Lower body contouring by dry, wet, superwet and ultrasound liposuction

Before the advent of liposuction and ultrasound therapies, the plastic surgery procedures that fall into the general cosmetic category of lower body contouring were very invasive and painful. The plastic surgeons often manually removed fat through long incisions beneath the buttocks that often took months to heal. But the modern procedure is noninvasive with a much reduced recovery period. Liposuction has become the mainstay of all body contouring procedures.

These procedures were, and still are, called the thigh lift (for lifting and removing fat from the inner thighs), flankectomy (for lifting the outer thighs and hips) and the buttock lift (for removing fat and lifting the buttocks.) The only difference today is that instead of having to make long lateral incisions beneath the buttocks for instance for a thigh lift the doctors can make a series of much smaller keyhole incisions through which fat is vacuumed out of the body.

To understand what is involved in lower body contouring you need to know a little bit about liposuction (also sometimes referred to as lipoplasty.) These two terms simply refer to a surgical procedure where an incision is made and the area beneath the skin is flushed out with lidocaine (a local anesthetic), saline (salt water) and epinephrine (a drug that narrows blood vessels and prevents bleeding during surgery.) Then fatty tissue (known as fascia) is suctioned out from beneath the skin’s surface with a wand that resembles a small vacuum hose. This hose is called the cannula. Depending on how large the area is to be vacuumed by the cannula, the patient may have skin removed or “pulled up” surgery and secured by surgical stitches.

There are basically four types of liposuction that are used for lower body contouring: dry liposuction, wet liposuction, superwet liposuction and ultrasound liposuction.

Dry liposuction is rarely used, the wet technique is gaining popularity since last few years. In this case the body is not flushed out with fluids and the fat is simply removed from the tissues by prodding the cannula through the tissues. Some plastic surgeons offer this technique to patients with a history of heart problems, fluid in the lungs or edema.

Wet liposuction involves the injection of a small amount of fluid (usually consisting mostly of the blood inhibiting compound epinephrine.) This method is usually used on patients that require less of a lift or a lift in only one area such as the buttocks only or the flanks only.

Superwet liposuction is generally used on individuals who are having the flanks, thighs and buttocks lifted all at once. This theory behind superwet liposuction is that the more fluid that is injected, the less blood loss that is likely to occur.

Ultrasound lower body contouring is a modified version of the superwet liposuction. After the tissues are saturated with saline, epinephrine and lidocaine a special type of cannula that vibrates at a high frequency is inserted under the skin and used to liquefy the fat before it is removed. This allows for the fat to be more easily vacuumed out from beneath the skin. This is a sophisticated noninvasive body contouring procedure.

Before you decide to have any of these procedures you should be aware that there is a potential for side effects.

• Dry liposuction poses a greater risk of “bleeding out”, bruising and cell death due to the lack of a bath of protective saline and other fluids.
• Superwet liposuction carries the danger of having the patient drown in bodily fluids and supplementary fluids if they are not carried out of the body fast enough. The overload caused by injection of fluid can be very hard on the heart, which cannot pump fast enough to aspirate the fluid through the lungs on its own. Also quite serious is a phenomenon called seroma in which pools of body fluid accumulate beneath the skin causing pockets of infection.
• Ultrasound lower body contouring is a relatively new procedure and nobody really knows the long-term effects of ultrasound plastic surgery on body tissues. As these ultrasound wands and cannulas are very hot there is also the risk of severe burns if the wand is not handled correctly by the plastic surgeon.

Other risks that are associated with all three types of surgery are infection, necrotizing fascitis, embolisms, cardiac arrhythmia, edema, deadening of the nerves, puncture wounds and of course scarring.

Your best approach to avoid these side effects is to choose a plastic surgeon that is well accredited and trained in the use of liposuction cannulas and ultrasound equipment.