with oral, IV sedation or general anesthesia DEPENDING on the extent of liposuction and the patient and doctor preference.
VASER Liposuction / Liposelection = After tumescent solution is infiltrated the fat is broken up with ultrasound waves providing a more homogeneous fat removal with less bruising. This is especially useful where the fat is encased in a lot of fibers such as backs, men breasts etc. Once the ultrasound treatment is over, the resulting fat is vacuumed just as in regular / traditional / tumescent liposuction.
Power Assisted (PAL) Liposuction - Identical to traditional / Tumescent / regular liposuction except that the back and forth movements of the suction tubes (canulas) are not done only by the surgeon's arm but by a reciprocally powered device (Google MICROAIRE to see).
Laser Assisted (LAL) Liposuction (such as SmartLipo, ProLipo, SlimLipo etc) - After Tumescent solution is infiltrated everything under the skin is heated / cooked with a laser fiber. The resulting fluid is then vacuumed just like regular/traditional / tumescent liposuction. THERE IS NO SCIENTIFIC EVIDENCE WHATSOEVER THAT THIS IS BETTER THAN OTHER METHODS NOR THAT IT SHRINKS SKIN despite all you read out there. Nonetheless, this appears to be THE favorite liposuction bait used by many NON-Plastic surgeons to lure uneducated and unsuspecting patients into their operative suites.
Hope this was helpful.
Dr. P. Aldea
I have performed the majority of different techniques including Power assisted, traditional, Vaser, etc. To me, traditional is the safest. They all do the trick. I always say to patients it is not the wand but the magician who waves the wand that creates the magic.
Traditional Liposuction is still the best option. Everything else is marketing.
The new alternatives to traditional liposuction, such as SmartLipo, are using very effective aggressive marketing techniques to promote their products.
Usually these procedures are offered by non-plastic surgeons who have done a short course in doing the procedure and then set loose on the public. They are also used by plastic surgeons who wish to promote their practices.
Only small areas can be treated with local anesthesia in the office with safety. But the proponents will claim that they can do large areas under local, in the office, and that it is safer than general anesthesia. This is clearly misleading.
The costs are much higher for these new procedures, without the benefit of anesthesia.
Get an opinion from a Board Certified Plastic Surgeon who has been doing liposuction for years, and compare, before proceding with a new highly marketed procedure.
Each of the techniques you mention have their place, and none are suitable for all patients. Traditional Liposuction works well for significant areas that can not be adequately treated by any other technique.
Vaser liposelection is the new mainstay
In my practice Vaser Liposelection is the mainstay. Since discovering Vaser I've not used any other technique as the results are so far superior. The technique incorporates the tumescent process. 3rd generation ultrasound breaks up the fat so the aspiration process is quite gentle. Actually, the entire procedure is very gentle. More fat can safely be removed and, since there is less bruising and swelling, recovery is faster.
Liposuction techniques and terminology
Traditional liposuction is the gold standard for liposuction. Liposuction results have nothing to do with how much fat you remove, it is all about how much fat you leave behind and the elasticity of the skin. It is important to leave a variable amount of contouring fat. If all of the fat is removed it will not look good. Once you have seen a patient who has been overly liposuctioned you will understand the difference. If a large defect is created under atrophic skin it will not only look bad but will be almost impossible to correct.
Traditional Liposuction is still a great procedure
Laser Liposuction Maybe More Hype than Benefit over Traditional Lipocustion
Benefits of Laser-Assisted Liposuction in my opinion are more theoretical than real.
The primary benefit of laser-assisted liposuction is that the recovery period has been touted as less painful, and you may experience less swelling and bruising. I have not seen any difference. The theory is that because the laser used to disrupt the fat cells it causes less trauma to your tissues than mechanical removal—but the surgeon still does have to get under the skin and remove the fat. It generally takes me longer to use laser assisted liposuction and there is the danger of heat generation and a burn complication.
Laser-assisted liposuction has not been demonstrated to produce better results than tumescent ("traditional") liposuction.
The #1 consideration—for both pain & swelling and your ultimate result—is your choice of surgeon. A skilled, experienced surgeon will give you the best surgical outcome with minimized pain and recovery time. I suggest looking up surgeons who are certified by the American Board of Plastic Surgery