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By Dr. Michelle Sieffert |

The Different Types Of Liposuction 

Comparing The Various Surgical Fat Reduction Methods Available 

Liposuction is an incredible, life-changing cosmetic procedure that works by removing unwanted fat deposits from various areas of the body. Throughout the years, different types of liposuction techniques have been developed, each with its own advantages and disadvantages. We will compare the three most common types of liposuction in the plastic surgery industry today: traditional, laser-assisted and ultrasound-assisted.

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Different Types Of Liposuction

Traditional Liposuction

Suction-assisted liposuction (SAL) — sometimes referred to as “Traditional Liposuction” — is a surgical technique that uses a thin, hollow tube called a “cannula” to remove unwanted fat from the body. First, a surgeon makes small incisions in the targeted area. Then, the cannula is inserted through the incision and is skillfully guided under the skin to suction out the fat cells. This procedure is most commonly performed under general anesthesia. 

The Benefits Of Traditional Liposuction

  • Effective in removing large amounts of fat in one procedure
  • Appropriate for patients at any point in their journey
  • Suitable for various areas of the body
  • Can be combined with other procedures like tummy tucks for even greater results 

The Drawbacks Of Traditional Liposuction 

  • May create irregular contours in the wrong hands
  • More time-consuming than other options 
  • Can require a longer recovery time

Power-assisted liposuction is a variation that basically uses a vibrating handle that breaks down the fat and helps the liposuction happen more effectively and efficiently. This is preferred for thicker and more fibrous fat deposits.” 

– Dr. Michelle Sieffert
Liposuction cannula

Laser-Assisted Liposuction 

Laser-assisted liposuction (LAL) uses a medical laser to liquefy fat cells before they are removed from the body. After numbing, the surgeon will create a small incision in the skin and insert the laser device under the skin, into the fat layer. Once the laser has ruptured the fat cells, the cannula is used to suction out the liquefied fat. 

This technique is considered less invasive than traditional liposuction and is ideal for patients who are at or close to their target weight. This procedure can be performed under local or general anesthesia. 

The Benefits Of Laser-Assisted Liposuction

Drawbacks Of Laser-Assisted Liposuction:

  • May not be as effective in removing large amounts of fat
  • Carries the risk of internal burn, which may make future surgeries more difficult
  • Can create contour irregularities 
  • Higher cost compared to traditional liposuction
  • May require multiple treatments to achieve desired results

What Are The Drawbacks Of Local Anesthesia Liposuction?

Some liposuction procedures can be performed under both local and general anesthesia. It depends on the surgeon’s confidence that they can get somebody adequately numbed; there are limits to how much numbing medication can be used to ensure patient safety. It can also be difficult to predict and manage patient behavior in the operating room. The total amount of fat and the number of areas treated must also be taken into consideration.

Ultrasound-Assisted Liposuction

Often referred to as “VASERlipo” or “Ultrasonic Liposuction,” this surgical approach starts with the introduction of a medical solution to the targeted area before using high-frequency, acoustic sound waves to liquefy fat cells before they are removed from the body. Like LAL, this technique is considered less invasive than traditional liposuction. 

The Benefits Of Ultrasound-Assisted Liposuction

  • A more controlled approach & precise result
  • Preserves surrounding nerves 
  • Less pain, swelling & downtime 
  • Can be combined with tummy tuck surgery for greater results
  • Enhanced skin retraction to tighten skin
  • Minimizes surgeon fatigue so more progress can be made in a shorter amount of time

Drawbacks Of Ultrasound-Assisted Liposuction

  • A limit to how much fat can be safely extracted in a single session
  • Carries the risk of internal burn, albeit lower than with LAL

We like to use VASER in specific cases. It is great for males with gynecomastia, patients with thicker, more fibrous layers of fat or repeat liposuction patients thanks to this technique’s minimal internal scarring qualities. 

– Dr. Michelle Sieffert

What Is Tumescent Fluid? 

