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ULTRASONIC LIPOSUCTION: REINVENTING THE WHEEL?
ORLANDO, FL (February 28, 1998)- Tumescent liposuction has been the standard of care for liposuction since 1987. This technique, developed by dermatologists, involves the infiltration of large volumes of diluted local anesthetic and epinephrine prior to the liposuction surgery. The tumescent technique allows liposuction to be performed with virtually no bleeding, under local anesthesia and without the need for heavy sedation or general anesthesia.
Speaking at the American Academy of DermatologyÃs 56th Annual Meeting in Orlando, William P. Coleman, III, MD, Dermatologic and Cosmetic Surgeon from Tulane University discussed this popular procedure. "Its chief advantages are that liposuction can be performed on an ambulatory basis, patients feel good immediately after the procedure, are able to walk on their own, experience minimal bruising and recovery is rapid."
In the past two years, a new technique for liposuction was introduced in the United States: ultrasonic liposuction. This technology involves the insertion of a rapidly vibrating cannula which causes the fat cells to rupture. The ruptured fat cells are then aspirated using traditional liposuction techniques. This procedure was originally developed in Europe, but was never widely used due to problems with skin burns and seromas (collections of serum). New instruments developed by American surgeons promised to provide a method by which liposuction could be easily performed with less complications.
Almost two years after its introduction, there is still a great deal of uncertainty as to whether this new technology has in fact advanced the field of liposuction surgery. "There has clearly been an increase in complications using ultrasonic liposuction over the standard tumescent liposuction approach.
We have found that ultrasonic liposuction makes the surgery easier to perform in areas where the fat is firm, (e.g. male flanks, male breasts, back and in touch-up liposuction cases.) The ultrasonic devices developed for liposuction continue to evolve and appear to be improving," Dr. Coleman stated.
A large number of liposuction experts remain skeptical of the eventual role of ultrasonic liposuction. The instruments are expensive, the potential for side effects is greater than with tumescent liposuction, and the procedure is more time-consuming. The benefits of greater ease of performing liposuction in difficult areas must be weighed against these drawbacks. It is clear that the same final results can be achieved using either method.
The advent of external ultrasonic devices which are applied to the skin prior to liposuction has further clouded the role of internal ultrasonic devices. External ultrasonic energy can be applied to the skin to loosen the fat prior to traditional tumescent liposuction. This may facilitate fat removal in more difficult areas, offering the advantages of internal ultrasonic liposuction without the drawbacks. These devices are less expensive and so far have not demonstrated any complications.
The notion that ultrasonic energy can be used to make liposuction surgery more efficient and produce better results appears to be an unfulfilled dream. However, technological breakthroughs often provide disappointment initially and then with continued advances produce desired results. "It remains to be seen whether future technology will enable further advances in this area. At the current time, it appears that tumescent liposuction remains the standard of care and the most efficient and safe way of performing liposuction," concluded Dr. Coleman.
The American Academy of Dermatology is the worldÃs largest organization of dermatologists, representing over 10,000 physicians who specialize in treating skin, hair, and nail conditions.
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