R.S.B. Dermatology, Inc.  

                                                             & Cosmetic Surgery Center  

Robert S. Bader, M.D.

Board Certified in Dermatology • Ivy League Trained Physician • Fellowship Trained in Cosmetic Surgery and Mohs' Surgery

Official Dermatologist & Dermatologic Surgeon for the Florida Panthers NHL Hockey Team • Voted one of America's Best Dermatologists 2004-2006

Instruments

Infiltrating needle

The infiltrating needle, which is occasionally called a Klein needle, is actually not a needle at all. It a blunt (not sharp) hollow tube which has many tiny holes on one end. The tumescent fluid (fluid which numbs the area) is delivered to the skin though this hollow tube.

Cannulas

A cannula is a hollow tube with one or more holes on one end. The cannula is attached to a suction machine or syringe to create a vacuum. The cannula is moved back and forth in the fatty layer and the fat is sucked out. There are many different kinds of cannulas. Each surgeon usually has his/her own favorite cannula

1. Diameter-Cannulas come in various diameters (thickness). Some surgeons prefer to use larger cannulas (wider) as it may be easier to remove the fat. Some surgeons believe that using larger diameter cannulas results in more post-operative bruising and an increased likelihood of irregularities in the skin (lumpiness or waviness). Most commonly, 3- or 4-mm diameter cannulas are used.
2. Length-Cannulas come in various lengths. The actual length of the cannula has minimal effect on the outcome of the procedure. The cannula only need be long enough to reach the entire area. A cannula that is too short will require multiple entry sites (cuts) and more scars.
3. Tips-There are many different types of tips available on cannulas. Most surgeons use a cannula that is shaped like a bullet, having a rounded, blunt tip.
4. Ports-The ports are the holes at the end of the cannula through which the fat is sucked out. Some surgeons prefer to use ports only on one side of the cannula, while others have ports on three sides. There are many different variations of port placement and number of ports available to surgeons.

Suction Machine

Most surgeons use a machine to create the vacuum necessary to remove (suck out) the fat. Some surgeons believe that this creates more trauma to the fatty layer and may result in more bruising.

Syringe (syringe-assisted liposuction)

Some surgeons use a syringe to create the vacuum necessary to remove (suck out) the fat. This is believed by some to be less traumatic and cause less bruising than the machine suction method. Some surgeons believe that the amount of fat removed can be measured more precisely than removal using a suction machine.

External Ultrasonic Liposuction

 A device is applied to the skin that sends ultrasonic waves through the skin to the fat. It was hoped that such a device, if used before liposuction, would "melt" fat, thus making it possible to remove more fat during the liposuction procedure. Unfortunately, most studies have shown that there is no advantage of external ultrasound when compared to traditional tumescent liposuction when comparing final clinical results. Some surgeons believe that there is less bruising when external ultrasound is applied following liposuction. In summary, external ultrasound has been largely abandoned.

Internal Ultrasonic Liposuction

A special cannula is used that vibrates at extreme high speeds, thus creating ultrasonic waves. It was hoped that these fast vibrations of the cannula would "melt" fat and allow the surgeon to remove more fat during the liposuction procedure. Unfortunately most clinical studies have proved that there is no advantage of internal ultrasonic liposuction when compared with traditional tumescent liposuction. In fact, there have been reports of increased burns to the skin and perforation of viscera (internal organs) when compared with traditional tumescent liposuction. Therefore, internal ultrasonic liposuction has been largely abandoned.

Power-Assisted Liposuction ("Power Liposuction")

A device is used that attaches to the cannula. The cannula then moves back and forth quickly. This movement differs from the movement achieved using ultrasound. Initial studies have shown no long-term benefits using power-assisted liposuction. Some short term advantages may include slightly decreased bruising for the first few days following liposuction and reduced operative time.

Send mail to webmaster@drbader.com with questions or comments about this web site.
Copyright © 2005 R.S.B. Dermatology, Inc.
Last modified: 09/26/07