Ultrasonic liposuction: invasive and non-invasive techniques. Types of liposuction Invasive and non-surgical liposuction

Liposuction is a method of removing excess fat tissue in problem areas in order to correct the silhouette. This method is not suitable for the treatment of general obesity. Liposuction is the final stage in the fight against figure imperfections, advisable when the total body weight is within the normal range. There are several ways to destroy fat cells during liposuction: mechanical, radiofrequency, laser and ultrasound. Ultrasonic liposuction has become widespread, especially the non-surgical method of performing this procedure.

How does ultrasound destroy fat cells?

The process of death of fat cells (adipocytes) under the influence of ultrasound is called cavitation. Ultrasound destabilizes the contents of adipocytes, causing the formation of tiny vacuum bubbles in them, bursting and thus causing water hammer, which destroys the cell membrane. The contents of the cells enter the intercellular space, where 90% of it is neutralized by lymph cells as a foreign body and excreted by the liver. The remaining 10% is used by the body as a source of energy.

Fat cells are voluminous and have a stretched membrane, which is why they are vulnerable to ultrasonic waves. On muscle cells, skin cells, blood vessels, nerve endings Ultrasound has no destructive effect. A internal organs and the joints remain outside the zone of its influence.

Surgical ultrasonic liposuction can be performed under both general and local anesthesia. The choice of anesthesia depends on the extent of the operation. Subcutaneous fat tissue is treated with ultrasound, and the destroyed fat cells in the form of an emulsion are removed through small punctures in the skin using a hollow titanium tube connected to a vacuum pump. Ultrasound from the inside has a lifting effect on the skin, which allows, in the case of small fatty deposits, to do without additional methods of tightening the skin in the treated area.

This method allows you to avoid large blood losses when removing a significant amount of fat (up to 2 liters per procedure). Ultrasonic liposuction removes body fat evenly, without scars, pits and bumps.

Non-surgical liposuction began to be used relatively recently; it became possible after the invention of special devices. The main difference between this technique and surgical liposuction is the preservation of the integrity of the skin. This technique does not require pain relief and does not leave bruises. Fat cells destroyed by ultrasound are removed naturally using venous and lymphatic systems body, breaking down in the liver into metabolites (less complex substances).

Since the natural process of removing metabolites from the body is not designed for a huge amount of them, in one session of non-surgical ultrasonic liposuction No more than 500 ml of fat can be destroyed. As a rule, 2-3 sessions are required to correct the problem area.

This method allows not only to remove excess fatty tissue in the treated area, but also to remove skin unevenness. The devices currently used for non-invasive ultrasonic liposuction are so “smart” that they themselves strictly control the entire process. In particular, if the ultrasonic wave is repeatedly directed to the same place, the device simply will not turn on. This avoids uneven removal of fat deposits and the “washboard” effect.

To enhance the effect, the method is often complemented by other techniques such as massage and lymphatic drainage.

The results of the procedure should be judged no earlier than a month later, since all this time the adipose tissue continues to be excreted from the body.

Contraindications to ultrasonic liposuction

Ultrasonic liposuction is a fairly serious effect on the body, and it has its contraindications:

any disease in the acute stage;
heavy chronic diseases;
violation of the integrity of the skin in the area of intended treatment (scars, rashes, cuts, abrasions, etc.);
diseases of the endocrine system;
decreased immunity due to diseases or any effects on the body;
divergence of the rectus abdominis muscles, abdominal hernia;
hip and knee joint prostheses;
age less than 18 years;
pregnancy and lactation.

This should be remembered

Adipose tissue in the treated areas is not re-deposited, or is deposited as a last resort. But if you do not adhere to the principles of proper nutrition, limit physical activity and lead an unhealthy lifestyle, fat will accumulate in areas where liposuction was not performed. Any liposuction is only a method of local silhouette correction, nothing more.

Non-surgical liposuction device based on low-frequency cavitation ultrasound - MegaSon.

The MegaSon ® device (Eun Sung, Korea) is designed for correction and modeling of the figure through non-invasive, non-surgical removal of local fat deposits.
It is important that the ultrasonic liposuction procedure, unlike classical liposuction, takes place without damage skin, painless and does not require rehabilitation period. The method is based on the occurrence of a cavitation effect in fat cells (lipocytes) under the influence of low frequency ultrasound.