Tumescent fluid is a solution made up of lidocaine (to prevent pain), epinephrine (to minimize blood loss), and sodium bicarbonate that is added to saline and pumped into the targeted area before suctioning occurs. Every surgeon who performs liposuction uses tumescent fluid to facilitate the removal of fat. If enough tumescent fluid is used, it makes it basically a bloodless surgery. Some surgeons may choose to use less fluid to save time in the operating room, but this can also be reflective of how they were trained. 

What Is “Tumescent Liposuction?”

This refers to the volume of tumescent fluid put into the target area relative to the amount of lipo aspirant that comes out. Tumescent liposuction involves 2 – 3 times of fluid vs. the amount of fat you expect to extract. The main benefit is that it makes the procedure virtually bloodless which reduces bruising during recovery. Fluid management in the operating room is critical to ensure enough is used to minimize blood loss but also to keep the amount in check to reduce the risk of fluid overload. I use a method that is in the 2:1 ratio range. 

Non-Surgical Options For Fat Reduction

  • CoolSculpting (Cryolipolysis):  An approach that uses freezing to destroy fat cells and a massage to break them up before the dead cells are metabolized naturally; this can be performed in the abs, thighs, buttocks, under the chin, upper arms, along the bra line and the flanks 
  • Kybella (Injection lipolysis): A controlled injection of deoxycholic acid designed to reduce fat below the chin and armpits 
  • Vanquish ME (Radiofrequency lipolysis): The use of radiofrequency energy to heat the fat layer below the skin (without touching the skin), causing the death of fat cells; can be used in the abs and thighs
  • SculpSure (Laser lipolysis): Similar to Vanquish, this method uses heat to destroy fat cells before the body naturally metabolizes them but uses medical lasers to get the job done; this technique can be performed in the abs, thighs, under the chin and the flanks 
Patient Talking With Functional Medicine Doctor After Liposuction Surgery

Sustaining Results With Functional Medicine & Lifestyle Intervention  

Beyond the rare risk of infection that is carried with any surgical procedure, there’s another issue that arises with liposuction results: they’re difficult to maintain without making positive lifestyle changes. We highly recommend patients consult with a functional wellness professional/certified weight loss doctor to establish a sustainable lifestyle plan that can help prolong the positive benefits of this procedure.

While repeat liposuction cases do happen, they are increasingly rare when paired with a comprehensive wellness program complete with nutrition planning, attainable exercise goals and a strong support network.

Tradition & VASERlipo: Our Preferred Methods Of Liposuction 

At Donaldson Plastic Surgery, our board-certified plastic surgeons employ both the traditional and VASERlipo methods to help patients achieve their goals. These two methods are excellent because they can be used to address a wide variety of cases. Power-assisted traditional liposuction is great for removing large areas of fat and breaking up some of the more stubborn fat areas. VASERlipo is incredible for more precise contours and treating multiple areas in one session. 

When considering liposuction, it can be reassuring to understand the differences between traditional liposuction, laser-assisted liposuction, and ultrasound-assisted liposuction. Each technique, on paper, has its own advantages and disadvantages, but the best option for you will depend on your individual needs and your surgeon’s preferences. Be sure to discuss your options with a qualified and board-certified plastic surgeon to determine the best course of action.

“People ask about different types of liposuction all of the time. Everyone is trained in different techniques, so all that really matters is what your surgeon is the best at and what they’re comfortable with. I can perform power-assisted liposuction and it can come out just as great as someone who uses a laser. It’s about skill and your aesthetic eye.”

– Dr. Michelle Sieffert

Dr. Michelle Sieffert Author Photo 2

About The Author

Dr. Michelle Sieffert is an expert liposuction surgeon in Columbus, Ohio. Throughout her tenure at Donaldson Plastic Surgery, she has completed hundreds of successful liposuction procedures using both the power-assisted traditional technique and the VASER approach. She continues to hone her craft in an effort to improve patient comfort before the procedure, her efficiency in the operating room and the individual’s recovery process. 

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