What is VASER liposelection?
VASER liposelection is a new form of liposuction. ‘VASER’ stands for Vibration Amplification of Sound Energy at Resonance which uses advanced ultrasound technology to gently break down fat from different areas of the body.
The technique uses sound energy transmitted through small probes that liquefy fat prior to removal by gentle suction. In conventional liposuction, fat is sucked into a cannula (a thin metal tube) which is then sheared off by the surgeon, moving the cannula back and forth. This action produces trauma to the tissues which can lead to unevenness of fat removal and sometimes complications such as irregularities, which can be seen on the surface of the skin. The conventional technique is also associated with elongated recovery times and more pain. This contrasts with VASER liposelection where the ultrasound energy is directed specifically at the fat to liquefy it prior to removal by gentle suction. The nerves, blood vessels and surrounding tissues remain relatively undisturbed and this allows smoothness during the contouring by the surgeon and allows precise control.
Since there is much less tissue trauma, there is also reduced pain and discomfort after surgery. A further advantage of VASER liposelection is that much improved skin retraction is seen when compared to standard liposuction. These benefits of VASER treatment have been reported in scientific studies.
Who should perform VASER liposelection?
There are many ‘clinics’ and ‘doctors’ advertising VASER treatment. Since VASER treatment allows fat to be removed under local anaesthetic with a faster recovery time, many clinics are advertising this as a noninvasive or nonsurgical treatment. However you should be under no illusion that this is a surgical procedure which involves the insertion of very long instruments under the skin. A high level of experience is therefore required and in order to avoid complications, it is important that your surgery be carried out by a fully trained plastic surgeon. Mr Chana was one of the first BAAPS accredited Plastic surgeons to introduce this technique to the UK in 2009.
In fact the recent Royal College of Surgeons guidelines states that liposuction should be carried out by doctors with a postgraduate surgical qualification such as the FRCS.
Even if your VASER treatment is carried out under local anaesthetic while you are awake, be aware that high doses of local anaesthetic do have side effects. The United States has the highest complication rates from liposuction procedures since they are mainly carried out under local anaesthetic in the clinic setting. Mr Chana always uses a fully qualified anaesthetist even if your procedure is carried out under local anaesthetic, since he believes every precaution should be taken to ensure your safety.
What happens during the operation?
The anaesthetic: If small volumes of fat are to be removed then VASER has the advantage that a local anaesthetic is all that is required and this means that you are awake during the procedure. For larger volumes of fat removal or if multiple areas are treated then a ‘twilight’ anaesthetic can be used which means that an intravenous sedation technique (TIVA, total intravenous anaesthesia) is more suitable. For even larger volumes of fat removal a full general anaesthetic may be required.
The procedure: During the procedure the surgeon will make small incisions typically 4 – 5 mm long and inject fluid which is absorbed by the fat. An ultrasound probe is then introduced under the skin to liquefy the fat. These probes are blunt and pass through the fat easily. There are different types of probes depending on the area of the body and the quality of skin overlying the fat. The probe disperses the ultrasound energy into the surrounding fat and emulsifies the fat. A different suction cannula is the introduced under the skin which then very gently and easily removes the liquefied fat. Once the treatment is complete either a small dissolvable stitch or a dressing is applied to the entry.
What is the recovery?
For small to intermediate volumes of fat removal you will be able to go home the same day. For large volumes of fat removal you will be required to stay the night in hospital.
A compression garment is required to be worn for a variable length of time. This may be for a period of 1 week only for very small areas or up to 6 weeks for larger areas. This garment will be provided for you.
The advantage of VASER is that pain and discomfort is minimal. However, painkillers are prescribed for you in case you need them. Significant bruising is unlikely but should any mild bruising occur this should resolve quickly within 1 to 2 weeks.
For small to intermediate volume fat removal you should be able to return to work within a few days but if large volumes of fat are removed you may require up to 1 week off work.
Strenuous exercise should be avoided for at least 2 weeks after the procedure. There will be some swelling after the procedure and it is important to allow the tissues to fully heal before engaging in heavy exercise. If multiple areas and large amounts of fat are removed your surgeon may recommend to avoid exercise for a longer period of time.
Although you will notice an immediate change after the surgery any swelling will take about a week to improve. The soft tissues and skin do take time to retract. Even though VASER liposuction allows improved skin retraction it can still take 3 to 6 months to see the full benefits and results of this technique.
What are the risks?
The main complications of liposuction include bruising, loose skin, surface irregularities and mild asymmetry. With VASER liposelection these complications are greatly reduced. With large volume liposuction patients sometimes needed to return for a small revisional or ‘touch up’ procedure. Revision rates have been reported to be reduced by up to 50% with VASER liposuction.
The other complications of liposuction involve the toxic effects of large doses of local anaesthetic which can precipitate irregular heart rhythms with dangerous consequences. These complications should be extremely rare when treatments are carried out in a large hospital setting and in the presence of an anaesthetist. It is usually safer to have a general anaesthetic in some situations and you should not be persuaded into having a local anaesthetic by some clinics who do not have the comparative facilities of a Spire Hospital and the availability of a fully qualified anaesthetist.
You can read more from Mr. Jag Chana on VASER in this published Huffington Post article.