Cavitation - (from the Latin cavitas void) is the process of formation in a liquid of cavities (cavitation bubbles, or caverns) filled with gas, steam or a mixture of them. Cavitation can be hydrodynamic or acoustic. In what follows we will only talk about acoustic cavitation because it is used in aesthetic medicine. As you know, ultrasound is an acoustic wave, and body cells contain a large number of liquids. Thus, the idea arose that cavitation effects could also occur in fat cells, and this idea turned out to be correct.
After numerous experiments, it was discovered that under the influence of low-frequency ultrasound with parameters of 25-70 KHz and a certain flux density of sound energy, a cavitation effect occurs in adipocytes overflowing with fat, i.e. microbubbles are formed. The higher the frequency, the smaller the bubbles, the lower the frequency, the larger the bubbles. The optimal frequency for adipose tissue was 31-43 kHz.

At this frequency, the maximum number of bubbles of the required size is formed. They increase in size, liquefy fat and displace it from adipocytes. Collapse of bubbles also occurs in adipose tissue, releasing a large amount of energy up to 100 kg per cm2.
When the bubbles collapse inside the fat cell, a hydrodynamic shock occurs, a kind of microexplosion. These microexplosions damage the cell membranes of adipocytes. The membranes of the cells most filled with fat are damaged first, due to their greatest tension. The released triglycerides, which make up fats, are removed from the intercellular space through the lymphatic and venous systems.

At the same time, other cells and tissues (muscle fibrils, epidermal cells, vascular endothelium, etc.) are not damaged by cavitation, because are relatively durable and have a sufficient coefficient of elasticity. Many scientific research, which have proven the effectiveness and safety of cavitation.
I would like to note that cavitation is not treated with ultrasound. Ultrasound is used here not as a method of influence, but as a physical factor that causes the effect of cavitation in adipose tissue. In other words, it is not ultrasound itself that affects fat cells, but the formation of microbubbles and their collapse with the release of a large amount of energy, which it causes in fat cells.

Ultrasound with a frequency of 0.8-3 MHz, which has long been used in medicine and cosmetology, cannot cause a cavitation effect in cells and therefore cannot be effectively used to influence adipose tissue. As already mentioned, fat breakdown products and destroyed adipocytes are eliminated from the body in natural ways - mainly through lymphatic drainage. Therefore, after the cavitation procedure, it is necessary to carry out lymphatic drainage. This complementary effect of different physiotherapeutic factors allows you to achieve excellent results. Moreover, the effect is not limited only to the subcutaneous fat layer, but also includes tightening the skin on thinning areas of the body.

A pronounced cavitation effect, for clarity, can be observed when low-frequency ultrasound (43 kHz) is applied to egg yolk.

Indications:
- Fibrous and dense cellulite;
- Local fat deposits;
- Elimination of consequences after surgical liposuction (irregularities and asymmetry).

Contraindications:
- presence of active implants (artificial pacemakers);
- cancer, diabetes, neurological diseases (epilepsy);
- pregnancy and breastfeeding;
- osteoporosis;
- cardiovascular diseases in the stage of decompensation;
- open skin lesions;
- immunodeficiency states;
- herpes (in the acute stage);
- hypo- and hyperthyroidism;
- acute and chronic diseases of the liver (fatty degeneration, hepatitis, etc.) and gall bladder (cholecystitis, cholelithiasis), pancreas and kidneys;
- chronic skin diseases(psoriasis, vitiligo);
- general obesity;
- keloid scars and skin atrophy.

The figures show the areas of local fat deposits where classical procedures are most often performed. invasive procedures liposuction.
The treated area of skin may turn pink. An internal sensation of warmth and tingling will appear. Hyperemia at the end of the procedure should not be too strong and should not last more than 60 minutes. The slower the movement of the working handle, the stronger the heating of the deep layers of tissue.

