Liposuction: the differences between the main types of surgery

Localized fat, dissatisfaction with breast size, increased expression lines… These are just some of the aesthetic issues that have led many women to plastic surgery clinics.

A latest survey by the International Society of Aesthetic Plastic Surgery (ISAPS) pointed to Brazil as the world leader in plastic surgery, with liposuction being the most performed procedure in the country.

André Colaneri, plastic surgeon, comments that plastic surgery has had a growing demand, by practically all types of patients: women, men, young people, middle age, etc. “I believe this is due to the increasing safety of surgery, better purchasing power of the population, greater number of specialist doctors and the consequent fall in costs, in addition to frequent media coverage”, he says.

The plastic surgeon adds that Brazil and the US are the largest and most qualified plastic surgery centers in the world.

“And liposuction is in fact the most performed plastic surgery in Brazil. As it is a tropical country, with frequent exposure of the body, concerns about excess fat increase. In Brazil, there is also a worldwide trend of increasing weight of the population, due to a sedentary life and a lot of work and with little time for leisure and exercise. With that, liposuction appears as an alternative way to lose unwanted fat”, highlights Colaneri.

Although most people have heard about liposuction, the procedure is still the subject of doubts, fears and even misleading advertisements. Many people do not know, for example, what is the difference between liposuction and liposculpture. Others have already heard about laser liposuction, minilipo, among other names, and did not understand which was the most suitable for each case.

André Colaneri explains that, like medicine in general, plastic surgery has also evolved a lot. Thus, today, there are indeed different types of liposuction, each one to better meet the needs of patients. In this sense, it is essential to understand the similarities and differences between the main ones.

1. Liposuction

According to Colaneri, liposuction is always a surgery that removes fat through cannula suction. “He placed a cannula and aspirated fat, it’s liposuction, no matter what name is given”, he says.

What can change, as the surgeon explains, is the type of cannula and the anesthetic size. “The liposuction technique changes depending on the type of cannula used (laser lipo, ultrasonic lipo, vibroliposuction, traditional lipo). The anesthetic size does not change the technique, although the media wants to give different names to liposuction with local anesthesia (minilipo, hidrolipo, lipo-light, etc. – this is all the same liposuction with local anesthesia)”, he highlights.

Surgical time and anesthetic size (local, local with sedation, peridual or general anesthesia), according to Colaneri, vary according to the amount of fat and areas to be aspirated. “A half-liter lipo can probably be done with local anesthesia, around 40 minutes. A 4-liter lipo, on the abdomen, flanks, back and arms, will probably take 4 hours, with general anesthesia”, he exemplifies.

Pre and postoperative

Colaneri explains that the preoperative period is like any surgery:

• The person should undergo tests to assess the surgical risk;
• Avoid taking anticoagulant drugs 14 days before;
• Shave the hair from the area to be operated (if any).
• For surgeries with epidural or general anesthesia, you should stop smoking and take hormonal contraceptives to reduce the risk of thrombosis.

For the postoperative period, the plastic surgeon advises:

• Lymphatic drainage and ultrasound are necessary to reduce swelling and the formation of fibrosis;
• Use compressive mesh for about 45 days;
• Do not exercise in this period of about 45 days;
• Avoid heat and hot, long baths.

“Of course, the postoperative period varies according to the size of the surgery (this is for medium and large surgeries). Lipos with local and small anesthesia have faster recovery”, adds the doctor.

2. Liposculpture

Colaneri explains that liposculpture is a liposuction in which, after the fat is removed and treated, it is grafted to give volume to another area (such as the buttocks, depressions, facial creases, cellulite filling, etc.). “Part of the grafted fat is absorbed (around 50%), but what remains is usually well accepted by the body, since it is the patient’s own fat”, he says.

Liposculpture usually lasts around half an hour longer than liposuction, as Colaneri explains, due to the need to apply the graft.

Pre and postoperative

Colaneri explains that the preoperative period for liposculpture is the same as for liposuction:

• The person should undergo tests to assess the surgical risk;
• Avoid taking anticoagulant drugs 14 days before;
• Shave the hair from the area to be operated (if any).
• For surgeries with epidural or general anesthesia, you should stop smoking and take hormonal contraceptives to reduce the risk of thrombosis.

For the postoperative period, the plastic surgeon advises:

• Lymphatic drainage and ultrasound are necessary to reduce swelling and the formation of fibrosis;
• Use compressive mesh for about 45 days;
• Do not exercise in this period of about 45 days;
• Avoid heat and hot, long baths.

