Liposuction is a procedure to remove fat. Unfortunately there are so many different types of liposuction that the terminology can be confusing. I’ll use this post to discuss the different types of liposuction.

– Dry Liposuction : A surgeon makes a incision without placing any “wetting solution” and removes fat using a suction based machine. Unfortunately nothing really controls blood loss and there is a large amount of bleeding. This is an antiquated technique and not really used by most surgeons anymore.

– Tumescent Liposuction : A surgeon uses a fluid (mixed of some recipe of saline mixed with lidocaine and epinephrine) to “fill” the fatty tissue or “tumesce” the fluid prior to fat removal. This solution serves several purposes including minimizing blood loss as well as pain control. Different surgeons use different amounts of fluid and describe the treatments as “wet,” “superwet,” and everything in between. Most surgeons use sort sort of tumescent technique these days.

– Regular Liposuction or Suctioned Assisted Liposuction (SAL) : This technique was the first liposuction technique and is still widely used. It uses a canula (hollow metal tube) which is passed through the fat and causes removal of the fat via a suction. It is important to note that there are many different types of canulas and many different types of suction sources. Thus, not all SAL is created equal and the result will be greatly varied based on exactly what is being used.

– Power Assisted Liposuction (PAL) : This technique employs canulas and suction however the canulas either vibrate, pulsate, or rotate electrically (or via air power) as they go through the tissue. The thought process behind this technique is that the machine can provide a mechanical result greater than a surgeon’s arm

– Ultrasound Assisted Liposuction (UAL) : This technique uses ultrasonic sound to create an acoustic streaming process where the fat is disconnected from the connective tissue matrix and becomes “liquified.” The technique’s proponents claim that it is “fat selective” and since the tissue matrix remains intact there is a quicker result and less trauma occurs.

– Laser Assisted Liposuction (LAL) : This technique uses a laser (various wavelengths are advocated by different manufacturers) that is passes through the tissue and vaporizes the fat cells. The goal here is to be “less invasive.” Many patients come in asking for this technique as they feel it is non-invasive. This is far from true. This procedure is still surgery with incisions, anesthesia, and surgical risks just like the other types of liposuction.

– Water Assisted Liposuction (WAL) : A newer technique using a water jet to dislodge the fat prior to using a suction to remove the fatty tissue. Conceptually I do not see a great difference between this and tumescent liposuction.

I hope this brief discussion helps explain the different types of liposuction on the market. In the end I do not believe it is which machine gets the result (as long as it is a decent machine) as much as the experience of the surgeon operating the machine. If you have any questions, please post a question or call the office.

Who is the ideal patient for liposuction? Is it someone who is in great shape and works out 3 times (or more ) a week but still has a stubborn spot of fat that she/he can’t get rid of or is it someone who has gained 5lbs a year for each of the last few years and wants to get rid of 25lbs?

Liposuction is a surgical procedure, and like all surgical procedures, carries some risks. The goal should be to minimize risk. Liposuction is very safe when performed in an appropriate setting on the appropriate candidate.

The question I often get by my New Jersey liposuction patients is “How much fat is it safe to remove?” Well, this is a difficult question to answer. It depends on multiple factors. I can clearly remove more fat from the lady who is 5 foot 10 inches than from the lady who is 4 foot 11 inches. Health problems such as diabetes or high blood pressure are going to change the amount safe to remove.

Prospective patients often call the office requesting appointments for liposuction and are asked by the receptionists for their height and weight. We are not trying to discriminate against overweight people, just trying to let them know before they waste their time coming in for a consultation that morbid obesity is not solved with liposuction. A simple BMI calculation can often give you a basic answer about whether liposuction is even an option. Surgical solutions for weight loss such as gastric bypass and even lap bands work in this situation, but liposuction is not a weight loss procedure per se. Rather, it is a contouring procedure intended to help in areas that are resistant to diet and exercise.

As a general rule, 5 or 6 liters of fat (one liter weighs about 2.1lbs) or 10-12 pounds of fat is the safe upper limit of what should be removed in one setting. Sometimes this number can be pushed up very slightly, but it is rarely going to be safe to remove 9 or 10 liters of fat. Extreme large volume liposuction such as 9 or 10 liters can be extremely risky and can even result in a dead patient.

I hope these brief comments help explain a little about what constitutes safe liposuction limits? With proper patient selection, liposuction is an extremely safe procedure….