How many types of liposuction techniques have been introduced throughout the years?
Liposuction technology was brought over from Europe in the early 1980’s. Through the years, it underwent many advances and refinements both in technique and cannula design to create better results, fewer complications, and less blood loss.
The tumescent or super wet technique was developed which decreased blood loss to less than 1%. Multiple technologies were developed including PAL (power assist liposuction), a mechanical break up of fibrous tissues and release of fat cells, ultrasonic liposuction which was greatly refined with the introduction of the VASER (vibration amplification of sound energy at resonance) technique in 2002. Laser lipo like Smartlipo, Airsculpt lipo, Tickle lipo and others were introduced along the way. Many of these fell out of favor due to less than expected results.
At Bellevue Plastic Surgeons, Dr. Marosan was an early adopter of the VASER liposuction technique since 2003. He was the first surgeon in the Pacific Northwest to introduce and use the VASER technique. This technology stood the test of time while other technologies which were introduced, later would fall out of favor in many plastic surgery practices.
VASER liposuction vs traditional liposuction, what is the difference?
All types of liposuctions involve two basic steps: 1. Infiltration of the tumescent solution into the fat compartments and 2. Remove the fat with a cannula that is connected to a suction machine. VASER liposuction causes ultrasonic disruption of the fat, emulsifies it, for easier and more precise removal with the cannula. This can be applied in both the superficial and deep fat compartments. Traditional liposuction is mainly a fat reduction technique within the deep fat compartment which can make one thinner, but not athletic or sculpted. There’s more bruising, tissue trauma and longer healing involved as well with the traditional technique.
How does VASER work?
The VASER handpiece has a solid probe that can have 1-5 rings at the tip of the probe that emits the ultrasound energy. The ultrasound energy can be set from 20-100% depending on the area of being delicate to thick scarred areas. It can be used in pulse mode in delicate superficial areas and continuous mode in the deep fat compartment or scarring from previous liposuction surgery. The extracted fat is intact, and pure, and the VASER prevents injury to the nerves and blood vessels. It is a more controlled liposuction which requires a well-trained surgeon in advanced technique. Once the fat is “loosened” it can be extracted safely with the VENTEX cannula.
Does VASER destroy fat?
No, fat is preserved and can be used to transplant it to the buttocks, hips, breasts, face or any other body area where significant contour deformities are present and need to be corrected. Dr. Marosan often combines VASER liposuction with fat transfer in his practice. Contrary to the VASER, Laser (Smartlipo) liposuction destroys fat. VASER liposuction is unique, it disrupts the connection between your fatty tissue and the muscles underneath without hurting your underlying healthy tissue.
What is High-Definition Liposuction (VHD)?
As a Total Definer plastic surgeon, Dr. Marosan trained extensively with Dr. Alfredo Hoyos of Bogota, Colombia, the inventor of the VHD. This technique goes beyond the basic tumescent liposuction technique of fat removal only. It truly sculpts the body based on the underlying muscle and bony anatomy of the person. It is for men and women who are fit and with a BMI less than 30. Best results are achieved at a BMI of 23-25.
Hi definition liposuction allows Dr. Marosan to remove fat from the superficial fat layer where different muscle groups merge to bring out the natural depression or shadowing of the muscles. All muscle groups can be defined over the abdomen, waist, hips, chest wall, back, arms and legs. This is a highly specialized technique, with many benefits which requires the intimate knowledge of underlying static and dynamic muscle groups and their interactions.
What is the technique used at Bellevue Plastic Surgeons?
Dr. Marosan prefers to use the VASER Hi Def Lipo technique in almost all patients who are good candidates, and those who have scarring from previous liposuction, and makes it difficult to achieve a good result otherwise.
What is different at Bellevue Plastic Surgeons vs other clinics?
Dr. Marosan specialize in advanced body contouring techniques while most clinics just do fat reduction basic techniques. He trained and operated extensively with Dr. Hoyos, the inventor of the VHD. He uses different size straight and curved stiff cannulas which are non-bendable and can intimately follow the curves of the human body for reshaping.
What is the postop recovery like?
At Bellevue Plastic Surgeons, we place the patient into a compression garment right after surgery. We also place thick foam pads underneath the garment. For full body VHD, Dr. Marosan uses drains to remove excess tumescent fluid from the tissues and preserve the definitions he created. The garment is worn for 4-6 weeks depending on healing.
When can I return to work?
This depends on the extent of the surgery, how long are you on narcotic pain medication and the type of work you do. Dr. Marosan will go over these time tables once you decide about the surgery and its extent. Since this is a significant investment into yourself, it is Dr. Marosan’s duty to strictly abide by the clinic’s protocol to achieve the best long term result. It might be to your benefit to allow your body to heal for 2-3 weeks before returning to work.
When can I return to exercise after VHD?
You can be up and walk from day one. Dr. Marosan recommends healing time for 4-6 weeks prior to returning to the gym. You will look better defined than before surgery in spite of your workouts.
Are the results permanent?
Results can be maintained long term if you maintain your weight, eat a healthy diet and exercise regularly. In his extended experience with this technique, Dr. Marosan notices that his patients look better in one year and even better at ten years post-surgery.
Are there any risks or side effects?
VHD is a surgical procedure even though the small skin insertion poke holes for introduction of the suction cannulas are imperceptible and hidden in skin creases. There’s expected swelling, minimal bruising, potentially loose skin in higher BMI individuals. Selecting the right candidate, based on age, skin elasticity, having realistic expectations, not being overweight and already following a healthy life style makes the potential risks and complications very rare. Infection, hematoma, bleeding, asymmetry, skin pigmentation changes and irregularities are about 1-3% for this procedure and even less than that at Bellevue Plastic Surgeons.
Is the VASER procedure painful?
Dr. Marosan does his surgeries in his Quad-A accredited operating room suite in his private clinic using the tumescent solution for local anesthesia, intravenous sedation and light general anesthesia for your comfort. You will not experience pain during and immediately after the procedure. You are discharged home in about half an hour after surgery.
How long is the VHD surgery?
This depends on the areas treated. If it includes the whole torso circumferentially to be sculpted and fat transferred to the pectoralis in men or buttocks in females, it can take 4-6 hours.
Is Coolsculpting a body sculpting procedure?
No. Non-surgical fat reduction is not interchangeable or as effective as surgical body sculpting. Coolsculpting or other non-surgical modalities freeze or heat the fat in an area where the pads are applied. This creates fat death or necrosis over time. Multiple sessions are required. The term “body sculpting” is often used by medspas, or surgeons who market it to attract patients, but have no training or understanding of VHD.
Where do I start?
If you are interested in an athletic, sculpted youthful male body or an hourglass female body, consult Dr. Marosan for an in-depth discussion and evaluation by filling out our consultation request form.
By Dr. George Marosan
