Ultrasound-Assisted Liposuction

Ultrasound-assisted liposuction (UAL) is a type of liposuction which uses ultrasonic energy, or high-frequency sound waves, to vibrate the walls of the fat cells. The ultrasonic energy causes the fat cells to break down and the triglycerides inside the cells to come out. This technique, which deflates or liquifies the fat cells prior to their removal via liposuction, is efficient and causes less trauma to the surrounding tissue than traditional liposuction. Ultrasound-assisted liposuction is considered a body contouring procedure since it can be used to effectively remove pockets of fat on various areas of the body.

Am I a Good Candidate for Ultrasound-Assisted Liposuction?

A GOOD CANDIDATE for ultrasound-assisted liposuction includes:

• Any adult who is close to their ideal body weight but has stubborn and isolated areas of fat which are resistant to diet and exercise.
• Men who have excess breast tissue which is otherwise known as gynecomastia. This type of treatment generally serves as an addition to tumescent liposuction for patients who need a more precise body contouring treatment.
• Patients who wish to remove larger volumes of fat in a single procedure.
• People in good physical health.
• Patients who are psychologically stable.
• Patients with realistic expectations.
• Patients with firm and elastic skin instead of excessively loose skin.

Ultrasound-assisted liposuction on the knees and inner thighs, or during facial liposuction, is typically not recommended since the high frequency energy may damage the anatomic structures in these regions. Traditional liposuction on these areas is effective and may be a better alternative.

Patients who are overweight or obese are generally NOT GOOD CANDIDATES for this procedure since UAL should not be used as a weight loss treatment. Ultrasound-assisted liposuction can remove unwanted fat in most areas but it is more beneficial to a patient when used to remove fat in hard-to-treat regions such as the neck, chin, calves, cheeks, ankles and back.

How is Ultrasound-Assisted Liposuction Performed?

When preparing for ultrasound-assisted liposuction, patients should follow all pre-operative instructions. Patients may be directed to stop the use of aspirin or other nonsteroidal anti-inflammatory drugs prior to surgery. Certain medications, vitamins and herbs may increase the risk of bleeding during and after surgery.

Ultrasound-assisted liposuction may be performed under general anesthesia, local anesthesia with a sedative or with an epidural block comparable to that used in childbirth. The procedure time can vary depending on the amount of areas to be treated and whether other procedures are done in combination with it.  

Fat Liquefying:

Ultrasound-assisted liposuction generally takes longer than traditional liposuction due to the added “fat-liquefying” step. There are two techniques for fat liquefying with UAL:

• External UAL – The ultrasonic device is placed outside the body and releases waves of light through the skin and fat tissue to loosen it up
• Internal UAL – An ultrasonic probe is inserted under the skin and the tip of the probe delivers a wave of light which breaks up the fat cells as it contacts them

The Procedure:

During either of the procedures, the surgeon will infiltrate a saline mixture containing a local anesthetic and adrenaline into the treatment area. This mixture is often referred to as tumescent fluid and it helps to constrict the blood vessels, prevent fluid loss and make the fat removal process easier.

A cannula is inserted through small incisions in the subcutaneous layer of fat. With the Internal UAL method, an ultrasound generator is connected to the cannula and delivers sound waves from the tip of the cannula. As the high energy of sound meets the tissue, it vibrates against the saline solution and breaks apart the fat cells with heat which releases the triglycerides and deflates the fat cells. During either technique, the solution and fat is suctioned from the body using vacuum pressure from the cannula. Patients who are awake during this process may feel some warmth and a sense of vibration.

Alternative Liposuction Procedures:

• Dry Liposuction – A technique which is rarely done since there is a high risk of complications and blood loss. Dry liposuction does not involve fluid infiltration. The surgeon uses a vigorous back and forth motion with the cannula to dislodge the fat and suction it out. The cannulas are larger with this technique which causes a need for the incisions to be larger as well.
• Tumescent Liposuction – This technique uses the tumescent fluid to swell the area in order to allow a gentler breaking up and removal of the fat cells. The cannula and incisions are both smaller. There is minimal blood loss with this technique and the risks are less than dry liposuction. However, tumescent liposuction is not capable of liquefying the fat cells. Furthermore, the heat from the ultrasonic light causes the skin and tissue to contract which results in tighter skin.
• Laser-Assisted Liposuction – A type of treatment which uses tumescent fluid and a fiber optic wand, or laser, to heat and melt the fat cells prior to liposuction. Laser-assisted liposuction has a skin tightening aspect but it can also result in a tissue burn if the surgeon is not sufficiently skilled.