Recommendations:
To avoid any complications during and after the procedure, it is necessary to consult with a general practitioner to determine whether there are any contraindications to this procedure.
The procedure for non-surgical low-frequency ultrasound liposuction should be performed no more than once a week. This is necessary so that fat breakdown products have time to be completely eliminated from the body. Otherwise, the load on the liver will increase, which can lead to undesirable consequences and a deterioration in the condition of the body as a whole.
The number of procedures is calculated depending on the thickness of the subcutaneous fat layer. In one procedure, up to 1-1.5 cm of fat layer is removed. A course usually requires 3-8 procedures.
One procedure should not cover a large area of exposure, so as not to increase the load on the liver and excretory organs due to the entry of a large amount of fat cell breakdown products into the blood and lymph. During one procedure, only two symmetrical areas should be treated, each with an area of one palm (for example: the breeches area on both sides, the inner thigh on both sides, etc.).
Between sessions and for 1 (one) week after the last session, various lymphatic drainage measures are recommended: lymphatic drainage massage (manual, vacuum), lymphatic drainage wraps, pressotherapy, etc. It is also possible to carry out mesotherapy with lymphatic drainage drugs.
For better and faster removal of fatty tissue breakdown products from the body, it is recommended to follow a drinking regime, namely consumption of up to 3 liters of liquid per day.
It is recommended to move more, walking long distances is especially useful.
Like any course of procedures to get rid of unwanted fat deposits, non-surgical liposuction involves following a diet consisting of low-fat foods and foods of predominantly plant origin.

Result:
Reduction in the volume of adipose tissue after the first procedure. Increasing effect of weight loss during a course of procedures.
Lasting results due to physiological characteristics adipose tissue.

Possibilities:
Non-surgical correction of the most problematic areas of the body that do not respond to diets and grueling sports training.

Effective fight against:
fibrous and dense cellulite;
local fat deposits;
elimination of consequences after surgical liposuction (irregularities and asymmetries).
Also, cavitation procedures can be used as additional method in the treatment of general obesity.

Advantages of the cavitation lipolysis method:
- Non-invasive use;
- Efficiency with complete safety, without pain;
- Speed of implementation - 15~20 minutes;
- Duration of the achieved result.

Efficiency:
Two advanced handpieces with ergonomic handles generate high-power ultrasonic energy sufficient to reliably destroy fat cells.
Synergy Availability additional function in maniples - red photochromotherapy - enhances the lipolytic effect of cavitation ultrasound and helps improve the elasticity and appearance of the skin in treatment areas.

Safety and painlessness:
A new method of selective destruction of adipose tissue is based on the influence of special low-frequency ultrasound.
The cavitation effect that occurs in fat cells leads to the destruction of lipocytes, and fats and their breakdown products are then eliminated from the body naturally. In this case, the surrounding tissues and organs are not damaged, and the reduction in volume is achieved solely due to fat mass.
It is important that the ultrasound liposuction procedure, unlike classical liposuction, takes place without damaging the skin, is absolutely painless and does not require a rehabilitation period.

Areas of use:
Reduction of local fat deposits in problem areas:
Waist and belly area
Side surfaces
Buttocks
Hips, riding breeches area
Back, back surface neck
Shoulders, arms
Above the knee area

Advantages of the MegaSon device:
- two ergonomic working handles for processing different areas
- additional function of red photochromotherapy in the handpieces
- good power reserve for efficient work
- complete safety for the patient and operator
- a large number of preset settings for ease of use.

Posted by:	Karitsky Alexander Viktorovich
Source:

Correcting figure imperfections by removing local fat deposits (liposuction) has already become a routine and well-established operation with a minimum of complications. The constant improvement of medical technologies and the increasing demands of patients have led to the development of a separate minimally invasive direction in this area. Currently, it is being used more and more widely and is gradually replacing traditional methods.

Relevance of the issue

Excess body weight creates an increased load on almost all organs and systems, leading to the appearance serious illnesses(including diabetes, fatty liver, ischemic disease heart), causes discomfort in Everyday life and negatively affects a person’s appearance. Being overweight can lead to awkwardness in communicating with other people and create difficulties in your professional and personal life.

Ultrasonic liposuction

In this case, the effect of cavitation is used - the destruction of fat cells under the influence of ultrasonic pulses. The method does not require pain relief and has positive side effect– stimulates skin contraction, which is important to speed up the recovery process.

