Micro-liposuction is the 'spot cleaner' of cosmetic surgery

Dr. Toledo

PRECISION PROCEDURE "In the last two to three years, liposuction, once used predominantly to remove excess fat from overweight patients, has become a tool to enhance the near-perfect body parts of the already-fit patient," says Luiz Toledo, M.D., a plastic surgeon at the International Modern Hospital in Dubai, United Arab Emirates. According to Dr. Toledo, "The goal of micro-liposuction is to remove ounces rather than liters of fat from ankles, knees, chins, necks, backs and upper arms. By employing a disposable syringe instead of an aspirator, surgeons can be less aggressive and more precise. In some cases, that fat may [then] be injected into other areas of the body via liposculpting."

Dr. Toledo says that, with such precise technique enabling the treatment of very small, focal areas, "even skinny people who have localized fat deposits — the kind that do not disappear with diet or exercise — can finally have the bodies they desire."

Beyond providing the benefit of increased precision for the surgeon-sculptor, adds Dr. Toledo, these "micro" procedures can be considerably easier on the patient: "Minimal trauma...means little or no pain, a quicker recuperation, less swelling and bruises."

Dr. Cuzalina agrees, noting, "micro-liposuction is for the patient who wants minor changes with less downtime. The smaller the cannula, the more precise liposculpting can be. Also, there is typically less chance for irregularities and seromas when performing liposuction using smaller-diameter instruments. The micro-instruments also improve how well we replace fat in addition to the skill by which it is removed."

TECHNIQUE TIPS The surgeons emphasize that there is an art to the redeployment of these micro amounts of removed fat elsewhere in the body, because with fat injection, what you see is not necessarily what you get. "The injected fat has a partial reabsorption of about 40 percent to 50 percent," Dr. Toledo explains. Therefore, to obtain an ideal result, the surgeon needs to inject more fat than appears necessary, to proactively account for this reabsorption. Even then, he says, it is sometimes necessary to "tailor" the result with a repeat procedure after a few months.

Dr. Cuzalina says that recently, the use of 1 mm laser-assisted liposuction has become popular with surgeons and patients, noting that these probes offer good control and are increasing in power as surgeons continue to make suggestions for their improvement. "One nice advancement with the newer energy liposuction devices," he says, "is the ability to remove areas of fatty excess from parts of the face, such as heavy nasolabial folds or even periorbital regions; previously, this was too traumatic. The 1-mm devices liquefy fat without the need for vigorous movement and therefore greatly lower the risk for bruising in delicate areas. Small areas of fat anywhere on the body that may require a minor touch-up are also candidates for these micro devices under local anesthesia."

Medical devices for micro procedures continue to evolve to meet the growing needs and demands, and "A variety of micro devices will inevitably create even more choices for surgeons in the future," says Dr. Cuzalina. But some of these devices are marketed to patients too early and, "More often than not, I have to advise against a particular new procedure that a patient has read about [because too often] early hype and hope is followed by the actual facts a few years later."

And therein may lie the micro-liposuction caveat. Dr. Cuzalina points out that, "The biggest problem for the experienced surgeon is realizing the limitations and not trying to over-promise the results."

Disclosures
Drs. Toledo and Cuzalina report no disclosures.

For more information
http://www.luiztoledo.com/,
http://www.tulsasurgicalarts.com/