Should I go for Vaser or traditional lipo?

Question

i’m indecisive on whether I should get Vaser or traditional lipo. I've heard Vaser lipo is great because of the less blood loss and pain... but I've also heard you're more prone to getting a burn. How true is that? My biggest fear is ending up with a lipo burn. Is it really worth it? How big are the differences between those two types of lipo?

George Marosan, MD · Answer

Thank you for your question. Traditional liposuction is different from the VASER liposuction technique. It is called traditional, since that is the initial liposuction technique. Initially, and even now, traditional liposuction is used as a fat reduction technique, not a sculpting or revealing liposuction. The VASER is an energy device which is advantageous in repeat liposuction ( internally scarred patients from previous surgery), fibrous areas or if the surgeon is trained in advanced body sculpting techniques. You can get burns from either, that is solely a result of poor technique from the part of the surgeon. With the VASER, there are skin protector ports, but with traditional liposuction moving the cannula in-out 50-100x through the skin incision without protection, you can get a burn. Surgeons who do fat reduction liposuction only, will tell you that there's no difference between traditional liposuction and energy based devices. They call it "marketing" to cover up their ignorance.The VASER is less painful and has less blood tinged aspirate if it is used strictly for fat reduction like traditional liposuction. If the VASER technique is Hi Def Lipo for muscle and bony anatomy definition, there's more and longer discomfort than the company brochure will say.My practice is mostly advanced body sculpting using the VASER Hi Def Lipo technique. I've used the VASER for over 15 years and never had a skin burn. My poke holes are hidden, there's no sign that surgery was even done. See a board certified plastic surgeon experienced in advanced liposuction techniques for an in person consultation/evaluation. Good luck.

Jason Emer, MD · Answer

You need a formal evaluation by an expert in body shaping and contouring to determine what is best. The best in body contouring not only removes fat with energy devices like VASER ultrasound but also internally heats the skin with radiofrequency devices such as Renuvion (J-Plasma), InMode BodyTite, and ThermiRF to heat the undersurface of the skin and tighten it at the same time as fat removal. These combinations are called 4D HI-DEF VASER Liposuction and can only be done by a well-trained body contouring specialist. At the same time, fat should be harvested and purified, with PRP and stem cells added, and then injected into muscles, indentations and cellulite to get body shaping and contouring. For a Brazilian butt lift (BBL), we inject the fat into the buttock for contouring and lifting, but fat can also be used in areas such as the chest/breast, arms/shoulders, calves and face. Cellulite should also be treated with a combination of Cellfina, subcision, and/or fillers such as Bellafill, Renuva synthetic fat, or Sculptra. If skin is very loose before surgery, then it will need to be removed: tummy tuck/abdominoplasty for lower abdominal skin; breast lift for excess breast skin; and/or a brachioplasty for loose arm skin.Overall, you need a full assessment, but simple liposuction alone will not tighten skin and needs a combination of various methods -- fat removal, skin tightening, defining, fat grafting, skin removal -- to get the best in body contouring and body sculpting. See an expert. Best, Dr. Emer.

John A. Millard, MD, FACS · Answer

VASER Hi-Def liposuction is one of my passions and I actually pioneered this procedure in the US while also teaching hundreds of other surgeons as well! The science of VASER was a quantum leap in liposuction, liposculpting, and fat grafting technology. It was the first device that took into account and respected those tissues that surround the patients fat cells
Functionally there are three layers of fat that can be removed during the liposculpting process.
First, from the sub-dermis, immediately underneath the skin. Fat removal from this area with retention of the connective tissue unloads the skin and for maximal skin tightening and shrinkage. Removal of fat from this area is required if one is going to obtain significant skin tightening during liposuction/liposculpture.
The next layer down is the superficial fat compartment, which can be both reduced during liposuction for more dramatic size reduction, and/or shaped for 3-D and 4-D liposculpting. Again, preservation of the connective tissue and small lymphatics and blood vessels helps minimize tissue trauma while achieving maximal fat removal, along with further skin tightening by vertical contraction of the retained connective tissue.
The last layer is the deep layer which also has the same connective tissue, blood vessel, and lymphatic structures. Left relatively untouched while removing fat, minimizing this layer allows for further vertical skin tightening. Many post-liposuction irregularities and deformities are caused not by uneven fat removal, but uneven connective tissue removal. This is commonly seen with traditional suction-assisted liposuction which rips the fat and connective tissue, lymphatics, and small blood vessels. This means the tissue will be pulled harder down towards the muscle in areas where connective tissue remains and less contracted towards the skin where the connective tissue has been ripped away.
Therefore, one could have an “even” fat removal and an “uneven” connective tissue removal and still heal with deformities and irregularities. The VASER and the special “Atraumatic Cannulas” designed by me significantly reduce this risk.

Timothy Alexander, MD · Answer

Thank you for your question. There are several different types of liposuction available today, but the original procedure is still the most effective. Other forms of liposuction may be less invasive, but they also do not produce consistent results. If you have stubborn fat that you cannot eliminate in any other way, liposuction may be the best solution for you. I would recommend that you do a virtual consultation to go over all your options. 
Best of luck

Vinay Aggarwal, MD · Answer

Thank you for your question.The medical consensus agrees (and I do too) that VASER lipo is far superior to traditional (or tumescent) liposuction. Some of the reasons for this are the very ones you mentioned. Tumescent lipo simply employs raw suction to aspirate the fat. This limits the procedure's range of effectiveness while elevating the risk for patient injury. From your question, it appears that you may have fallen victim to a common misconception. VASER is not a laser. There is no heat and no risk of burns, as there is with SmartLipo. VASER stands for "Vibration Amplification of Sound Energy at Resonance." Its gentle vibration actually shakes fat globules loose from their moorings, creating a smooth slurry that is safe and easy to aspirate. This is why VASER is capable of such precise body contouring.  Best of luck on your journey.

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