What is Ultrasound Liposuction?

Liposuction is a medical procedure used to remove subcutaneous fat, or fat lying just below the skin, from a patient in order to improve his or her appearance or, in some cases, health. Ultrasound liposuction accomplishes the same task as standard liposuction, with the exception that high-frequency sound waves are first applied to the area in order to break up and partially melt the fat, making it easier to remove. Ultrasound liposuction has both pros and cons, based on the frequency of complications involved with the procedure and their supposed causes.

Standard liposuction involves the insertion of a tube under a patient's skin. A suction force, referred to as negative pressure, is then applied to the tube, which sucks the fat through the tube and out of the body. During this procedure, it is possible for unintended damage to occur, as the suction literally rips the fat from the surrounding tissue. Ultrasonic liposuction was first developed to limit this potential damage by first breaking up and partially melting the fat so that it could be more easily, and safely, removed.

There are two methods of ultrasound liposuction: external and internal. The external method involves generating high-frequency sound waves, which are then passed through a paddle-shaped instrument. The paddle is applied to the outside of a patient's skin, allowing the sound waves to penetrate the skin and disrupt the fat lying just beneath it, and the fat is then removed in the same manner as it would be in standard liposuction. When using the internal method, the sound waves are passed through a metal rod that is inserted directly into the layer of fat beneath the skin. The fat is then affected and removed in a manner identical to the external method.

Debate over ultrasound liposuction has arisen in the medical community. The primary factor is that while the sound waves make it less likely that a doctor will cause unintended injury during a liposuction procedure, the sound waves themselves are not limited to damaging fat cells. The energy created by the sound waves also creates a certain amount of heat in the body. Though this heat is intended to partially melt the fat to make it easier to remove, it can also severely damage other tissues, such as skin, nerves and blood vessels. Complications that can occur as a result of ultrasonic liposuction include blood clots; tissue necrosis, which is dead tissue; nerve damage; seromas, which are fluid-filled gaps in the tissue; Reston foam blisters; and other tissue-specific burn-related damage.

Proponents of the procedure claim that it is the physician's skill, or lack thereof, that accounts for most of these complications and point to a specific study: "Ultrasound-assisted lipoplasty: a clinical study of 250 consecutive patients; Plastic Reconstructive Surgery 101:189-202, 1998," which claims the procedure to be safe. Detractors of the procedure claim that the nature of the sound waves themselves is the cause of damage. They also point to the same study, noting that of the 250 patients in the study, 66, or 26.4%, suffered serious complications as a direct result of the sound waves used in the procedure. In any case, ultrasound liposuction has seen a continuous decline in its use since its initial introduction, with many physicians electing instead to use either standard liposuction or the newer, more precise, laser-assisted liposuction.