Medically reviewed by Dr. John Rosdeutscher – Written by Sine Thieme
Which Type of Liposuction is Best?
Liposuction is the most common plastic surgery in the United States. In a nutshell, it breaks up and removes fatty tissues and cells from under your skin. The fat is physically removed or “suctioned” from the body. It is a one-time procedure that permanently removes the fat.
In recent years as new technologies have emerged, the term “liposuction” has been expanded to cover treatments that don’t technically suction off the fat, but some of these treatments are nevertheless considered liposuction types – such as laser, ultrasound, and radio frequency assisted liposuction. The correct term is actually “lipectomy,” meaning fat removal of any type. Sometimes the term “lipolysis” is used to differentiate laser and radio frequency based methods. But in common lingo people simply use liposuction, or lipo for short.
Without going into too much detail, it helps to look at the history of the liposuction procedure. It was first developed in its initial form in the late 1960s in Italy, where a gynecologist invented a hollow surgical instrument to “vacuum” fatty acid from a patient’s body without the risk of damaging blood vessels. The game changer came when a pair of French physicians added the injection of saline fluid to the procedure. This “wetting” technique substantially decreased the common adverse effect of bleeding and bruising, reduced the risk of injury, and made suctioning off the fat much easier.
Now add lidocaine and epinephrine (local anesthesia) to the saline solution to relieve discomfort and better constrict the blood vessels, and you have the “tumescent” liposuction practiced by most plastic surgeons today. Some other improvements were made along the way, such as more sophisticated cannulas and suction equipment and improved placement of multiple tiny surgical incisions to make fat cells easier to remove and provided a better body contour. But essentially, the type of liposuction surgery practiced today has not changed all that much over the last 50 years.
This traditional or common liposuction is sometimes referred to as “suction-assisted liposuction” or “suction-assisted lipectomy” to differentiate it from other, non-suction forms of liposuction that we will get to in a minute.
Water-Jet or Water-Assisted Liposuction
This is essentially another name for tumescent lipo. In reality, the liquid injected to break up the fat cells is not water but a saline solution containing the aforementioned drugs. “Wetting” the area prior to breaking up the fat has so many benefits that it doesn’t make sense to perform liposuction without it.
Equipment manufacturers often create brand names that sometimes make their way into common language. For a while, Body-Jet Lipo was much talked about. Aqualipo is also a form of water-based liposuction, but with the addition of laser technologies to aid in skin contraction.
Think of this as the power steering upgrade to traditional liposuction. A power-assisted liposuction device includes a cannula that vibrates throughout the procedure. To remove the fat, the surgeon moves the cannula back and forth under the skin to reach all the fat cells evenly. This is simply made easier with a vibrating cannula. It is particularly helpful when harvesting a larger volume of fat.
Whether or not a cosmetic surgeon uses a power-assisted or plain device is often his or her preference and does not necessarily affect the outcome.
Next we will discuss liposuction types that do not necessarily suction off the fat the traditional way, but are still grouped with the liposuction family.
Variously known as laser assisted lipolysis, laser lipo, or under the brand names SlimLipo and SmartLipo, laser liposuction uses targeted and controlled heat generated by laser energy to reach and destroy fat cells under the skin. TriSculpt is a brand name that combines power-assisted liposuction with laser-assisted liposuction.
But laser lipo has its limitations. Large amounts of fat are often better eliminated with more powerful means, meaning traditional or tumescent liposuction. This is why laser liposuction works best when paired with these other methods. The first round of liposuction targets the bulk of the fat, breaking it down and flushing it out of the body. The next round of laser liposuction can then be used to reach smaller pockets of fat, or fat in areas that might otherwise bruise too much, and to tighten the skin in all treated areas.
As the name suggests, ultrasound assisted liposuction uses ultrasound energy to attack fat cells. Pulses of this energy are delivered through a thin wand that is inserted under the skin – liquifying fat cells. Once the fat has been melted, the liquified fat is then removed. This might be beneficial for areas that are difficult to reach with a traditional cannula, or smaller areas like the upper arms or under the chin.
As with laser liposuction, a surgeon will typically combine ultrasound technology with tumescent liposuction for additional skin tightening benefits he or she can’t achieve with fat removal alone.
Radio Frequency Assisted Liposuction
Also referred to as radio frequency assisted lipolysis or RFAL, this form of liposuction should also be viewed as a skin tightening treatment vs pure fat removal. The radio frequency energy is delivered through a thin wand that is inserted under the skin. It targets the underlying tissue with short bursts of heat and thereby contracts or “coagulates” the skin, and also stimulates collagen production.
BodyTite and Renuvion are two FDA-approved radiofrequency skin tightening technologies that have shown great promise with skin contraction. They can contract the skin from 35% to 60%, which is higher than previous laser or ultrasound technologies are able to achieve. This is very encouraging for candidates with poor skin elasticity who previously could not hope for good liposuction outcomes.
BodyTite (including its variant, FaceTite) and Renuvion are radiofrequency skin tightening alternatives to tummy tucks, thigh lifts, arm lifts, and facelifts. See our Skin Tightening page for more detailed information.
Liposuction with Fat Transfer (aka Liposculpture)
This is a variation of liposuction that preserves the harvested fat so that it can be injected into other areas of the body. A surgeon can thereby contour and sculpt (hence “liposculpture”) the body even better by accentuating its curves.
Fat transfer basically combines liposuction with an injectable filler, except that the filler in this case is your own natural fat. The fat is a safe alternative to artificial fillers for face and hands. Most commonly, fat transfer is used to add volume to the breasts for women who want a breast augmentation without the use of implants.
However, fat transfers to the buttocks (aka Brazilian Butt Lifts) have come under increased scrutiny in recent years for their elevated risks compared to other cosmetic surgery, which is generally very safe.
This is not really its own liposuction technique as much as it is a marketing term. It refers to using liposuction in a way that treats your midsection all the way around, front and back and 360 degrees of it.
This is not really a new concept. Most plastic surgeons offer liposuction for several areas at once, and it is just a matter of pricing how these areas are combined. You typically pay a certain amount for the first area and can add on several more areas at heavily discounted prices. Lipo 360 simply refers to a combination of areas in one single procedure for evenly toned results around the abdomen.
Which Liposuction Type Should I Choose?
You might ask, which of all these procedures is best? We hope that we’ve given you a good overview of available treatments to help you better decide. But you should know that a surgeon’s skill and experience plays a major role in your results as well. Picking an experienced, board-certified cosmetic surgeon you are comfortable with is a major first step in getting the type of liposuction that is right for you. You should also know that most plastic surgeons will use two or more of the different techniques in the same session. How you can customize your procedure to best meet your needs is something you’ll discuss with your surgeon in a personal consultation.
Does Liposuction Work?
No matter which type of liposuction you end up getting, you can rest assured that you are likely to see excellent results. Liposuction has been around for many decades, and there is a reason for this: It works extremely well! It’s less invasive than a tummy tuck (full surgery), and it’s more effective than non-invasive fat removal like CoolSculpting, which needs repeat treatments to yield results that still can’t match the quality of fat removal with liposuction.
We hope that we’ve given you a better understanding about the different liposuction types. Please don’t hesitate to contact us if you have any other questions.
- Wikipedia: Liposuction