How high is the risk of nerve damage caused by vaser lipo in the abdomen and flank area? 42 y/o male

Question

Hello, I am considering Vaser Lipo to my abdomen and flanks. I am a 42 yo male in good health, and considering a board certified plastic surgeon who has experience with this technique. I am reading conflicting information online about the potential for permanent nerve damage following Vaser Lipo: some sources say it is less invasive and therefore safer, and others say that the energy / heat from Vaser poses higher risks of permanent nerve damage. Can you help me assess this risk? Thank you.

Elizabeth Kiwanuka, MD, PhD · Answer

VASER Liposuction is a great way of addressing stubborn fat, thereby contouring the body. VASER stands for vibration amplification of sound energy at resonance. Although the ultrasonic energy is primary targeting the fat, there is a risk that surrounding structures might be affected. By having your procedure done by an experienced provider, that risk should be minimal. VASER liposuction is a safe and reliable way to remove fat deposits from under the skin.

J. Timothy Katzen, MD, FACS · Answer

Thank you for your question regarding nerve damage after VASER liposuction in the abdomen and flanks. The risk of permanent nerve damage with VASER liposuction is less than one percent. The risk of permanent nerve damage during VASER liposuction is highly remote. These are highly isolated cases and cases that perhaps the surgeon was not experienced. Perhaps it was caused by the intensity of the VASER being at its maximum intensity—experienced plastic surgeons rarely, if ever, have permanent nerve injury from VASER liposuction. As it is scarce, I would not be concerned about the permanent risk of nerve damage with VASER liposuction. The most common complication with VASER liposuction is skin contour irregularities, fibrosis, and possibly skin burns. These are much higher complication rates than permanent nerve injuries. Therefore, I would not be overly concerned about nerve damage. Good luck; I hope I helped to answer your question regarding nerve damage after VASER liposuction in the abdomen and flanks. 
Sincerely,
Dr. Katzen

Jerimiah Mason, MD · Answer

We regularly use Vaser with liposuction, and I can't recall a single case of nerve injury attributed to Vaser. I have seen several cases of temporary nerve injury with Bodytite, but never with Vaser. That being said, I'm sure it's possible, but I don't think Vaser carries a significant risk.

Navjot Singh, MD, FACG · Answer

Hello, Thank you for your question. Vaser is a great device that helps make liposuction more effective. Vaser pre-treats the area of liposuction by melting the fat. Liposuction is done afterward to remove the melted fat. Liposuction can interfere with the nerves making one small area numb for a little bit. Usually, it gets resolved in a few weeks. If you choose an experienced provider and the area you want to target (abdomen/flank), that risk should be minimal.