Electrolipolysis

The operating factor is alternating current high frequency, which causes the breakdown of adipocytes (fat cells). The procedure is low-traumatic, highly effective, does not require anesthesia and also has a tightening effect on the skin.

Cryolipolysis

The method is intended for treating local areas (stomach and sides, thighs). The working attachment of the device lowers the temperature of the tissues in the desired zone to approximately +25 C and compresses them. Fat cells are exposed to hypoxia and disintegrate. In this case, there are no skin punctures at all.

Injection liposuction

A complex of drugs is injected under the skin by injection (it includes bile acids, enzymes, vitamins and plant extracts) that cause active breakdown of fat. The method is safe and low cost compared to other liposuction options.

Patients often ask the question: where does the adipose tissue destroyed using non-surgical liposuction go? It is excreted naturally. First, it breaks down into fatty acids and triglycerides, is absorbed into the blood and lymph, then is finally “burned” in the liver. Naturally, in the postoperative period the load on the liver increases sharply, so the technique is contraindicated in patients with liver failure. To facilitate the breakdown and utilization of fat, it is necessary to consume a large amount of fluid and follow the prescribed diet.

Laser liposuction

Laser liposuction is not used as monotherapy. Laser liposuction procedures such as CoolLipo, Slimlipo, Smartlipo and Prolipo are not actually alternatives to surgery, but are often used to support and improve the results of surgical liposuction. Laser fat melting before liposuction surgery makes it easier for the doctor to remove unwanted fat deposits in the abdomen, thighs, and waist.

How is the procedure performed?

Laser lipolysis is a non-surgical, innovative method that produces dramatic body sculpting results and is often used as a treatment to correct the shortcomings of traditional liposuction. Laser lipolysis was invented at the end of the last century with original name Smartlipo. Currently, there are many non-surgical laser lipolysis devices.

Equipment designed to perform laser lipolysis is based on the use of selective interaction between the laser beam and adipose tissue.

Laser lipolysis can be performed in areas that traditional liposuction cannot reach, especially in areas such as the face, neck, back and knees where standard liposuction can only be performed on a limited basis or not at all. Laser lipolysis can reduce excessive deposits of adipose tissue in the abdomen, waist, hips, buttocks, knees, pubis, and chest (false gynecomastia in men). Laser lipolysis offers the possibility of non-surgical facial contouring by, among other things, eliminating a double chin. Laser treatment used as part of combination therapy in the treatment of cellulite.

The best candidates for laser lipolysis are:

patients are in good condition general condition healthy, physically active, slightly over ideal weight;
patients with one or more areas of stubborn excess fat on the body;
patients wishing to improve skin elasticity to combat cellulite;
patients with sagging and uneven skin after classical liposuction, especially in the abdominal area.

Treatment time ranges from 20 to 60 minutes depending on the area of the body. Laser methods treatments are considered minimally invasive, painless procedures that do not require general anesthesia. These procedures are performed under local anesthesia. The discomfort felt by the patient during the procedure is minimal. Most often, patients feel a slight tingling or stretching of the skin.

Laser lipolysis devices use very thin optical fibers (with a diameter of 300 microns and 600 microns) placed on a special cannula having a diameter of about 1 mm. The doctor makes a small incision (mostly in the folds of the skin, so as to hide tiny scars). The heat generated during the procedure by the interaction of the laser beam and tissue can reduce excess body fat and improve the texture, firmness and elasticity of the skin. Thus, the fat cells turn into an emulsion, which is carefully removed from the body by suction, as well as naturally.

The laser beam penetrates the patient's skin, dissolves fat cells and causes heat shrinkage of skin fibers, giving the effect of immediate skin tightening and cellulite removal. The laser destroys the cell membranes of fat cells and leads to the release of triglycerides. During the procedure, the heat of the laser affects the tissues under the skin and stimulates the production of collagen and elastin.

Immediately after surgery, you may experience minor bruising and swelling of the tissue, as well as some numbness in the treated areas. They usually disappear within a few days after treatment. The swelling subsides in about a week. With laser liposuction, slight swelling may persist for 6 to 12 weeks.

