COSMETIC TOWN JOURNAL



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Types of Wet Liposuction

Types of wet liposuction include wet, super wet and tumescent. The type used is determined by the amount of solution infiltrated throughout the treatment area prior to fat removal. Wet liposuction uses a combination of epinephrine, lidocaine and saline solution for a safer and more comfortable procedure that has less downtime and recovery than the older method of dry liposuction. This technique is less traumatic to the body since the solution helps to minimize the damage of blood vessels. It also results in less bleeding and bruising. Furthermore, lidocaine is a local anesthetic which serves to numb the region and may void the need for general anesthesia.

Am I a Good Candidate for Types of Wet Liposuction?

A GOOD CANDIDATE for types of wet liposuction includes:

  • Patients with isolated pockets of fat on the abdomen, thighs, buttocks, flanks or other region of the body
  • A patient who has excess fat deposits that are resistant to diet and exercise
  • Male or female patients within 30% of their ideal body weight
  • Men suffering from gynecomastia or enlarged breast tissue
  • A patient with good muscle tone and firm, elastic skin

The following patients are NOT GOOD CANDIDATES for wet liposuction:

  • Patients who are overweight or obese
  • Any patient with an eating disorder, diabetes or poor circulation
  • A patient with a life-threatening condition which may increase surgical risks or impede healing
  • Patients with loose or excess hanging skin

How are Types of Wet Liposuction Performed?

Wet liposuction is typically performed on an outpatient basis with the use of local anesthetic but general anesthesia also may be an option. The procedure can take between 45 minutes and two hours depending on the type of liposuction.

The surgeon will inject a diluted solution of lidocaine, epinephrine and saline into the treatment area. The lidocaine numbs the region, the epinephrine causes the capillaries in the fat to constrict and the saline engorges the fatty tissue which causes it to become firmer. The constricting of the capillaries helps control bleeding, bruising and keeps the lidocaine from being absorbed by the body too soon. Wet liposuction does require the use of general anesthesia since it uses a smaller amount of solution. The amount of fluid injected into the patient is less than the amount of fat which will be removed.

Super wet liposuction is similar to the wet technique except that the surgeon will inject an amount of fluid closer to the total amount of fat being removed.

With tumescent liposuction, a larger amount of fluid will be infiltrated into the area. In fact, the amount of fluid is normally three times the amount of fat expected to be removed. The fluid that is injected causes the treatment area to become tumescent, or swollen with fluid, which creates more space between the subcutaneous tissue and the skin. This technique helps to separate the fat cells for easier removal which results in less tissue damage. After the fluid is administered, the surgeon will make tiny incisions in the treatment area. A cannula will be inserted through the incision and moved vigorously to break up the fat while simultaneously suctioning it out. The incisions are less than 5mm in length and usually do not require sutures. However, a bandage or surgical dressing may be applied.

Alternative Techniques

Alternative tumescent liposuction techniques include:

  • Power assisted liposuction (PAL) – A liposuction technique that uses an oscillating tip to help loosen the fat cells.
  • Ultrasonic assisted liposuction (UAL) – A technique that uses high-frequency sound waves, either through the cannula or the skin, to liquefy the fat cells before they are suctioned.
  • Pulsed ultrasonic liposuction (PUL) – This technique uses ultrasound energy, to loosen and liquefy fat, with energy that is cycled on and off. The cycling of this energy allows for a more aggressive treatment.
  • Laser assisted lipolysis – A technique that uses laser energy to break apart the fat cells. This liposuction technique is reported to cause even less trauma since it liquifies the fat cells and only requires very small incisions.

Combined with Other Procedures

Wet liposuction is often performed with a tummy tuck or a mommy makeover which includes a tummy tuck and breast lift. Wet liposuction can also be performed with a facelift or breast reduction.

What is the Cost of the Types of Wet Liposuction?

The cost varies according to the type of wet liposuction, the number of treatment areas, the amount of fat to be removed and the surgeon’s experience. The different types of wet liposuction average between $3000 and $5000. The difference in cost is due to the amount of fluid used, any fees charged by the doctor or the facility and if other cosmetic procedures are being performed at the same time.

Recovery and Downtime

The RECOVERY time depends on the type of wet liposuction, how many areas had liposuction performed on them and the size of the area(s). Therefore, patients should understand that their DOWNTIME may be a few days or a few weeks. Patients can expect to feel some pain or discomfort after the local anesthesia has worn off but pain medications will be prescribed and should be taken as directed. There will also be some bruising and swelling but a compression garment will be placed around the surgical area to help minimize swelling. This garment should be worn 24 hours a day for the directed amount of time. The tumescent fluid may drain from the incision site over the first few days. Patients will be able to shower but will not be permitted to bathe, swim or soak in a hot tub. Patients are advised to limit their activities during the first week and build up to normal activities during the following weeks. Light duty work may resume at 1 to 2 weeks post-op. By 2 to 3 weeks, most of the bruising and swelling should have subsided. Patients can return to all daily activities by the 4th week but vigorous activity and exercise should be avoided until 6 weeks post-op. Residual swelling can last for 3 months or more.

Results

Patients will be able to see some results after wet liposuction but much of the effects will be masked by bruising and swelling. It can take up to 3 months for the swelling to subside and 6 months for the skin to tighten over the area where the fat was removed. Therefore, the final results may not be apparent for 6 months. After wet liposuction, patients should see a better contoured figure with more muscle definition. The results after wet liposuction are permanent and can last for years since the fat, which is removed, can never come back. However, the remaining fat can expand in size if a proper diet and exercise routine is not established.

Limitations of Types of Wet Liposuction

The limitations involved with types of wet liposuction include:

  • Patients who are overweight or obese may be limited from liposuction until they can lose some weight
  • Patients with excess or hanging skin may be limited from liposuction alone since liposuction does not remove excess tissue
  • Portions of the body, such as the upper back, are more fibrotic and may not respond as well to liposuction
  • The amount of fat that can be removed at one time is a limitation
  • The amount of skin tightening that occurs with liposuction alone

Risks of Types of Wet Liposuction

The risks associated with types of wet liposuction include:

  • Infection
  • Bleeding
  • Numbness
  • Damage to the skin or underlying structures
  • Excessive fluid loss
  • Fluid accumulation
  • Friction burns
  • Fat or blood clots which could migrate to the lungs and result in death
  • Lidocaine Toxicity
  • Changes in skin pigmentation
  • Lumps, dents or skin irregularities
  • Asymmetry
  • Sagging skin after surgery
  • Scarring
  • The need for further surgery to correct irregularities

Patients Should Conduct Proper Research

There are several different types of wet liposuction and patients should do proper research about each one before making a final decision. While any surgery has a certain degree of risks and recovery time, tumescent liposuction tends to have fewer risks and minimal downtime. Prospective patients should consult with a board-certified surgeon, who performs the various wet liposuction techniques, to determine which type of wet liposuction may be best for them.

Written by Cosmetic Town Editorial Team- MA

Based on an exclusive interview by Mark Mofid, MD in San Diego, CA