What is the Cost of Ultrasound-Assisted Liposuction?

The surgeon’s fee for traditional liposuction is approximately $2800 for one area. The fee increases when the ultrasound technology is added. The cost of ultrasound-assisted liposuction is around $3000-$11,000. This does not include medical tests, anesthesia options or other related costs. A patient having one area treated will pay a lower fee than someone having multiple areas treated. The cost can also vary according to the geographic location and skill of the surgeon.

Recovery and Downtime

Since ultrasound-assisted liposuction is a gentler approach, the RECOVERY TIME is significantly shorter than other liposuction techniques. After UAL is performed, the patient can expect to see some fluid drainage from the incisions. Some surgeons will place a drainage tube beneath the skin that protrudes from the incision to prevent fluid build-up since it will help excrete excess fluid. Since the incisions are so small, stitches are often not required. However, surgical tape and dressing will be applied. A compression garment or elastic bandage will be placed over each treated area. This garment is generally worn 24 hours a day for up to four weeks. This compression garment will maintain the swelling and help the skin shrink. The garment may be removed during showering but patients should adhere to the post-surgical instructions for how and when to clean the treated area.

Patients may experience some degree of pain, swelling and temporary numbness but the doctor will prescribe some pain medication until these side effects subside over time. Some doctors also prescribe a course of antibiotics to ward off infections. Bruising is also common due to the trauma of the procedure and the swelling will fade over a few weeks. In some cases, swelling and bruising can persist up to 6 months after liposuction.

It is important for the patient to rest during the first few days. Walking around the house is recommended to speed the healing process and to alleviate the risk of blood clots. If the patient has stitches, they will be removed about one week post-op. At this time, light work and activities can resume. Depending on the amount of liposuction performed, some patients may need up to two weeks off work. It is not advisable to engage in strenuous activities for 3 to 4 weeks or until the doctor has given clearance.

Results

Ultrasound-assisted liposuction results can take some time to be revealed due to the healing process and any bruising and swelling. The fat which is removed cannot ever come back and any fat which was liquefied, but not suctioned out, will pass through the urine over the first 6 (or so) weeks. The patient will see some slight changes to the treated area but the results are not usually noticeable until after the swelling significantly subsides. After that period, the patient will be able to see dramatic improvements which will continue for three to four months.

At six months post-op, the results will reveal a better contour as well as tighter and more youthful looking skin. Although the results are permanent, it is possible to increase the fat in other areas of the body if the patient does not maintain their weight. Weight fluctuations, pregnancy and aging may impact the results. However, following a healthy diet and exercising regularly can help maintain the positive results.

Limitations and Risks of Ultrasound-Assisted Liposuction

Common LIMITATIONS of UAL include:

• Ultrasound-assisted liposuction is not designed to be a weight loss treatment and is limited with the amount of liposuction which can be done during one procedure
• Having realistic expectations about what UAL can do is crucial because, otherwise, not being happy with the results is possible
• Although the heat from the ultrasound device can promote skin tightening, this procedure is also limited by the amount of skin shrinkage it can achieve and this is especially true in older patients and those with less elasticity in the skin

Some common RISKS include:

• Discomfort
• Bruising
• Swelling
• Infection
• Blood clots
• Seroma
• Uneven skin contouring/Small bumps under the skin
• A change in pigmentation or skin texture
• Burning
• Blistering
• Scarring from a burn

Discussing Concerns and Goals with a Doctor

Like any cosmetic surgery, ultrasound-assisted liposuction has its advantages and disadvantages. Patients who are considering this type of liposuction should openly discuss their concerns and goals with a surgeon, prior to the procedure, to ensure that UAL can provide the results they desire. Ultrasound-assisted liposuction can gently and effectively remove fat cells, while tightening the skin, to provide a better contour and more youthful looking skin.

Written by Cosmetic Town Editorial Team- MA

Based on an exclusive interview with Julio Garcia, MD in Las Vegas, NV