The Aesthetic Society’s statistics show that men had almost 1 million cosmetic procedures last year, both minimally-invasive and surgical. Many of the fastest-growing cosmetic procedures are surgical. In our practice, the most common plastic surgery procedure for males is liposuction to treat areas of excess fat in the abdomen and “love handles.” 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. Some describe the procedure as “liposculpture” because the process of fat reduction with liposuction creates slimmer and more ideal shapes and contours. Liposuction surgery can be performed alone or in conjunction with an open procedure to contour the overlying skin. The results are best when you are near your ideal weight, but have some specific areas or “pockets” of fat that are exercise and diet resistant.
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 1920s. Modern Liposuction using blunt, hollow cannulas to suction fat began in the early 1980s and surgeons since then have added new techniques to make the fat removal process less invasive, 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 yet another important development.
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 (external ultrasound or other) to “melt the fat” and allow the fat to be reabsorbed by the body without suctioning (no incisions or scars).
Here are some common terms to know when considering liposuction surgery.
Tumescent liposuction is a type of anesthetic used during liposuction. A “wetting solution” that usually contains a local anesthetic such as lidocaine and another medication is injected prior to surgery, which causes blood vessels to shrink down or constrict in a balanced salt solution. Most surgeons will use this in combination with their liposuction techniques to reduce post-surgical pain and bleeding.
Suction-assisted liposuction (SAL) is the traditional form of liposuction and involves the removal of fat with a vacuum-assisted device.
Power assisted liposuction (PAL) is traditional SAL with the addition of a motorized cannula that increases the motion of the cannula, which can speed the removal of your fat.
Laser assisted liposuction (LAL) is a relatively new technology that harnesses laser energy to loosen and melt fat, as well as tighten skin. Fat removal is more efficient and less traumatic using the laser.