When considering liposuction, it is important to remember the adage "it's not the car, it's the driver." There are a number of available modalities for fat reduction (with new technologies arising regularly). It is important to seek out an experienced surgeon with a history of results. Generally speaking all of the liposuction modalities (SAL, PAL, UAL, Laser) are variations on the same theme. Surgeons will have a preference but will typically be able to obtain a consistent result using the tool of their choice. With regards to your specific question, Water Assisted Liposuction (WAL) marketed under the name BodyJet is a modality which is purported to be less traumatic and preferred in the lipoedema population. It employs high pressure water streams to separate the tissue planes facilitating fat removal. In theory, easier extraction would lead to less lymphatic trauma. However, it is important to remember that save for the use of the high pressure water jets, the remainder of the procedure is performed in much the same way as any other liposuction modality. In fact, many practitioners will combine modalities or technologies to acheive the best outcome for patients ("Aqualipo"= "SmartLipo" + WAL).As a patient with high grade lipoedema, you should understand that there is always some degree of lymphatic trauma (regardless of technique). You can generally expect prolonged swelling after any procedure especially on the extremities. Additionally, excess skin will likely be an issue depending on the degree of bulk reduction performed. Any liposuction may necessitate skin removal either concurrently or at some point in the future.Ultimately, your board certified plastic surgeon (ABPS) is uniquely qualified to discuss the differences between the available modalities as well as justify his/her choice of "paint brush." An experienced practitioner can obtain good results regardless of the type of branded liposuction employed.