Skin Clinic MD

Liposuction: Is tumescent or laser liposuction better?

Plastic Surgeons today are using various types of liposuction. I prefer tumescent liposuction with thin cannulas instead of laser lipo. This is a manual method of liposuction that I believe yields the best liposuction result because the surgeon has the most amount of control.

Traditional tumescent liposuction

Tumescent liposuction has been around well over a decade and allows the surgeon to have complete control of the amount of fat being taken out. The  tumescent liposuction technique is mechanical as it involves the surgeon using a long rod called a cannula to extract the fat. The motion is a continuous back and forth rhythm to remove the fat. Since the motions are repeated over the course of 1-3 hours, your surgeon must be in good aeroebic shape to give YOU a good result!  Honestly, this is one reason why some surgeons do not use this technique!

While the basic technique used in tumescent liposuction has not changed, the size of the cannulas used to extract the fat have gotten much slimmer over the years. In the past, surgeons used larger 5mm cannulas , but  this sometimes resulted in lumpy or uneven results. Most surgeons now use 3mm or smaller cannulas.  This will increase the length of the surgery as it does take longer to remove the fat from small cannulas, but the results are well worth the longer surgical time!  The thinner 3mm cannulas produce excellent and consistent liposuction results. With thin cannulas, traditional tumescent liposuction can achieve the smoothest and most even result possible . 

Laser and ultrasonic liposuction

The new technologies for liposuction technique  include laser liposuction and ultrasonic liposuction. They emit high energy that liquefies and destroys tissue around the cannula. I do not think these technologies are worth the risks they pose to the patient. Both of these techniques essentially melt the fat under your skin. As they melt the fat, other tissues are damaged. I am not a fan of damaging tissue or fat cells that are not being extracted.  Often times, the extracted fat could be used for fat injections to rejuvenate another area of the patient’s body.  These technologies destroy that possibility. Additionally, these high energy ultrasound and laser technologies can have complications such as burning, and results can be very unpredictable as it is impossible to tell how much damaged tissue is left behind.

Best technique is tumescent liposuction with slender cannulas

In summary, the best technique available for liposuction is the  traditional tumescent liposuction technique with small diameter cannulas. It has stood the test of time. Sometimes the latest is not the greatest. I perform hundreds of liposuction procedures each year and I do not remember the last time a patient asked for a touch up for lumpiness or unevenness. Thin cannulas give you the best chance to get the result right each and every time!

Ricardo L Rodriguez, MD