Lipedema: tumescent vs VASER?

Hello and thank you for your question.Tumescent and Vaser are 2 different things. Tumescent is an approach to doing liposuction surgery and to me the approach is either under tumescent anesthesia or general anesthesia. VASER is a tool to help optimize results, similar to Smart Lipo laser. In my practice, I currently use both in a particular fashion. My approach to lipedema surgery is a version of the tumescent approach, using the WAL (Water-assisted liposuction), but I find that the WAL simply isn’t enough to get the best result in every patient, especially if they are fibrotic. I now use VASER as a second step for emulsification, prior to my contouring and sculpting of the area as a final step. Many times, I employ a fourth step, using the Smart Lipo Laser in very fibrotic areas and patients with dercum’s disease. In terms of invasiveness, I feel that the approach of doing the patient under a version of tumescent anesthesia is a safer approach than general anesthesia. I also find it is a more effective approach to better position the patient throughout the entire surgery. VASER is another tool that can add to the results if used properly by the surgeon.

Liposuction for patients who have lipedema is somewhat controversial.Some feel the use of water jet-assisted liposuction is the preferred method.VASER is a fairly aggressive form of treatment.I would probably steer you away from that form of liposuction.I am not aware of any scientific research that has proven which form of liposuction has the least damaging effect to the lymphatic system.In my opinion, a conservative treatment using a very gentle technique and making sure the patient is not over-treated would be paramount.It may also be worthwhile to have a limited area treated at first and progress from there once it's shown not to cause any problems for you.Please make sure you only go to properly trained and experienced, board-certified plastic surgeons.Best of luck,Mats Hagstrom, M.D.