What is the difference between Vaser lipo and tumescent lipo?

Hello daphj,
Thanks for your questions!  Tumescent liposuction technique involves subcutaneous infiltration of large volumes of crystalloid fluid (Klein’s solution), which contains low concentrations of lidocaine, bicarbonate and epinephrine, followed by suction-assisted aspiration of fat by using small aspiration cannula (microcannula). Tumescent liposuction is by definition a method for performing liposuction surgery with the patient submitted totally under local anesthesia. Tumescent liposuction is both utilized in traditional and VASER liposuction.  The difference between the traditional and the VASER liposuction is the additional step of emulsifying the fat.  During the VASER liposuction, tumescent fluid is infiltrated, which is then followed by emulsification of the fat using the VASER probe.  After the emulsification process, the fat is the aspirated using the Vent X cannula. The liposuction cannulas used in VASER liposuction are smaller in diameter since the fat is emulsified.  The advantage of using a smaller cannuale during VASER liposuction is that there is less risk of contour irregularities. Both traditional and VASER liposuction can be performed under local anesthesia, but the amount of fat that can be harvested is limited. Another advantage of emulsifying the fat cells during VASER liposuction is that there is less trauma to the tissues, leaving the surrounding nerves, blood vessels and connective tissue unaffected. By only melting fat, the VASER leads to more rapid healing and smoother results. Since the VASER also creates thermal energy, this generated heat causes further fat to dissolve and causes significant skin contracture. Results from clinical studies presented by the American Society of Plastic Surgeons in October 2009 demonstrated a 53% improvement in skin contraction relative to the standard liposuction procedures. It’s worth noting that thermal skin contracture is not attainable with tumescent lipo. These clinical studies have also shown significantly less blood loss with the use of the VASER. Specifically, an average reduction in blood loss of 26% compared with suction-assisted liposuction methods. Tumescent lipo is usually cheaper than VASER lipo procedures, which prices fluctuate between $10,000 to $20,000 in the U.S. However, I would recommend you avoiding simply choosing the lowest-priced procedure since cost could be an indicator of quality. Set up an in-person consultation with an experienced plastic surgeon to discuss your specific needs and cosmetic goals. Kind regards! Dr. De La Cruz.

All liposuction done these days follows the principle of tumescent lipo or filling the tissues before liposuction with enough salt solution with epinephrine to allow a bloodless and smooth fat removal. Tumescent means "swollen".When liposuction is done under local anesthesia, "tumescent local", there needs to be somewhat more fluid infiltrated to get good anesthesia. When the procedure is done under general anesthesia, lesser amounts are needed and it is called "wet" or "super-wet".  Tumescent usually indicates 2-3 times as much fluid is being infiltrated as expected fat removal volume. Wet or super-wet is understood as 1-1.5 times infiltrate to  expected volume to be removed.   So "tumescent" is a general term, but Vaser is a specific technique that uses the vaser-ultrasonic probe to break up and separate the fat before the fat is aspirated. If Vaser is not being done, one would assume that after infiltrating the tissues (tumescent infiltration), the fat is going to be removed directly by a liposuction cannula connected to suction. Another way of removing the fat is with a laser-assisted liposuction device like Smartlipo which actually melts the fat before removing it with a non-aggressive, blunt suction cannula. The idea behind these assisted techniques is that the fat can be broken down or separated with a small probe or laser fiber that very evenly prepares for aspiration, in my hands, leading to a smoother, more even and predictable result.   When one is treating the inner thigh, with its soft fat, regular liposuction has to be done very carefully to avoid over-removing fat, or getting an area that is deeper or over done, leading to a groove deformity. It can be done, of course, but the inner thigh is a less forgiving area, as is the broad surface of the front or back of the thigh.  Bottom line, technology and device are good adjuncts to a good results in the hands of a skilled plastic surgeon, but the skill and experience of the surgeon are more important than the particular device used. I have seen bad post-op deformities done by unskilled surgeons using both vaser and regular (tumescent) liposuction.

It is not really the tool it is the technique used that gives the results of liposuction. You want to find someone who is an expert in the field and has a practice dedicated to body contouring/liposculpting. A formal assessment is needed to determine which techniques are best, often I am using 2-3 devices to get the most fat removal, skin tightening, and contouring. Also, I am often transferring fat to other areas to get better shape and long term contouring. I suggest a consult with a liposuction expert.  Hi definition procedures needs VASER in my opinoin or revision cases with scarring.  Best, Dr. Emer.

  Tumescent liposuction is a two-step process.The fat is first filled with tumescent solution.This is simple saline solution same stuff that is used for IV drips. It is mixed with lidocaine which is a numbing agent  and epinephrine.The epinephrine causes blood vessels to constrict tightly minimizing bleeding during the procedure.It also allows the use of much higher doses of lidocaine safely.All forms of liposuction  include tumesceing the fat first.Tumescent liposuction  simply means following  tumesceing   with liposuction using a standard liposuction cannula.  VASER is a three-step process.After placing the tumescent solution a thin ultrasound probe is moved back-and-forth throughout the fatty layers.This probe liquefies the fat making it easier to remove it.The third step is again using a regular liposuction cannula to remove the fat. .Almost all forms of liposuction use the same traditional standard canula to remove the fat.Laser liposuction such as smart liposuction is also a three-step process.With laser liposuction a laser fiber is moved back-and-forth through the fat after the tumescent  solution has been placed and before doing the actual liposuction which again has done it with a traditional liposuction cannula. Of all forms of liposuction VASER is perhaps the one that can be most differentiated.The VASER has the ability to break down fat in a quite aggressive manner.This can be helpful when working with firm  tissue such as male breast tissue.Hard fibrinous  fat can be challenging to remove  and the VASER can be very helpful.VASER also has proven higher complication rates.This includes the formation of seromas  and skin burns. Based on anecdotal observation I also see more gross disfigurement from patients having been treated with VASER.This is not to say that VASER is a bad technology.It's an aggressive tool that can be of immense benefit if used correctly by a practitioner who knows how to use it.  As I have said numerous times on real self, choose the surgeon not the equipment and everything falls into place. My practice is almost exclusively devoted to body contouring using liposuction and fat transfer.I have used all of the above technologies.  I would estimate that 70% of my surgery is done using laser liposuction, 25% tumescent liposuction and 5% VAS ER liposuction. There is no shortage of talented plastic surgeons in Los Angeles.If you would like I would be happy to forward if you names of plastic surgeons who are  exceedingly talented and have expertise with their practiced focused on liposuction. Best of luck,Mats Hagstrom M.D.