Liposuction with ‘Sonic Sculpture’: Four Years’ Experience in Over 250 Patient Procedures

Abstract

RA Kloehn. Liposuction with ‘sonic sculpture’: Four years’ experience in over 250 patient procedures. Can J Plast Surg 1994;2(2):85-89. The author has now used ultrasonic liposculpture for over four years on a large series of patients, employing first the Ultravac Series 3 and currently the Surgitron Series 2000 prototypes for this application. Use of ultrasonic energy for liquefaction of body fat has evolved from the earlier use of such energy in phacoemulsification for cataract removal. This adaptation has proven advantageous to both patient and surgeon alike, when comparing previous methods of closed liposuction with those of ultrasonic-assisted lipoaspiration. Specific patient advantages include greater comfort postoperatively due to decreased tissue trauma, more refinement possible in body sculpting, diminished blood loss during surgery, and an opportunity for the larger patient to benefit from technology heretofore reserved for only the smaller individuals. The benefits to the surgeon include greater speed of execution in liposuction surgery and reduced physical effort. Electrical energy is transformed to high frequency energy by the ultrasonic generator, which is transmitted to a piezoelectric transducer or handpiece. The handpiece changes the energy into ultrasonic mechanical vibrations which are conveyed and amplified by the hollow titanium cannula to the fatty tissues. These ultrasonic mechanical vibrations, capable of creating microcavities within fluid and fat, do not affect the more dense structures in the area such as vessels, nerves, muscle or bone, at the specific energy levels employed. Following the initial creation of microcavities within fatty tissue, these cavities implode with continued energy application. This leads to cavitation, with explosion of fat cells and fatty liquefaction within adipocytes. Triglycerides are released into extracellular tissues and aspirated along with damaged fat cells, connective tissue and infused fluid. Heat generated in the process is not damaging if the tumescent technique is used.