Mats Hagstrom, MD (license on probation) · Answer

Liposuction causes sensory nerves to be a little stunned. This is called neurapraxia. The level of neurapraxia from Liposuction is typically pretty mild and most patients have completely normal skin sensation at 2 to 3 months.
It’s exceedingly rare and I’ve never seen it in my career that someone has permanent numbness from Liposuction.
The equipment used is not really all that important when it comes to Liposuction. VAS ER is simply a pre-treatment using an ultrasound probe before doing a traditional liposuction. does the ultrasound probe make the procedure better? it allows the surgeon to remove fat faster.
One issue with VAS ER is that the ultrasound probe treatment does not remove any fat so the impact of the ultrasound treatment cannot be seen while the surgeon is doing it.
How do ultrasound probe treatment is done is then reflected when the surgeon goes to suck out the fat using traditional Liposuction.
There’s a learning curve to all new devices but a talented plastic surgeon can deliver the same results with any liposuction device.
Would you choose a mechanic based on the brand tools they use?
Do you buy bread because a bakery has a certain brand oven?
Choosing a plastic surgeon because I have a certain brand equipment is about in the same league as the other two examples.
The only thing that matters is the skill and experience of the provider.
 Plastic surgeons who do enough liposuction to have mastered the procedure typically have the type of equipment they like working with.
Personally my favorite tool is Microaire Power assisted Liposuction aka PAL. I can certainly do the procedure without the power on but using power assistance makes my life a little easier.
To find the right plastic surgeon have multiple in person consultation to vet surgeons to find the right and most talented an experienced provider.
Results vary massively depending on who you choose.
There is a substantial difference among plastic surgeons when it comes to the outcomes of Liposuction results.Being board-certified in plastic surgery with an overall good reputation is not a guarantee that someone has mastered liposuction.
Delivering consistent quality liposuction results is far more difficult than most people believe and this includes plastic surgeons.
During each in person consultation ask each provider to open up their portfolio and show you their entire collection of before and after pictures. they may not be willing to do that but you should push them to show as many pictures as possible.
To put this in reference an experienced plastic surgeon should have no difficulty showing you at least 50 sets of before and after pictures of commonly performed procedures like abdominal liposuction. male procedures represent about 5 to 10% of the patients who get this treatment. still, a surgeon should be able to show you at least 20 or 30 sets of before and after pictures of the male abdominal liposuction results.
As the provider Jose many pictures as possible of patients who have similar body characteristics to your own. Ask the provider to show you examples of excellent outcomes, average outcomes of less than outcomes.
Being shown a handful of sample pictures which most likely represent the best results of the providers career is completely insufficient to get a clear understanding of what average results look like.
Make sure you know exactly what areas are being included with the treatment.
Look carefully at previous before and after pictures and I asked the provider to point out what areas were treated and what areas were not treated and look carefully on transition zone between the treated and untreated areas.
Scrutinize all the results pictures carefully for any evidence of skin contour irregularities.
Personally I view the torso as a single anatomic unit and for male patients this generally means treating upper abdomen, lower abdomen, love handles, waist(conservatively), and the under arm area all the way up into the armpit and chest. and some individuals I’ll treat the entire back but having a little extra volume on the back tends to look good on men. What’s more important is liposuction in the under arm area between the latissimus muscle and pectoralis muscle.
To avoid feminizing the male figure the waist should not be brought in on the male patients.
Aggressive emphasis should be placed on love handles. Love handles sometimes fail to deliver the results patients at home for an individuals who have had any history of weight fluctuation or have even slight skin laxity.
These are all points that should have been discussed during a consultation.
If you’re having your backside or waist love handles and under arm treated you should have a clear understanding if the surgeon is going to turn you in the operating room if the procedure is done under general anesthesia.
There’s only so far you can reach with someone on their back and laying on the back changes the body is contour on the sides.
To shape those areas correctly it’s far better to have the patients laying on their side or face down.
These and many others are all important aspects to discuss during a thorough consultation.
More than anything else you need to make sure that the surgeon has done enough procedures that they’ve mastered delivering consistent quality outcomes on a regular basis and has enough before and after pictures to convince you.
Liposuction results are permanent and irreversible. If done poorly patients are left disfigured.
It’s virtually impossible to correct poorly done liposuction results.
Choose your provider wisely.
What do you should be worried about is not having chosen a sufficiently talented provider not if you’re going to be numb.
Being numb for the rest of your life it’s like being worried about being struck by lightning.
You will get your sensation back but you may not get the results you had hoped for it.
I cannot emphasize enough the importance of provider selection for this procedure.
Good luck,
Mats Hagstrom MD

Randy Dean, MD - Account Suspended · Answer

Hi and welcome to our forum!
Significant nerve injury is quite rare with any type of liposuction (traditional or augmented with laser or ultrasonic energy) and is due to an inexperienced operator holding the cannula in a stationary position for too long a period of time, or from inadvertent penetration of deeper structures with the suction cannula. 
Temporary numbness after the procedure is not uncommon. It is due to swelling and resolves within a few weeks.
Visit an experienced board certified plastic surgeon for evaluation and discussion.
Best wishes...

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