Liposuction is a surgical procedure in which an experienced and qualified plastic surgeon removes fat from the under the skin by inserting a hollow tube called a cannula assisted by a suction device called an aspirator.

There are many techniques that all follow this basic procedure but vary by the kind of anesthesia used, the insertion of liquids, and the incorporation of mechanical devices used to break up the fat. The cells are then suctioned out through the cannula.

Dry liposuction
This method does not use any fluid injection at all and has become almost completely obsolete.

Tumescent liposuction

A high volume of fluid is inserted directly into the tissue that is to be removed. The fluid contains a saline solution, lidocaine, and epinephrine. The fluid inserted breaks up the cells and reduces blood loss and bruising. The large amount of fluid also separates the muscle from the fat which makes it easier for the surgeon to move the cannula around and thus it is easier to remove the tissue.

Because the area is only locally anesthetized by lidocaine, the patient can sit or stand which makes it easier for the doctor to make sure the contour is even and smooth. This method does not require a hospital stay and generally takes 2-3 hours to complete.

Wet and Super wet liposuction

Both wet and super-wet procedures are very similar to tumescent liposuction. During wet liposuction, a small amount of fluid is inserted under the skin in the area where tissue is to be removed. The area is locally anesthetized with lidocaine and the epinephrine and saline solution within the fluid helps to contract the blood vessels which minimizes blood loss and bruising.

The fluid also helps to loosen up fat cells so they can be suctioned up through the cannula. The super-wet method is the same as the wet technique only the amount of fluid is increased to equal the volume of fat removed. This method is preferred when there is a high volume to be removed. IV sedation in addition to local anesthesia is necessary during this procedure.

Microliposuction

This technique is used to remove small pockets of fat, usually on the face. Tiny incisions are made and tiny cannulas are used for refining contours. Because smaller cannulas are used it may take a long time to remove the cells although it is just a small area.

Ultrasound assisted liposuction

A specialized cannula sends ultrasonic waves through the cells making them easier to remove. Ultrasonic waves literally breaks up the tissue by shaking it and applying heat. This method is preferred in areas of the body where the fat is more fibrous such as the back or on the chest in cases of gynecomastia (male breasts).

There is more of a risk of pockets of fluid forming and thus it may be necessary for doctors to leave drains exiting the body for a few days. This procedure generally takes longer than the tumescent technique.

Power assisted liposuction

During this procedure a specialized cannula emits high speed vibrations to loosen up the fat cells, making them easier to remove. This procedure is also physically less tiring for the surgeon as the cannula helps in the mechanical movement. This method is preferred in cases where the fat is fibrous as well as in areas where there is scar tissue from previous procedures.

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