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Stephen Miller MD PC FACS

Monthly Archives: September 2018

Large Volume Liposuction

Power assisted liposuction and Large Volume Liposuction is similar to tumescent liposuction but uses a motorized, (electric or pneumatic) hand piece to move the cannula which is less traumatic to the patient and less strain on the surgeon.

Ultrasound assisted liposuction evolved from the early ultrasonic cannulas which were hollow and had a high complication rate (burns of skin and other soft tissues) to the use of solid ultrasonic cannulas and 2 stage fat removal. A variation of this is the VASER which is an ultrasonic cannula with several grooves which more evenly disperse the energy improving fat disruption and removal. It uses pulses of ultrasonic energy to minimize the risk of injury to the skin or other structures and tends to target fat cells preferentially.

Laser assisted liposuction and Large Volume Liposuction is a relatively new technology and includes Smartlipo, Slimlipo and other brand names used for marketing. The theory is that the laser will work like ultrasound to disrupt the fat cells and make fat removal more efficient and less traumatic. Some of the drawbacks of this technology is finding a laser wavelength which targets fat cells and so far there are few studies which show any increased effectiveness using laser technology for fat removal.

For Large Volume Liposuction contact our Las Vegas Plastic Surgery Clinic at 702-369-1001.

Tumescent Liposuction Las Vegas NV

Tumescent Liposuction Las Vegas NV

Men and women who come to our Las Vegas NV practice for liposulpture each have their own reasons for wanting to enhance their body.Liposuction surgery involves the removal of fatty tissues through small puncture sites as opposed to large incisions to remove the fat “en-bloc” or as a whole piece. Most liposuction procedures involve making a small skin puncture and then utilizing various modalities to loosen the fat prior to suctioning the fat through a small hollow tube or cannula. Liposuction surgery can be performed alone or in conjunction with an open procedure to contour the overlying skin. Care must be taken to minimize injury to the underlying blood supply of the overlying skin when tightening procedures are combined with liposuction.

Liposuction surgery can be performed by a variety of methods and there is no one method which is best for all patients. It is common in most practices that the patient makes various decisions regarding their liposuction surgery. Like everything in life, there are advantages and disadvantages for each option and every patient has different opinions and desires, so you are encouraged to discuss the various options with your plastic surgeon at length to find out which option is best for you. Your plastic surgeon will review a few common options and some of the advantages and disadvantages of each option.

There are a multitude of technologies used for liposuction procedures and some are well established and others are relatively new. Liposuction techniques for body contouring and removal of fat were performed by French surgeons in the 1920’s. A tragic case that resulted in a gangrenous leg of a French ballerina from a procedure performed by Dr. Dujarier in 1926 set back interest in body contouring for decades. Liposuction evolved in the late 1960s from surgeons in Europe using curettage techniques and then introducing suction. These techniques were mostly ignored by traditional surgeons, and even criticized as they often resulted in significant bleeding and pain. Modern liposuction using blunt, hollow cannulas to suction fat was presented at the American Society for Aesthetic Plastic Surgery meeting in Honolulu in 1982 by the French surgeon, Dr. Yves-Gerard Illouz. He described a technique of placing hollow cannulas into the fatty tissues and suctioning out the fat. This procedure was still quite bloody, but was the beginning of a procedure which was embraced and improved upon significantly over the next 3 decades. Many surgeons added new techniques to make the fat removal process less bloody, more predictable, and safer. The introduction of tumescent fluid for anesthesia as well as minimizing blood loss was a tremendous improvement early on in the evolution of liposuction. The use of ultrasonic energy to “loosen up or melt” the fat prior to suctioning it out was another big improvement and led to the VASER technology still used today. Other modalities of “loosening up” the fat prior to suctioning it out and in some cases, not even suctioning the fat out have all been introduced in the past decade. Various lasers and other energy sources have been used with mixed results. Some newer technologies involve using energy sources, ultrasound or other, to “melt the fat” and allow the fat to be resorbed by the body without suctioning, no incisions or scars. These are relatively new procedures and are now being investigated as to how effective they are and how they compare to liposuction using cannulas to remove the fat. Here are some of the current modalities for liposuction surgery.

Tumescent or traditional liposuction utilizes a type of “wetting solution” which usually contains a local anesthetic such as lidocaine and another medication to cause blood vessels to shrink down or constrict in a balanced salt solution. This is usually injected into the areas to be suctioned prior to surgery and allowed some time to take effect prior to suctioning out the excess fatty tissues.

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