Recent advances in liposculpture technology, particularly with VASER (ultrasonic assisted liposelection) has resulted in the development of Hi Def Liposculpture.

Hi Def Liposculpture refers to the use of the VASER technique to not only remove unwanted fat, but also create muscle definition. This gives the patient a lean, toned look, something many folks exercise hard to attain, but fail to achieve.

Most well known for the tummy area, Hi Def VASER not only reduces the fat in the abdomen and flanks, but also continues to thin out the skin over the rectus muscle lines, creating six-pack definition. It can also be used in the arms to define the deltoids, biceps and triceps.

Hugely popular all over the world now, this technique does involve more discomfort than standard VASER liposelection. Drains are also required, as is a special sponge suit that has to be worn under the normal compression garments.

However, most patients are delighted with the results of the procedure, as they can finally see the muscle definition that they’ve worked so hard but failed to see naturally.

Hi Def Liposculpture costs more than standard liposculpture as each procedure takes around six hours to perform! General anaesthesia is often required, as the operation is too uncomfortable when done under tumescent anaesthesia alone.

There are certainly pros and cons to this technique, and only you can decide if muscle definition is your ideal goal, and whether it justifies the additional cost, discomfort and downtime. Ironically, Hi Def Liposculpture is best for athletes, but can stop vigorous training for many weeks.

Tumescent liposculpture refers to the use of tumescent fluid to distend and numb fat tissues prior to sculpting with liposuction.

The tumescent technique has revolutionised fat reduction surgery. The infiltration of tumescent solution serves many purposes:

1. Numbing the tissues, so minimal intravenous sedation is required
2. Stops bleeding by constricting blood vessels in the area
3. Distends the tissues, allowing easier surgery

The tumescent fluid comprises local anaesthetic, epinephrine and sodium bicarbonate in normal saline. For more techniques, the volume infiltrated is equal to the anticipated fat extraction volume.

The solution is injected into the tissues by a high pressure delivery system. Generally, this is administered to the areas of operation only.

Although tumescent liposuction has greatly increased the safety of liposuction surgery, it does contain some inherent risks of its own, primarily related to its local anaesthetic component. To numb the area completely, large amounts of local anaesthetic are used. However, because it is administered with epinephrine, the local anaesthetic stays in the operative site, rather than goes into the circulation. As the epinephrine wears off some 12 hours after the surgery, the local anaesthetic can slowly be released into the circulation and taken to the liver for metabolism.

Occasionally, a large amount of local anaesthetic is absorbed into the circulation at one time. If this is over the safe dose, some toxicity reactions can be observed. These include timgling around the mouth, fingers, drowsiness and heart arrhythmias. These are fortunately rare.

In general, tumescent liposculpture is safe and greatly enhances the results of liposuction surgery.

Most liposuction operations involve the use of tumescent solution to numb & distend the tissues and reduce bleeding. This solution contains local anaesthetic, adrenaline and sodium bicarbonate in normal saline. Some surgeons (with co-operative patients) can rely on this alone for anaesthesia. Others prefer general anaesthesia or at least some degree of sedation.

Once the tissues are numb and the adrenaline has caused the blood vessels to constrict, the surgery proceeds through tiny holes spaced at various points over the operation site.

A long, thin cannula is inserted, and the surgeons moves it backwards and forwards to suck the fat over the entire treatment area. A cross-hatch pattern is preferred, so each area is approached from 2 directions. This is thought to produce a more even result.

The fat is suctioned off into a bottle, where it slowly seperates. The top layer is pure fat, the bottom a mixture of blood and tumescent fluid. Initially, the fat comes out clean, but as treatment in one area progresses, there is often some degree of bleeding. Excessive bleeding is an indication to move to a different area, as there is often little fat remaining.

The surgeon keeps an eye on the contours as the operation proceeds, stopping and moving to the next section once the desired amount of fat has been removed. The final stage of the operation involves checking that the final result is even and pleasing.

Sometimes stitches are needed to close up the holes, and occasionally a drain may even be left behind.

All forms of liposuction can be used for liposculpture. The technology is advancing very quickly in this field, and it can be very confusing for the consumer.

Traditional Liposuction

This techniques uses negative pressure (vacuum suction) plus effort from the surgeon to suck out the fat. It can be an extremely traumatic procedure, resulting in significant swelling and bruising that can last for weeks.

Power Assisted Liposuction

This has a mechanised tip which nibbles away at the fat. The surgeon exerts little effort here. However, there is no distinguishing of fat from nerves or blood vessels.

Laser-Assisted Liposuction

This uses laser to melt the fat first. Some surgeons leave the fat inside the body, and this is absorbed out of the area over the following few weeks. Others will use suction to remove the fat immediately. The former is less traumatic. This technique can produce some skin tightening, but has limited effectiveness, removing about 250ml of fat only.

Ultrasound-Assisted Liposuction

This technique uses ultrasound to melt the fat first, before the fat is sucked out. This is the first advance which both selectively removes large volumes of fat, as well as tightens the skin.

Waterjet-Assisted Liposuction

This technique uses a jet of water to flush out the fat. Also selective for fat, this technique produces little tissue trauma, hence recovery is very fast.

Radiofrequency-Assisted Liposuction

The latest development, this technique uses radiofrequency to melt the fat externally, with simultaneous suction of fat out internally. This technique is associated with the greatest degree of skin tightening.