What are the approaches in liposuction?
Liposuction is performed with different approaches. Removing the proper amount of fat is a sensitive and precise procedure that must be performed by a specialist after initial assessments. Overall, fat is removed by a cannula and using a vacuum device. Liposuction systems are classified according to the amount of fluid injected and the mechanism of action of the cannulas.
Mechanism of Suction-Assisted Liposuction (SAL)
This technique is the standard method of liposuction in which a small straw-like cannula is inserted through a small incision. This cannula is connected to a vacuum device. By pressing and pulling it back and forth on the fat, the surgeon breaks down the fat and removes it from the body.
(UAL) Ultrasound-Assisted Liposuction
In this technique, a special cannula transmits ultrasound vibration waves into the body, which causes the fat cell walls to break down, become liquefied, and facilitate suction.
UAL is a suitable choice for fibrous areas such as the upper back or chest of men. This method takes more time than traditional liposuction but less time than Tumescent liposuction. In addition, it causes less bleeding. This method has a higher risk of causing seroma, which must be drawn with a needle.
After ultrasonic liposuction, an assisted liposuction must be performed to remove liquefied fat. UAL techniques performed in the 1980s and 1990s caused tissue damage due to high ultrasound waves. Using third-generation UAL systems, the physician can safely remove fat by delivering pulsed energy through a dedicated probe.
Power-Assisted Liposuction (PAL)
This technique is performed using specialized movable cannulas, some of which have only forward, backward and transverse movements. The new-generation cannulas have three-dimensional movements (forward, backward, transverse, rotational) and allow the physician to lyse and remove fats only by directing the cannula without any special force on it.
Twin Cannula Assisted Liposuction (TCAL, TCL)
This technique uses a twin cannula, one tube inside another one. The cannula that sucks the fat is mechanically placed in front of the internal cannula, so there is no pressure on the patient’s tissue or the surgeon’s hand joints.
The inner suction cannula within the outer cannula moves up to 5 cm and vibrates 1-2 mm, helping to reduce the force required to perform the process. Superficial or subdermal liposuction is performed without the cannulas getting hot, due to the spacing effect of the outer cannula. The result is less burning and scarring.
