The Evolution of Liposuction Techniques and Technology

February 18, 2019

Liposuction is the most popular cosmetic surgery procedure in the world for rhinoplasty and breast augmentation. It allows to suck up excess fat cells accumulated in certain areas (thighs, belly, back, arms, love handles, calves, ankles, knees ...). Discover its indications, its techniques, the suites and the cost of this operation.

Surgical technique created by Dr. Yves Gérard Illouz in 1977, liposuction is today the most widely practiced aesthetic procedure in the world. Liposuction is by far the only reliable way to effectively remove localized and refractory fat surpluses from sports diets and activities. Whatever the origin of the fat deposits removed, the results are in the great majority of cases very satisfactory and definitive.

Early development of liposuction?

Invented by Dr. Yves Gérard Illouz in 1977, liposuction involves the introduction, through small incisions, of small cannulas (3-4 mm) of rounded tip (non-cutting) foam perforated at their ends with several orifices. Connected to a closed circuit with negative pressure, they allow a harmonious and non-traumatic aspiration of excess fat cells. Knowing that these cells (adipocytes) do not have the ability to multiply, the result will be final.

Advancements in Instrumentation and Technology

Water jet assisted liposuction (WAL)

With the water-jet-assisted liposuction, the surgeon loosens the fatty tissue in a tissue-friendly manner with a wafer-thin stream of water. It requires up to 70 percent less tumescent solution, which limits saline and drug burden. The body is not absorbed by large amounts of fluid. With a fine, fan-shaped water jet, the surgeon deliberately releases the fat cells from the environment. Through a second channel, the fat is removed simultaneously with the previously introduced liquid. This also allows the treatment of small and problematic body areas. At the WAL, the surgeon controls the natural shape and contours of the body at all times and can thus assess the end result very realistically during the operation. Even small bumps can be eliminated. Dents are thus avoided more safely. Of particular importance is the WAL method if the patient wishes lipo-transfer - for example, for breast augmentation with autologous fat. In addition, waterjet-assisted liposuction is often performed in lipoedema, as this method usually allows very large amounts of fat to be sucked off.What advantages does the method have for patients? Till Scholz in an interview .

Vibration-assisted liposuction (VAL)

The vibration-assisted liposuction or "Power Assisted Liposuction" (PAL) called, is particularly suitable for sensitive skin types and complex body zones such as knees and ankles, as this method, the tissue is spared to a greater extent than in the classic liposuction. After introducing the tumescent solution, oscillating cannulas (about 6,000 oscillations per minute) are introduced via small skin incisions. The vibration causes a faster bursting of the fat cells than with a classical liposuction.

Ultrasound-assisted liposuction (UAL)

The ultrasound-assisted liposuction is based essentially on the classic liposuction method using TLA. Ultrasound probes are inserted into the area to be aspirated, causing the fat cells to burst and liquefy. Because the fabric is heated to a high degree, an additional tightening effect can be achieved with this method.

Laser assisted liposuction (SmartLipo)

A further development of ultrasound-assisted liposuction is laser-assisted liposuction (LAL). Instead of ultrasound probes, laser probes are introduced into the area to be treated. The delivery of laser pulses of different wavelengths liquefies the fat cells. The LAL is particularly suitable for solid body regions such as the back area.


A large number of areas of the body can benefit: belly, saddlebags (trochanteric region), hips, thighs, knee, calves, ankles, arms, back ... and even at the level of the face and neck for double chin in particular. Surgery for gynecomastia (a hypertrophy of the breast in men) may include liposuction to remove excess fat. The craze for this procedure is due to the fact that people today feel much less guilty of having resorted to an aesthetic intervention to find a harmonious silhouette. Especially since it is now a proven technique, which has more than 40 years of decline, and predictable results.


Be careful though, liposuction is not a cure for obesity . It is an alternative to thinning and can only be practiced in well-defined areas where exercise or dieting is ineffective. The goal is not a thinning but the search for a harmony of shapes and silhouette, we also speak of "liposculpture".

Cosmetic surgeons always advise to be closest to their ideal weight before performing liposuction. Thus, only fats that could not be eliminated by diet or exercise will be treated and, moreover, much more effectively.

Using liposuction does not save you from a healthy lifestyle. Indeed, if the liposuction of fat is effective and the final results, the patient who emerges from a healthy lifestyle may however see the accumulation of fat occur in areas that have not been treated. Good advice: eat healthy, exercise regularly, avoid stress , tobacco and alcohol ...

The plastic surgeon will be able to make sure of the quality of the skin of the candidate to the surgery, of his good elasticity, without relaxation in order to avoid a result with unsightly irregularities (waves, folds).

The procedure of the intervention

For the majority of people, the procedure is very short, between 20 minutes and 1 hour, and is most often performed on an outpatient basis, although in some cases an extra night of hospitalization is required, especially for the withdrawal of more large amounts of fat.


One to two prior consultations with the plastic surgeon are essential in order to clearly define the patient's goals and the relevance of the request. The surgeon performs an interrogation then a careful examination of the areas to be treated. The quality of the skin, especially its retractability potential, is carefully examined by the surgeon. In fact, poor skin elasticity does not guarantee a satisfactory result, the skin having to shrink on a reshaped and refined silhouette.

In cases of substantial skin laxity in the abdomen, the surgeon has other operative procedures to conduct a retightening of the skin ie abdominal dermolipectomy also called abdominoplasty or tummy tuck where, this time, skin and fat are removed.

If it is not a repair intervention (cases of diseases where there is a disorder of the distribution of fats called lipodystrophy), a period of 15 days between the first consultation and the operation must be respected ( this is a mandatory reflection period for all aesthetic acts). Before the operation, a visit to the anesthesiologist is mandatory in case of general anesthesia.

A detailed estimate and an operative record are given to the patient.


A preoperative blood work is performed according to the prescriptions:

  • It is recommended to stop smoking at least one month before and after surgery to avoid impairing healing;
  • Taking aspirin is prohibited during the 10 days preceding the operation;
  • Stopping oral contraception may be required in case of other risk factors for phlebitis (obesity, poor venous status, coagulation disorders);
  • The skin will be disinfected with an antiseptic solution or soap applied the day before and the morning of the operation;
  • It is recommended to eat nothing or drink 6 hours before the operation in case of general anesthesia.

The cosmetic surgeon recommends a convalescence of a week or so. For major liposuction, the cosmetic surgeon prescribes anticoagulants. Moderate pains can be felt but are alleviated by taking conventional analgesics. Fatigue often follows the procedure. As incisions are very short, scars are usually minimal.

The recovery time is proportional to the amount of fat removed. A work stoppage of 3 to 10 days is advisable. Eviction of activities that are too intense or sporty is recommended for a month. The son being absorbable, there is no need to remove them. The appearance of edema is traditional but wearing the compression panty allows its attenuation after one month, then its total resorbability after 6 months. The cosmetic surgeon may possibly advise lymphatic drainage sessions for certain topics.

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