Do surgeons still do dry lipo technique & do you get better results?

Question

Do doctors still do dry lipo technique for smaller areas? Do you get better results with dry lipo technique? Is fibrosis more or less likely with dry lipo technique?

Lucian Ion, FRCS · Answer

Thank you for your enquiry.
I have not come across anyone promoting dry liposuction in recent years. The amount of bleeding generated in the tissues by dry liposuction is likely to produce more scar tissue rather than less.
Using fine instruments for small areas and a moderate amount of infiltration can be a good mechanism to achieve the results whilst reducing post-operative fibrosis.
Products that reduce bruises can also be of help to minimise this tendency to scar tissue formation, as they clear the blood from the operation area quicker. The amount of blood in the tissues seems to have a correlation with the amount of scar tissue that builds after trauma or surgery, possibly due to the longer inflammatory process associated with removing the blood collected at the surgery site.

Matthew Schulman, MD · Answer

Dry Lipo means that NO local anesthetic fluid (or minimal fluid) is injected. Quite frankly, this is a terrible way to do it. The fluid allows the fat to come out easier and smoother. It also reduces pain, bleeding, and bruising. Modern advances in liposuction have all involved using more fluid, not less. So, dry technique is not good and I do not know of any board certified plastic surgeon who would ever advocate this.

Mats Hagstrom, MD (license on probation) · Answer

I’m going to assume that when you say dry liposuction, you’re referring to doing the procedure without first injecting tumescent solution.
Tumescent solution serves multiple purposes for quality Liposuction outcomes.Primarily it adds local anesthesia, making the procedure tolerable as an awake operation without general anesthesia. This also helps reduce postoperative pain.
The second major advantage to the use of tumescent solution is the use of the drug Epinephrine.
This drug is a potent vasoconstrictor, basically shutting down the blood supply to the area during the procedure.
Without tumescent solution, Liposuction is extremely bloody and messy. it leaves unnecessary, bruising and postoperative hematoma‘s. doing liposuction without the proper use of tumescent solution, including giving sufficient time for the solution to work.(ideally 20 minutes.) is the gold, standard, standard of care, and is the correct way to do Liposuction. Doing dry liposuction, or in other words, liposuction without appropriate use of tumescent solution is foolish and will have detrimental side effects leaving people are unnecessarily bruised with poor outcomes and unnecessary complications.
Delivering consistent quality, liposuction, results is more difficult than most people realize. The number of plastic surgeons who have truly mastered this procedure are in a small minority. Never assume that somebody has the necessary skill for this procedure without seeing clear documentation of quality outcomes. Being board-certified in plastic surgery with years of experience, and overall good reputation does not mean somebody has mastered any one single procedure especially not Liposuction.
I cannot emphasize strongly enough the importance of provider selection when it comes to Liposuction.Poorly done, Liposuction can leave people disfigured and improving previously done undesirable liposuction results is almost impossible, and only slight improvements may be possible.
The following are some general guidelines and recommendations to find the right provider for anybody interested in Liposuction.
To find the best provider, I suggest patient schedule multiple in person consultations with experienced plastic surgeons in their community. During each consultation, ask each provider to open up their portfolio and show you their entire collection of before and after pictures of previous patients who have similar body or facial characteristics to your own. An experienced plastic surgeon should have no difficulty showing you the before and after pictures of at least 50 previous patients. An experienced provider should in fact have hundreds or preferably thousands of before and after pictures to choose from for commonly performed procedures. 
Being shown a handful of preselected images, representing the best results of a provider’s career is insufficient to get a clear understanding of what average results will look like in the hands of each provider.
There is no correct number of consultations needed to find the best provider. The more consultations you scheduled the more likely you are to find the best provider for your needs. 
Take careful notes during each consultation, especially regarding the quantity and quality of before and after pictures. It’s not a bad idea to bring pictures of your own body/face to use as reference when reviewing before and after pictures. 
The biggest mistake patients make is scheduling only one consultation without properly vetting or comparing providers before scheduling surgery.
Best,
Mats Hagstrom, MD

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