Laser lipolysis requires a shorter recovery time and reduces the potential for many of the side effects that occur with traditional liposuction. Patients are usually able to resume normal activities within 1-2 days after surgery.

To improve the effectiveness of therapy, doctors recommend wearing compression garments for about one week after surgery and a short course of antibiotics to prevent infection. You should avoid strenuous exercise for one month.

Laser lipolysis provides:

constant destruction of fat cells;
skin density and flexibility;
reducing the appearance of cellulite;
rapid recovery after surgery;
minimal risk of complications.

After laser lipolysis surgery, the body gradually improves day by day. Gradually the skin becomes more elastic and dense. The final results obtained after laser lipolysis are permanent. These effects appear gradually after 1-2 months. In some cases, this process can continue for six months. If body weight increases again, fat will be deposited in different areas than those that were processed.

In most cases, to get what you want clinical effect One procedure is enough. After the operation, gradually over several months the skin becomes smooth, elastic and healthy. These effects persist for a long time when healthy way life, proper nutrition and general care behind the body.

Modern laser liposuction devices have efficient systems to ensure maximum patient safety and eliminate the risk of skin burns, which were sometimes previously side effect laser treatment.

Contraindications for laser lipolysis

Contraindications to laser lipolysis are:

epilepsy, multiple sclerosis;
diabetes;
thyroid diseases;
liver diseases, kidney failure;
bleeding disorders;
open wounds or skin diseases in the treatment area;
pregnancy;
cardiovascular diseases;
taking antiplatelet agents, anticoagulants, thrombolytics, some anti-inflammatory drugs or photosensitizers.

Ultrasonic liposuction

The goal of ultrasonic liposuction is to reduce fat deposits in the abdominal area and cellulite. Ultrasonic liposuction of the abdomen allows you to remove fat in a much safer, more precise, less painful way than traditional liposuction. This significantly reduces recovery time. Ultrasonic liposuction is a modern non-surgical method for reducing fat deposits and cellulite located in aesthetically important areas, namely the abdomen, hips, waist, buttocks and arms. The method should not be considered as a form of treatment for excess weight!

The best candidates for therapy are:

women aged 25 to 55 years, with accumulation of adipose tissue mainly in the abdominal area and lower limbs, not necessarily with cellulite;

men aged 30 to 50 years, with obesity in the abdominal area.

How is the treatment carried out?

Ultrasonic liposuction is a non-surgical technique that uses ultrasound energy to precisely separate fat from surrounding tissue. The method does not affect surrounding tissues, therefore eliminating the risk of damage to connective tissue, nerves or blood vessels.

The hardware method is based on selective damage to the membranes of fat cells with ultrasonic energy (without damage to surrounding organs - blood vessels and nerves), with the result that fat is released into the intercellular spaces.

The use of ultrasonic waves of different lengths, penetrating deep into the skin and emitting energy, leads to the phenomenon of cavitation in fat cells. Countless small air bubbles are created using a vacuum, which causes vibration of fat cells and affects the membranes of adipocytes, leading to their complete destruction. In this case, triglycerides are converted into glycerol and free fatty acids. The released fats are transported through the lymphatic and vascular systems to the liver, where they are metabolized and eliminated from the body through normal physiological processes.

Ultrasound allows you to perform a light massage deep in the tissues, which stimulates blood circulation, lymph flow and local metabolism, and also improves cell turnover, so that the body better gets rid of waste products. Toxins released from adipose tissue are removed from the body through the sweat glands and the lymphatic and vascular systems. The ultrasonic thermal effect has an analgesic effect and relaxes muscles.

Unfortunately, this treatment has a small disadvantage. In fact, the released fat is often not eliminated from the body once and for all. During one treatment, you should not eliminate more than 0.5 liters of fat, so as not to overload the liver.

During the hardware procedure, patients may experience discomfort, cold, tingling, stinging or burning. Patients describe the sensation of ultrasonic waves as deep heating of adipose tissue. After treatment, patients complain of discomfort (pain), bruising, redness and swelling. Redness of the skin lasts for approximately 4-24 hours. The area may have some visible bruising for 1 week after treatment. After the procedure in the abdominal area, patients must wear special underwear to achieve the best effect. Minor discomfort may occur when performing physical activity or by applying pressure to the treated area for a week after treatment.