3. Vibroliposuction

Colaneri explains that vibroliposuction is a type of liposuction in which a cannula with a vibrating mechanism is used, which facilitates penetration of fat and its removal. “The movements are usually softer, since there is not so much resistance to move the cannula. With this, the fat comes out easier, with less effort and the bleeding is usually less,” he says.

The surgeon adds that the indications are the same as for traditional liposuction: localized fat accumulation.

As it is a liposuction, explains Colaneri, the surgical time is basically the same as in traditional liposuction (depending on the amount of fat and areas to be aspirated).

Pre and postoperative

Colaneri adds that, as it is a liposuction, pre and post-operative are the same as in the case of traditional liposuction.

4. Laser liposuction

Laser liposuction, according to Colaneri, is liposuction in which, before aspirating the fat through any type of cannula, a cannula is used that emits a laser at its tip. “The laser burns the fat, liquefying it and releasing heat. The heat burns small vessels, reducing bleeding. The heat, in contact with the skin, causes greater collagen retraction, enhancing skin retraction and reducing slight sagging”, he says.

“It does not treat moderate or intense sagging, nor does it prevent skin removal if abdominoplasty is indicated (which occurs in cases of moderate or intense sagging)”, adds the surgeon.

The indication, according to Colaneri, is for patients who, in addition to having localized fat, have mild sagging or who need to enhance skin retraction.

The surgeon adds that ultrasonic liposuction is basically the same thing. “But a cannula is used in which the tip releases ultrasound and not laser. The mode of action is also releasing heat and the indication, the same as laser lipo,” he says.

Surgery time is slightly longer than liposuction, without laser. “That’s because there is an extra surgical time, that of passing the laser, before starting liposuction. The time is usually around 15 minutes longer per liposuction area”, says Colaneri.

Pre and postoperative

Pre and postoperative are the same as in the case of traditional liposuction and will be guided by the surgeon.

5. Hydrolipoclasia

Colaneri emphasizes that hydrolipoclasia is not surgery. “It is a treatment in which a solution of saline solution and distilled water is injected to stiffen (swell) the fat, followed by the application of ultrasound. Fat with a greater amount of liquid is more predisposed to have its cells ruptured by ultrasound. The fat is absorbed by the body afterwards”, he says.

This type of treatment, according to the plastic surgeon, is only indicated for little fat in small areas and is less effective than liposuction (in which case the fat is removed).

“In cases in which liposuction is performed after the use of ultrasound, it is called aspiration hydrolipoclasia (HLPA)”, adds the doctor.

Pre and postoperative

In the preoperative period, explains Colaneri, the person should not take anticoagulants. “For the postoperative period, lymphatic drainage and ultrasound sessions are indicated”, she says.

6. Minilipo (hydrolipo, light-lipo and tumescent lipo)

Minilipo, hidrolipo, lipo-light, lipo tumescent, according to Colaneri, are all non-technical marketing names for liposuction with local anesthesia. “Often they are performed by non-specialist doctors by the Brazilian Society of Plastic Surgery and in a non-hospital environment”, he says.

But, as Colaneri explains, they are, yes, liposuction. “However, to do it with only local anesthesia, with the patient awake, it needs to be little fat and in small areas; do several sessions to cover many areas and get more fat. It is more dangerous than just having surgery, with a larger anesthetic and in a hospital”, he highlights.

Pre and postoperative

Because it is a smaller surgery, where a small area is operated and little fat is removed, recovery is faster. “The compression garment should be used around 21 days to 1 month. Drainage and ultrasound are also indicated. Exercises can be performed after 30 days”, highlights Colaneri.

What to Consider Before Getting a Lipo

Every patient must take into account that liposuction is surgery and must be performed by a specialist. “You don’t deliver with an orthopedist, or treat a fracture with a pediatrician. So, do lipo with a plastic surgeon!”, guides Colaneri.

According to the surgeon, according to Resolution Number 1711 of the Federal Council of Medicine, liposuction is a technique in the arsenal of plastic surgery, and the surgeon must perform it. “Aspirated volumes should not exceed 7% of body weight,” he adds.

To make sure the doctor is a specialist, check if you are a surgeon by the Brazilian Society of Plastic Surgery. And remember: all surgery performed in a hospital environment is safer.