San Francisco Plastic Surgery Dr James Romano

126 Post Street, Suite 618, San Francisco, CA 94108 | 415.981.3911 

San Francisco Plastic Surgeon

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Ultrasonic Liposuction

BACKGROUND INFORMATION

Over the years the technique of liposuction to remove excess fat tissue, as we know it, has steadily improved. Suction assisted lipectomy (SAL) has undergone many modifications and improvements to become one of the most important tools in the collection of cosmetic surgery techniques. Ultrasound assisted lipectomy (UAL) has been practiced in Europe since the mid 1980's and has recently gained much interest and popularity in the United States. There are numerous reported advantages of this technique over traditional liposuction.

 

Ultrasonic systems are not new and not experimental. They have been used for military and industrial applications since the 1940's. Dentists were first to use this technology medically in the 1960's for the purpose of scaling and cleaning the teeth.

 

UAL is the surgical technique that allows for very efficient, smooth, and exacting body contouring by the liquification of fat which is then removed by low power suction (SAL).

 

UAL involves the transformation of electrical energy into high frequency sound waves that are transmitted into the tissues by a probe on a handpiece to create a mechanical vibration. It is similar to the energy produced by a vibrating tuning fork, just that it is a higher frequency, and not audible. It is called ultrasonic because these sound waves are just above the upper limit of human hearing. The effect of these sound waves, when applied to low density tissues like fat or water, is to cause microcavities or bubbles which eventually burst and cause "cavitation" and then disrupt the fat cells. Once the cells are disrupted, the contents flow out and mix with the surrounding fluid and form a stale fatty emulsion that can be easily suctioned out. Here is where the conventional SAL is used to finish and "fine-tune" the procedure. Because of this mechanism of action, the surrounding more dense and stable structures like the skin, vessels, nerves, muscles and ligaments are preserved and unharmed.

 

The procedure is performed very similarly to conventional SAL. A light general anesthetic is used and a dilute local anesthetic solution is infused into the tissues. This is called a wetting solution and is for the purpose of providing additional excellent anesthesia, less blood loss, more comfort, less bruising, and also cools the tissue and makes it less dense and better for performing the UAL technique.

 

Surgery is performed in the outpatient surgery center and usually lasts about 2-3 hours. There are no drains. The incisions are very small and are closed under the skin in a plastic surgery fashion with dissolving stitches. Foam pads and a compression garment are placed after surgery. The dressings are changed in three days. The garment is worn for three weeks all of the time, then another three weeks only during the day.

 

Recovery is surprisingly fast. Most bruising is gone in about 3 to 5 days. There is some edema and swelling that rapidly subsides. Most patients can return to work in less than a week.

 

The result is wonderfully natural and lasts the rest of your life as long as you maintain your weight in a stable range.

Copyright 2007 James J. Romano, M.D., 126 Post Street, Suite 618, San Francisco, CA 94108, 415 . 981 . 3911
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