The effect depends on the individual metabolic rate of the body. The estimated time for fat expulsion is about two months. With ultrasonic liposuction, recovery time depends on the amount of fat that is removed from the body and the area of the body treated. During this period, the body naturally processes and removes destroyed fat tissue. It is extremely important to ease the work of the liver during this period.

To facilitate and speed up metabolic processes, it is recommended proper nutrition, reducing protein and saturated fat intake. Dishes should not be overly salty. After ultrasonic liposuction, it is recommended to consume at least 2 liters of water per day. Using dietary guidelines will help remove fat from the body and reduce stress on the liver. Best results can be seen after three to six months.

In order to achieve the expected results, you need to undergo a number of procedures, usually ten. The first series of 3-5 procedures is performed every 5 days. The next two series are held at intervals of 2-5 days.

Contraindications for treatment

Contraindications to ultrasonic liposuction surgery are:

pregnancy and breastfeeding, menstruation;
diabetes;
poor blood clotting;
HIV status;
hernia;
tumor diseases (up to five years after treatment);
heart failure, arterial hypertension;
viral and bacterial skin diseases, damage to the epidermis;
fever, weakness and exhaustion of the body;

Non-surgical liposuction is a safe method for correcting body contour deformities, allowing you to reduce body volume and weight, eliminate cellulite, and improve skin condition. lpg cool...

What is cryolipolysis?

Cryolipolysis is a fight against excess fat by freezing fat cells. Fat cells freeze before surrounding tissues, die and are destroyed over time during the course of the inflammatory...

Liposuction – effective method removal of local fat deposits in patients who do not suffer from general obesity. These accumulations of fatty tissue most often form in certain parts of the body in both men and women. Removing these deposits using liposuction allows you to correct the contours of the patient's body and make them more attractive.

Since the first presentation of the technique of removing subcutaneous fat deposits using a blunt cannula and a vacuum aspirator in 1982, many technical and technological innovations have been used in liposuction. The traditional procedure of suctioning adipose tissue began to be combined with ultrasound, vibration, laser, radio frequency and other techniques. Each of them has its own advantages and is associated with certain complications.

All available to the patient today. The goal of the most modern of them is not only to remove excess fatty tissue, but also to simultaneously tighten the skin. Ideally, liposuction should provide several effects at once. First, effectively remove excess fat tissue. Secondly, to provide tightening of soft tissues in the area of removed fat deposits. Thirdly, it must be safe and used under local infiltration anesthesia. And fourthly, rehabilitation after liposuction should be short with a minimum number of bruises and swelling. To date, none of the liposuction methods demonstrate results in skin tightening that are superior to those of analogues.

As for the indications for liposuction, they traditionally include fat deposits that naturally form during the aging process and various pathologies.

Modern technologies of invasive liposuction

Traditional liposuction

In the late 70s and early 80s of the last century, many surgeons worked on the technology that today we call traditional liposuction. Initially, surgeons used sharp curettes, which led to many complications, including bleeding, uneven body contours, insufficient skin contraction, seroma formation, and even sometimes necrosis. In 1977, the Fischer brothers first described the technique of removing subcutaneous fat deposits using a vacuum aspirator. Using a sharp instrument connected to a suction device, the Fishers improved the effectiveness of the procedure for removing excess fat tissue. However, the number of complications remained high, so this technology was not widely used.

Ulrich Kesserling tried the same technology, but inserted a surgical instrument deep into the fatty tissue, just above the muscle fascia. Kesserling also selected young, healthy women with good skin elasticity for operations, which allowed him to obtain significantly better results and became the reason for the renewed interest in liposuction.

