Frequently Asked Questions
Q: I have heard that there is a new liposuction that involves a laser device. Is that what you offer?
A: The idea behind laser liposuction has been around at least since the early 90s and a variety of devices have been utilized. These devices have shared the problem of questionable safety and efficacy, and while there has been at least one device currently being marketed, I am waiting for a little bit more development on this idea before I offer it to my patients. Patient safety is of preeminent importance and the current ultrasonic apparatus gives an excellent tactile feedback so that one does not have unintentional penetration of vital structures.
Q: What exactly is ultrasound-assisted lipoplasty?
A: Ultrasound-assisted lipoplasty (UAL) is a method of liposuction that has been practiced in Europe and South America for a number of years and has been in Dr. Wallace's practice since 1995. It is similar to traditional liposuction techniques in that fatty tissue is removed from the body through small (less than one centimeter) incisions for the purpose of improving body contour. However, with UAL the fat is first liquefied with the application of ultrasonic energy. The ultrasonic energy is delivered to the fat via a long narrow probe that is inserted through the same small incisions used for traditional liposuction. The ultrasonic energy targets the fat cells, leaving the surrounding structures, such as blood vessels and connective tissues, apparently undamaged. The liquefied fat can then be removed using standard suction.
Q: What is liposelection?
A: Liposelection is a term coined by the people involved with the VAZER ultrasound machines. This is the machine we currently use for UAL. We have found it to be an improved device offering better customization of settings for different areas. Part of the liposelection strategy is the use of more tumescent fluid and less suction to evacuate the effluent. This seems to result in less pain and produce the best overall liposuction results of all techniques we have used
Q: How does ultrasound liquefy fat?
A: Ultrasonic energy is transmitted to the fat via a long narrow probe that is connected to a handpiece held by the surgeon. The handpiece is connected to an ultrasonic generator that converts electrical energy to ultrasonic energy. When the ultrasonic energy comes in contact with the fat, the high frequency vibration effectively bursts the fat cells allowing release of the emulsified fat from the cell. This fat mixes with the body fluid and the wetting solution infused by the surgeon to form a stable fatty emulsion that is a creamy light yellow color. This can then be removed from the body with suction.
Q: What are the advantages of UAL?
A: Early data indicates that UAL is not a substitute for traditional liposuction, although there may be some benefits, including decreased postoperative swelling and bruising in some patients. Some physicians believe that UAL allows better control of contour or shape of the body in the areas treated with liposuction and experience has shown minimal problems with postoperative contour irregularity. It allows relatively large volumes of fat removal per operation with relatively little blood loss and minimal postoperative bruising. UAL is also physically less demanding from a surgical standpoint. Certain anatomic regions, such as the hip, posterior back and central body regions may respond preferentially to UAL. In fact, traditional liposuction is combined with UAL in almost all cases.
Q: Are there any possible complications associated with UAL?
A: As with any surgical procedure there are possible risks and complications. The risks and possible complications of UAL are essentially the same as with traditional liposuction techniques. Bleeding and infection are very rare with either technique (a good estimate would be less than 1% of cases have either of these problems.) Contour irregularity (or unevenness of the body contour) is possible with either technique. With any large amount of liposuction, there is the possibility of accumulation of fluid in an area that was suctioned. This is called a seroma and is easily treated by drawing of the fluid in the office. Overaggressive liposuction by any technique, especially when carried out very close to the skin can compromise the blood supply to the overlying skin. This could lead to loss or scarring of the skin. There is also the potential for burns at the entry site or along the path of the probe. These problems are all rare.
Q: What kind of anesthesia is used for UAL?
A: UAL can be performed using a number of different kinds of anesthesia, just the same as with traditional liposuction techniques. Almost all procedures are done with sedation and tumescent solution. This has numerous benefits including improved safety, faster recovery, and less nausea.
Q: How much does this procedure cost?
A: The cost of the procedure will vary depending on a variety of factors. In general, the more areas of your body that you have suctioned the more it costs. This question also must be discussed with Dr. Wallace and the Staff. Once you and Dr. Wallace have discussed which areas you might like addressed and which areas he feels are appropriate for this procedure, the cost can accurately be established.
Q: What can I expect during the postoperative period?
A: The answer to this question depends largely on what areas and how much fat you have suctioned. In general, the more aggressive the removal and the more areas you have suctioned, the more "strict" the postoperative regimen. In general, you can expect some discomfort during the first week or so. Most people describe it as discomfort rather than actual pain. Many say it feels like a deep bruise. The skin over the areas suctioned is often numb for a variable length of time. We require you to wear some kind of postoperative compression garment such as a girdle or an abdominal binder. This is used to compress the tissues to lessen swelling and bleeding. The type of garment you will wear will depend on which areas you have suctioned. In general, we have you wear this for anywhere from three to six weeks after surgery.
Q: What about pain?
A: Standard liposuction and earlier UAL procedures gave one the sense of being beaten up for several days. With liposelection and the use of modern anti-inflammatory medicines before and after surgery, many people require no pain medicine at all. This has been a major advance in the last year
Q: Can I gain the weight back?
A: Yes, you can regain weight after any kind of liposuction. You have a set number of fat cells as an adult and liposuction simply removes a certain number of them. If you gain weight, the remaining fat cells can grow bigger, which is how we gain weight. The good news is that there are fewer fat cells remaining in the area of the body that was suctioned and the "weight" tends to distribute itself more evenly in harmony with your new body contour. All in all, liposuction is not the answer to weight control; rather it is a surgical method of contouring the body. It is always best to be at a stable and realistic weight when you undergo this procedure. Above all, liposuction is not a substitute for sensible diet and exercise management.
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