Liposuction – VASER

Liposuction is a procedure that is designed to remove excess fatty tissue (from between the skin and the underlying muscle layer) utilizing tiny incisions. The final result is not really determined by what’s removed, but what’s left behind.

At Dr. John M. Sarbak’s practice, we utilize both conventional tumescent and internal ultrasound assisted approaches to liposuction. The Vaser is our internal ultrasound device of choice. Dr. Sarbak has been performing liposuction with internal ultrasound since 1999. Ultrasonic liposuction was designed to make the process of fatty tissue removal more efficient. The vibrations created from an internal ultrasound device actually cause the fat cells to rupture allowing for easier fat removal than with standard vacuuming techniques. This method is inherently less traumatic and can often lead to decreased recovery times. It is also very proficient at treating more fibrous areas such as the lower back and in patients with scar tissue from previous surgeries. Ultrasonic energy also provides more of a stimulus for the overlying skin to shrink back into place than with conventional techniques.

Liposuction can be performed under local anesthesia for small areas. In general larger areas are treated under anesthesia (delivered by a board certified anesthesiologist) providing a more comfortable and controlled setting. Up to four liters of fatty tissue can be removed in one operation in an office-based operating suite (State of Florida Law). If liposuction is combined with any other procedure the limit is one liter of fat removal. We can and do remove more than four liters in one operation; however, these procedures are scheduled at Indian River Medical Center and usually entail at least one night stay in the hospital.

Many different machines have recently been developed to assist in this process. These include internal ultrasound (Vaser, Lysonix), external ultrasound, mechanical devices (Wet Jet, Power Assisted Liposuction), Internal lasers (Smart Lipo, Slim Lipo), and external lasers (Zerona). The choices can be confusing. All of these devices can be utilized to bring about improvements. However, the single most important determining factor of the overall quality of a patient’s liposuction result is the experience and training of the surgeon performing the procedure regardless of device.

No device can overcome inadequate training and experience. In fact many of these devices have the potential to produce much more harm than conventional liposuction. As a side-note, many of the above devices are very expensive. In order to be profitable they have to be utilized on large volumes of patients which are usually accompanied by large advertizing campaigns. Over the past five years or so companies worried more about their bottom lines than patient safety have been selling their machines to any medical doctor willing to pay for them. It doesn’t matter to these companies whether that doctor is a dermatologist, eye doctor, ear nose and throat doctor, family practitioner, cardiologist or plastic surgeon. Many times these companies will push their devices onto non-plastic surgery physicians, because plastic surgeons as a group through our societies (American Society of Plastic Surgeons and the American Society for Aesthetic Plastic Surgery) are still evaluating the safety and efficacy of those devices. Some of them may indeed prove beneficial, but we as plastic surgeons want to make sure that they are safe and effective before offering them to our patients.

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