The main contribution to the development of liposuction was made by Kesserling’s colleague, Yves-Gerard Illouz. He modified the sharp curette, essentially turning it into a blunt-tipped cannula, which, unlike its predecessor, made it possible to easily penetrate fatty tissue and remove it without damaging the integrity of the adjacent soft tissue. The use of a blunt cannula has not only led to a dramatic reduction in the number of complications after liposuction, but has also allowed surgeons of varying degrees and experience to perform this procedure safely. Then, curved cannulas of various lengths and diameters appeared. However, they all had two general features: Rounded end and side opening. Initially, cannulas with a diameter of 10 mm were used for extensive fat deposits, 8 mm for the knees, elbows, abdomen and arms, and 5 mm for the face. Modern cannulas for liposuction of the body rarely exceed 5 mm in diameter, for the face - 2.4 mm. In addition, today's cannulas have multiple holes, which allows for more efficient removal of fatty tissue.

Ultrasonic liposuction

Ultrasonic liposuction is a liposculpture method that uses ultrasound energy to target fat deposits. The method proposed by Zocchi includes two stages: ultrasonic stimulation of lipolysis and subsequent removal of the split adipose tissue in the traditional way using a vacuum aspirator. Lipolysis of fat cells occurs during exposure to ultrasonic vibrations, which create negative pressure in adipose tissue and trigger the process of cavitation, which leads to rupture of cell membranes.

One of the advantages of ultrasonic liposuction is that the aspirate obtained in its process is a homogeneous emulsion of viable adipocytes, which can be used for lipofilling.

The advantages of ultrasonic liposuction, namely cavitation of adipose tissue before its removal, are also called a reduction in blood loss and duration of operation, a decrease in the number of bruises and discomfort for the patient after the procedure, combined with better contour correction results even in places with an abundance of connective tissue, for example, on back and chest. The results of some studies confirm the effectiveness of ultrasonic liposuction as a complement to traditional liposuction, as well as for the removal of fat deposits on the sides and chest in men.

The most modern devices for ultrasonic liposuction of the third generation, for example, VaserTM Lipo, allow you to correct body contours using pulsed ultrasound with less energy consumption.

Among the disadvantages of ultrasound technology are its high cost, invasiveness and risk. thermal burns. In general, the popularity and market share of ultrasonic liposuction devices are declining, including due to the factors mentioned above, as well as due to the emergence of safer and less traumatic techniques that do not require such high qualifications of the surgeon.

The first vibration liposuction device to receive FDA approval in 1998 quickly became very popular among plastic surgeons. The indications for use of the device, developed by MicroAire Surgical Instruments, were “removal of tissue and fluids... including suction lipoplasty for aesthetic correction of body contours.” The first generation devices operated using medical nitrogen or compressed air. The vibrating cannula performed 2-4 thousand vibrations per minute with an amplitude of 2 mm. The surgeon could independently control the vibration speed. In subsequent generations of devices, quieter electrical vibration sources were used instead of compressed gas.

The advantages of vibroliposuction include its greater efficiency in destroying adipose tissue than traditional liposuction. Many surgeons consider this technology less labor-intensive than traditional technology, which reduces operating time.

Among the disadvantages of vibration liposuction are its high cost, the requirement for highly qualified surgeons, the vibrations transmitted to the hand of the operating doctor and the noise produced by the device.

Laser liposuction

The laser liposuction technique was described in 1994 by Apfelberg et al. This group of scientists first tested the technology of combined use of a neodymium laser and a surgical cannula. However, despite the success of the first experiments, this technique did not receive FDA approval. Since then, many specialists have tried using lasers of different wavelengths to stimulate adipocyte lysis and reduce blood loss during surgery and minimize bruising and improve body contouring results after surgery.

The operating principle of laser liposuction is based on selective photothermolysis, which leads to lysis of adipocytes, but does not affect adjacent tissues. Laser waves of different lengths have different effects on subcutaneous structures such as collagen, fat, vascular system, hemoglobin and water. Laser liposuction destroys adipocytes, causes photocoagulation of small blood vessels and reduction of collagen fibers in the skin.

For laser liposuction, three types of lasers are most often used: neodymium with wavelengths of 1064 nm and 1064/1320 nm and diode with a wavelength of 980 nm. The first is the most studied, and its safety and good tolerability by patients have been proven in many studies. The 980nm diode laser is more powerful and allows you to achieve better results in areas of large accumulations of fat deposits, for example, in the thighs or abdomen. Neodymium laser 1064/1320nm has the most intense effect on collagen, which provides the best results in skin tightening and stimulates neocollagenesis. In addition, the 1320nm laser is better suited for highly vascularized areas because it converts hemoglobin into methemoglobin, which can have positive influence for hemostasis.

