Introduced in Europe in 1989 and shortly thereafter in the United States, internal ultrasonic liposuction has been performed on thousands of patients. It was introduced as a way to help liquefy fat using ultrasonic energy and enable it to be removed easily through a cannula during traditional modern tumescent liposuction. It is technically called ultrasonic “assisted” liposuction (UAL). The two procedures many times go hand in hand.
Dr. Michael J. Brown uses Ultrasonic Liposuction to Perform a Male Breast Reduction
Tumescent liposuction is the most common form of liposuction performed today. Very small cannulas are inserted in the skin through tiny incisions. An anesthetic saline solution is injected to swell the fat cells, minimize bleeding, and make the fat easier to remove using smaller tools than were used in older versions of liposuction (the ones that caused significant bleeding, bruising and scarring). Manual effort on the part of the surgeon is necessary, however, to break up the fat with the cannula in order to suction it out.
What is ultrasonic liposuction?
Ultrasonic technology allows ultrasonic energy waves to be delivered through the end of the cannula into the fat and liquefy or “melt” it. Essentially, when mixed with the injectable solution and heated, the fat turns into oil. The fat is far easier to suction out when it’s in this liquefied form.
These ultrasonic waves are believed to target only fat cells, so the possibility of damaging or losing surrounding tissue along with fat cells is minimized. Also, there are certain areas in the body where the fat is more fibrous. Ultrasonic liposuction was designed to make treatment of these areas easier. Because ultrasound is very precise, better body contouring results can be obtained. An added bonus is that the process also thought to posses a skin-tightening capability.
Tumescent liposuction works best on younger patients who have mild to moderate amounts of fat to be removed. Ultrasonic liposuction makes it possible for patients who are more overweight and have less elasticity in their skin to enjoy the benefits of liposuction, probably because of its fat-liquefying and skin-retracting capabilities.
Are there different types of ultrasonic liposuction?
Ultrasonic waves can be applied internally or externally. Doctors were very excited when internal ultrasonic liposuction arrived on the scene, but reports of complications and side effects caused some loss of enthusiasm. The early versions of this method, like its laser lipo counterpart, apparently emitted too much vibrating ultrasonic energy (and heat), causing burning of the skin, tissue damage and excessive bleeding. So an external version (XUAL) was developed to reduce the negative side effects of the internal version.
- UltraShape® is one of those external methods. It is a machine that uses high frequency ultrasound waves to pass through the skin and destroy the fat cells beneath. The fat is removed by the body through urination. This method of non-surgical liposuction has not been approved for use in the U.S. but is available in Canada, Mexico and more than 50 other countries.
- LipoSonix® is another method of non-invasive liposuction using external ultrasound to melt the fat cells. The body absorbs the fat cells over time. It has only been used on abdominal fat to date, and should not be used if there is less than a half-inch of fat or if the patient has already had liposuction. LipoSonix® has not been approved for use in the U.S. but is in clinical use in Canada and elsewhere.
With external ultrasound, there appears to be a high risk of affecting other organs besides the fat and skin. Apparently there is also less evidence of the technique’s effectiveness, so this method is not widely accepted.
However, as with most technologies, significant improvements have been made. The most widely accepted form of ultrasonic liposuction today is the Vaser® ultrasonic liposuction system. This is an internal system. It is said to use half the ultrasonic energy of its predecessors and, because the sound waves pulse on and off and a special probe is used for fat removal, this procedure causes less burning and tissue damage.
The upsides and downsides of ultrasonic liposuction
The procedure can be done in a doctor’s office, an outpatient surgery center or a hospital. It can be performed under local anesthesia (awake), IV sedation or general anesthesia. You may need to wear a compression garment after surgery to help your skin conform to your new shape and you will have to avoid strenuous activities for several weeks.
- A minimum of pain, bruising and swelling;
- Reduced trauma to the body’s tissues;
- Improved skin tightening;
- Can remove tough and fibrous fat;
- Can remove larger volumes of fat with up to 50% less bleeding compared with laser liposuction or stand-alone tumescent lipo;
- Smoother body contours are possible;
- Results are quite obvious and can be noticed immediately;
- Less need for re-treatment;
- May also work on cellulite.
- Danger from excessive heat from the sound waves;
- Burns and blistering of the skin and internal tissues could occur;
- Incisions may be bigger to accommodate a skin shield to protect skin from being burned by the probe. Larger incisions may result in more noticeable scars;
- May lead to blood clots in small blood vessels (a potentially life-threatening complication);
- Damage to the sensory nerves could occur, resulting in permanent numbness in the treated area;
- May cause seromas (pockets of fluid) under the skin (which must be continually removed by a needle until the pocket closes);
- Poorly maintained equipment can affect the sound wave frequency (and possibly result in burns);
- If you have swelling, it may take months to see results;
- You may see no obvious results.
As with all surgical procedures, there can be risks and complications. Your doctor’s expertise with both the procedure and the equipment is very important.
Who is a good candidate for ultrasonic liposuction?
The ideal patient for ultrasonic liposuction is:
- at least 18 years of age;
- in good health;
- heals quickly;
- fights infection well;
- does not smoke;
- has no serious medical problems such as heart disease or lung disease;
- and does not have an excessive amount of loose skin.
Ultrasonic assisted liposuction is best suited for patients who want to sculpt upper arms, abdomen, love handles, hips, lower buttocks, inner and outer thighs, or the areas above the knees. Patients who want to touch up their chin and neck may also opt for this procedure.
How much does it cost?
Ultrasonic liposuction prices are a bit higher than traditional liposuction. The average cost of liposuction in the U.S. is about $3,500 for a single area, while the average cost of Vaser® ultrasonic liposuction is usually between $4,000 – 5,000. (That assumes only one treatment area.) One reason for the difference is that the ultrasound equipment is quite expensive. Another is that the procedure takes longer than traditional liposuction.
This procedure is considered cosmetic and will not be covered by your insurance.
Ultrasonic liposuction is not intended to be a weight loss solution. It is intended to improve the contour and proportion of your body, resulting in a more flattering shape. It is FDA-approved and affordable for people who want an alternative to old-fashioned liposuction. Major complications are rare but it is always advisable to have your doctor guide you toward the best procedure for you.