Professional associations of physicians specializing in aesthetic plastic surgery, such as ISAPS (International Association for Aesthetic and Plastic Surgery), offer a wealth of information on liposuction techniques on their sites. SAL, UAL, PAL and WAL are just some of the names of the most well-known liposuction techniques. So, when your doctor does not mention one of the above techniques, you might be confused about the process.
We asked Dr Violeta Skorobac Asanin, a specialist in plastic, reconstructive and aesthetic surgery, an expert in body shaping who also holds the positions of ISAPS secretary for Serbia and the presidency of the Association of Aesthetic Surgeons of Serbia (SRBSAS), whether liposuction techniques are important and if so, how much. Here are the answers we received:
There are frequent debates among professionals about the choice of liposuction techniques: which are better, the ones we are for or against, which ones does not serve to present some techniques as prestigious, while downplaying others, but to establish standards and protocols that would be the safest for patient's health.
All types of liposculpture have the same principle of fluid infiltration - mechanical removal of fat cells or emulsifying-aspiration. Fluid (infiltration) and probe break down fat cells into the fatty tissue layer, releasing triglycerides that make a greasy emulsion with liquid, which is then aspirated. This technique is called ultrasound liposculpture (UAL). Due to the removal of a large amount of fat, it requires several days of lymph massage and the obligatory wear of the corset.
What makes each liposuction method different than the next, is the way each one is conducted,
1. SAL or Suction Assisted Liposuction is a standard liposuction method and the oldest technique (since 1982) in which the aspiration is carried out immediately using a vacuum aspirator. The cannules are 2 to 4 mm thick. This method can eliminate excess fat up to 5 kg and is used for smaller and individual regions.
2. UAL or Ultrasound Assisted Liposuction was introduced in 1988 in Italy. The technique is based on the generation of an ultrasonic wave that results in the bursting of the fatty cell, already swollen by infiltration. After the action of the ultrasonic waves, the fat cells break down and create a completely bloodless fatty emulsion. The probes are 2 to 4 mm thick and 25 to 45 cm in length, depending on the part of the body. In this technique, uniform and abundant infiltration is very important in all layers of the skin from the subcutaneous fat to the deep layers of the skin. Over the past 17 years, I have performed this technique in a great deal of patients and in a safe and non-aggressive manner, so that patients felt good after surgery and moved freely without difficulty. This technique lasts longer than traditional liposuction. It can eliminate a higher amount of oily emulsion compared to SAL (my personal maximum is 18 l).
3. PAL or Power-assisted liposuction was introduced in 1997 and uses a special 3 to 5 mm thick cannule that simultaneously vibrates and rotates, using compressed air. Otherwise, the technique is similar to traditional SAL liposuction, it uses moderate infiltration and at the same time eliminates fat. The experience is that this technique is suitable for fibrous tissue and hard fat and can be used in all regions of the body, as well as for submental fat.
4. Laser lipolysis was introduced in 2007 in the United States. Fat is dissolved by the action of thin laser beams (laser fibers) with a smaller diameter of 0.5 to 1.5mm and there is no damage to the skin. The effect of the air leads to retraction and tightening of the skin. By other characteristics, the technique is similar to UAL.
5. In 2008 a new WAL technique (Water assisted liposuction) was developed. This technique uses a two-lumen cannula, with the inner lumen infiltrating the fluid under pressure, and an external lumen at the same time evacuates the excess fatty tissue.
As we have seen, all techniques are based on the same principle, so the basic challenges for any surgeon who performs liposuction in all techniques is the same:
• To sufficiently infiltrate the tissue so that the bleeding is minimal
• To remove the appropriate amount of fat
• The patient's fluid balance remains not disturbed
• To make the patient feel postoperatively and recover quickly
What then does the patient do?
The patient needs to be informed about what liposuction can and cannot achieve in his specific case. In addition, he should choose the right doctor who has enough experience in body shaping. Only such a doctor can help a patient to make a good choice of technique in order to achieve the desirable results: your dream body.
The cost of liposuction in Serbia lies between 1000-7200 EUR, depending on the technique and the amount of fat a patient wants (and is possible) to eliminate.
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Photo: Specialized hospital for aesthetic, plastic and reconstructive surgery Diona Belgrade.