Liposuction has been refined dramatically since it was introduced in the 1970's. It is now the leading cosmetic surgery performed. Liposuction recently improved with the tumescent technique resulting in better and more predictable results. Today the news is about ultrasonic assisted liposuction. Plastic surgeons in Europe have been combining ultrasonic waves to melt fat with suction to accomplish liposuction.

Ultrasonic-assisted lipoplasty involves the application of ultrasonic energy to adipose (fat) tissues which effectively "liquefies" the fat, which in turn can be removed using a low vacuum suction. The process is similar in concept to lithotripsy, a procedure in which sound waves are used to break-up kidney stones, allowing them to freely move through the urinary tract. In this same manner, ultrasound-assisted liposuction uses sound waves to liquefy fat with mineral damage to surrounding cells. Through small incisions, a tube delivers sound waves to a specific area of fat which has been injected with saline solution (salt water). The fat is removed with mild suction. UAL is a gentle technique which allows a larger volume of fat to be removed while the patient experiences minimal bruising, blood loss and swelling.

The optimal candidates for all types liposuction are patients who are within 15 pounds of their ideal body weight but have localized fat bulges that are non-responsive to diet and exercise in specific areas of the body. In women, these localized fat deposits may occur in the hips, flanks, inner or outer thighs, abdomen and other areas. Localized fat deposits are usually genetically inherited and are non-responsive to diet and exercise. Generalized excess fat deposits are usually acquired and are more responsive to diet and exercise.

1. Most effective in certain areas where fat is fibrous and difficult to remove by traditional liposuction such as the hips, back, love-handles and large volume liposuction patients.
2. Less surgeon fatigue, allowing the surgeon to focus on true sculpting in body contouring. This may be one of the major benefits of UAL.
3. Less tissue trauma because less force is needed to push the cannula through tissue compared to traditional liposuction.
4. Possibly, less bleeding, hence less bruising and shorter recovery (this benefit has yet to be totally defined).

1. UAL does not correct dimpling skin.
2. Most patients experience less bruising with both traditional liposuction and UAL using tumescent techniques, but even with these techniques bruising is probable. Permanent skin staining from bruising is possible.
3. Most irregularities after surgery resolve in 6-8 weeks. You may need to message persistent areas to assist in improving any irregularities. Although small lumps usually resolve without treatment, small areas of scar, firmness or lumpiness may remain.
4. The energy of the ultrasound can burn the skin and can result in skin loss. This may require additional surgery for reconstruction resulting in additional time off from work or other activities, permanent scarring or deformity. This is very uncommon.
5. Scars are usually small and inconspicuous, but scar quality and visibility vary and are not totally predictable. Burns from friction or ultrasound at or near the incision site are rare, but possible, even though we use protection procedures.
6. Numbness usually occurs over the areas that undergo UAL. Most patients recover sensation in one to two months. Prolonged numbness has been reported after both traditional liposuction and UAL, but is rare. We have not experienced any permanent loss of sensation in our patients.
7. Depending on the quality of your skin, your age, the amount of fat removed and other factors, you can develop skin laxity that may require a surgical procedure for skin removal.
8. UAL carries the potential risks of any operation, including infection, bleeding, scarring, unsatisfactory results and problems with wound healing. It also carries the potential dangers of any procedure involving a general anesthetic, including untoward drug reactions, nausea or even death.
9. Smoking or use of any medication containing nicotine prior to surgery or postoperatively increases the risk for wound healing problems or loss of skin. All nicotine in any form, smoking or otherwise, is prohibited for four weeks before and after surgery.

1. The compression garment(s) placed at the time of surgery should be worn as much as possible for the first two weeks. You may remove it to shower on the third day and daily thereafter. Do not bathe or submerge the incision area for the first week. The garment helps prevent accumulation of fluid in the areas where fat has been removed. The more you are able to wear the garment in the first two weeks, the less fluid will accumulate. This allows you to see the final results following surgery much sooner, hopefully in 6-8 weeks.
2. Discomfort from UAL is usually moderate and lasts 5-7 days following the procedure. However, it depends on the extent of the procedure and your individual tolerance. Pain medications are prescribed to control the discomfort following UAL.
3. The tenderness resolves over the areas that have been suctioned in 5-7 days and then you may message them gently by hand or even using a rolling pin. This gentle message stimulates blood flow in the area and may help in resolving swelling and accumulated fluid.
4. Bruising, skin discoloration and numbness as well as tissue firmness and swelling will be present for several weeks. You may resume normal activities with slow walking and sitting after 1-2 days following the procedure. You can resume athletic activities gradually 3-4 weeks after the procedure.