Liposuction, Liposculpture
Liposuction from Bellevue Plastic Surgeons
Liposuction, liposculpture, liposelection and suction assisted lipectomy are terms used to describe surgical aspiration of fat from under the skin. Originally introduced from Europe in the early 1980's, the technique has been evolving ever since. The basic procedure involves aspirating the fat with a hollow instrument called a cannula either attached to a syringe or a machine which creates negative pressure.
Placing liposuction in a historical context will give you a better idea about safety as well as understanding why your plastic surgeon's training and competency is crucial for a successful outcome of this seemingly "simple" procedure. In the "early" days there was a lot of blood loss with liposuction due to the limited fluid infusion with epinephrine (constrictor of blood vessels to minimize bleeding). This dry technique was gradually replaced by adding more wetting solution with epinephrine. This led to a dramatic reduction of blood loss with this procedure. The "super-wet" and "tumescent" techniques were developed which further reduced blood loss to a negligible 1% or less, but practitioners with poor surgical judgment and increased complication rate, gave the impression of liposuction as a "risky" procedure. Physicians of varying backgrounds and training (some with no surgical residency training), have chosen to incorporate liposuction in to their practices. Improper patient selection, excessive fluid volumes, too much local anesthetic in an attempt to avoid using other forms of anesthesia, too much fat extraction, inappropriate instrumentation and delayed recognition of potential complications led to poor surgical outcomes and sometimes dire consequences.
Liposuction is a very safe procedure in the hands of a well trained and competent plastic surgeon!
I often use the VASER liposelection technique. This is internal ultrasound technology which "melts" the fat avoiding damage to the surrounding tissues. It is an excellent technique for more fibrous areas such as the upper abdomen, back, hips and the male chest or gynecomastia. It also promotes better skin tightening. In my practice I see more and more patients with poor outcomes who seek correction of their contour deformities from their previous liposuction. I could not give them a good result without the VASER. These patients often have excessive internal scarring which would limit removal of fat with traditional techniques. These patients are often dismayed when they find out that their "cosmetic" surgeon wasn't even a surgeon. Many can be helped and their results can be improved, albeit, might not achieve the same aesthetic results as if it would have been done correctly the first time.
Liposuction is not only a procedure by itself. I often use liposuction in conjunction with facelift surgery, abdominoplasty, breast lift/ reduction surgery, arm lifts, body lifts or if I collect fat for micro fat grafts to the face, hands, buttock augmentation, breasts or correction of depressions.
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