Disadvantages of laser liposuction include the risk of thermal burns, the high cost of equipment and the duration of the procedure. Early studies did not demonstrate any differences in aesthetic results after laser and traditional liposuction. However, with the development of technology and the use of lasers with different wavelengths, which have different effects on the tissue adjacent to fat deposits, it is now possible to achieve better cosmetic results with minimal complications.

Water-jet liposuction is based on a Body-Jet nozzle, which delivers a solution under high pressure into the patient’s fat deposits. The liquid breaks up loose fatty tissue without affecting adjacent vessels and connective tissue. The surgeon independently sets the desired angle of fluid supply and the number of injections per second. The fatty tissue is then separated from the connective tissue and removed using a vacuum pump.

Like ultrasound, water-jet liposuction is a softer and less traumatic form of traditional liposuction, and also allows you to effectively remove large volumes of adipose tissue. However, water-jet liposuction does not tighten the skin after removing the aspirate.

Radiofrequency liposuction

Under the influence of the thermal effect exerted by radio frequency energy, fat cells are destroyed, collagen fibers are reduced and the synthesis of new ones begins. Thus, radiofrequency liposuction destroys fat deposits, removes them and at the same time tightens the skin in the area of treatment.

The first device for RF liposuction was the Israeli BodyTiteTM. The BodyTiteTM internal electrode is a silicone-coated (except for the tip) cannula for removing fatty tissue. From this internal electrode, radio waves go to the external one, and then to the adipose tissue. Under the influence of radio waves, adipocytes are heated and turned into an emulsion, after which they are removed using a vacuum aspirator. At the same time, active contraction of collagen fibers occurs, which provides a skin tightening effect.

One of the main advantages of RF liposuction and BodyTiteTM in particular is considered to be a significant reduction in skin and soft tissue, which, according to some data, can exceed 35% one year after the procedure, compared to less than 8% after traditional liposuction. The risk of radiofrequency liposuction is the possibility of thermal damage to adjacent tissues, but there is no evidence of this in the literature. The most common complications after RF liposuction are bruising, uneven skin surface after the procedure and soreness.

Each liposuction using additional technical means is fraught with risks that are not typical for this operation when performed classically. First of all, there is the danger of burns. At the same time, a surgeon who has mastered one or another combined technique receives advantages. They consist in the fact that some stages of the operation are facilitated. For example, water jet liposuction (WAL) saves time on infiltration of adipose tissue, and when exposed to ultrasound (UAL), vibration (PAL) and radio frequency (RFAL), the surgeon’s physical costs for performing the mechanical part of the operation are reduced. In turn, the patient receives a more favorable postoperative period, since the use of laser (LAL) and radio frequency (RFAL) coagulates small blood vessels and reduces the number of hematomas, and due to the compaction of collagen fibers, skin contractility improves.

Modern alternative non-invasive techniques for eliminating fat deposits

On a par with invasive techniques Liposuction is also developing non-invasive technologies for body contour correction. Today, there are already several hardware techniques that allow you to get rid of local fat deposits without subsequent rehabilitation, and also provide skin tightening, which allows you to avoid surgical excision of its excess. The results of such hardware techniques, as well as the indications for them, are completely different from the results and indications for liposuction, and therefore cannot be compared.

Among modern non-invasive methods for correcting local fat deposits are RF technologies. The action of all of them is aimed at reducing the volume of adipose tissue and simultaneously tightening the skin.

Of course, there is no ideal method. But, if you try to take the best from existing devices, you can hope in the near future for the appearance of a device that combines the effects of several physical factors. The most promising is likely to be a combination of water jet (WAL) or ultrasonic (UAL) liposuction with radiofrequency assisted (RFAL). These devices are now purchased separately by many clinics in order to be used together during surgery. This immediately reduces the time of liposuction, reduces its trauma and helps to reduce the skin flap in postoperative period. True, the cost of such devices will be higher than the price of a conventional surgical cannula.