Vaser LipoSelection (VL) is a modern and effective liposuction technique that utilizes ultrasound energy to break down the fat and liquefy it before it is removed by vacuum suction. The ultrasound energy is delivered via a rod-like probe that is inserted directly into the fat. After the fat has been liquefied, a suction cannula (tube) is used to remove the fat.
Liquefying the fat confers a tremendous advantage because it greatly facilitates its removal, because liquid fat is easier to suck out than more solid fat. Thus, the fat can be more thoroughly removed. This ensures that the debulking objective of liposuction can be well achieved. In addition, from a body contouring standpoint, it is easier to create smooth contours when removing the fat, because liquid fat is easier to remove uniformly than solid fat. This advantage helps to minimize the risk of post liposuction uneven contours.
Another important benefit of the ultrasound energy is that it heats up the collagen fibers that connect the underside of the skin to the muscles below the fat. The heat causes the collagen fibers to shorten, pulling the skin inwards and effectively tightening the skin.
VL is very versatile and can be used to treat virtually any part of the face or body that has excess fat. Apart from commonly treated areas such as the abdomen, waist, love handles, saddle bags, inner thighs and arms, it can also be used to address the double chin, face, bra fat, knees and gynecomastia (unwanted breast tissue in the male).
Finally, VL can used to create highly defined abdominal contours in both male and female patients, such a tube packs in females and six packs in males.
Dr Huang has more than twenty years of experience with liposuction and more than fifteen years of experience with VL, so you can rest assured that you will be in the hands of an experienced user of this technique.
A few small incisions (less than one cm each) are made in strategic locations to minimize visibility of the scars. The areas to be addressed are first infiltrated with a saline solution containing long acting local anesthetic and adrenaline. The fluid causes the area to become swollen (tumescent), causing physical expansion and loosening of the fat and constriction of blood vessels by pressure. The tumescent effect thus facilitates fat removal and reduces bleeding. The local anesthetic ensures that after the surgery pain is well controlled. The adrenaline further reduces bleeding by causing blood vessels to go into spasm.
Next, the ultrasound probe is inserted into the fat through the same incisions and moved back and forth in a fan shaped pattern while the ultrasound energy is delivered. After this, a suction tube (cannula) is inserted and moved back and forth while the vacuum suction removes the liquefied fat. The wounds are then closed with fine sutures.
The length of the procedure depends on how many areas are operated on and the amount of fat removed. It can range from less than an hour for a single small area to many hours for large or multiple areas. Small areas can be carried out under local anesthesia or intravenous sedation, whereas large and multiple areas are best addressed under general anesthesia. It is completed as a day surgery procedure when less than two liters of fat are removed in total. For larger amounts of fat removal, hospitalization is required.
Pain after surgery is mild and well controlled with oral pain medication. Moderate swelling and bruising are common side effects. The bruising normally takes two to three weeks to subside. About half the swelling will usually have subsided by two weeks, and about seventy percent by one month. Downtime ranges from a few days to about one week, depending on the amount of work done. Stitches are removed after one week.
Compression garments are worn over the treated body parts for a total of six weeks, initially all the time for the first two weeks, then about half the time for the next two weeks, followed by nightly for the last two weeks.
Exercise can be resumed at one month after surgery. By three months, about ninety percent of the final result can usually be seen, with the final result being attained at about six months postoperatively.
The results are normally long lasting as long as body weight is maintained.
Risks associated with liposuction include blood loss, infection, uneven contours, and skin burns. Blood loss is carefully managed by technical measures that minimize bleeding during the procedure. If large volumes of fat are to be removed, a planned blood transfusion using the patient’s own blood previously donated to the blood bank specifically for this purpose is carried out. This is known as autologous blood transfusion, and the blood is transfused immediately after the surgery. Another useful blood preservation technique that is used for large volume liposuction is hemodilution. In this technique, one or two units of blood are drawn out by the anesthetist at the start of the operation, and transfused back into the patient at the end of the surgery. These types of proactive management of blood loss ensure that the patient does not lose excessive amounts blood from the procedure, and maintains the safety of the procedure.
Infection is rare, and is prevented by attention to sterility during the procedure and prophylactic antibiotics.
The problem of uneven contours caused by uneven fat removal is minimized by the liquefying effect of the ultrasound energy on the solid fat.
The ultrasound energy of Vaser translates into heat energy. This is what produces the skin tightening effect. However, excessive heat energy applied to the skin can cause burns. Therefore, several technical precautions are observed in using this technology that ensure that the risk of this complication is low.