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Sound waves that you can’t hear (referred to as ultrasound) are making a loud noise in the world of cosmetic surgery. Introduced in America only five years ago from Europe, ultrasound-assisted liposuction (UAL) is now used in as many as 40 percent of liposuction operations. The number is growing as doctors and patients discover its advantages.

In traditional liposuction, a powerful vacuum force literally tears excess fat from beneath the skin and suctions it out of the body through a hollow tube called a cannula. In UAL, a special cannula carries high-frequency sound waves into the body to burst the fat cells and turn them into a liquefied creamy solution that can be suctioned out more easily and with less bleeding. The result, in the hands of specially trained surgeons, can be a smoother, more sculpted body contour.

UAL usually is used in combination with traditional liposuction. Traditional liposuction alone may also achieve very satisfactory results when used appropriately by an experienced doctor. But UAL is entering the mainstream of cosmetic surgery as an important adjunct tool for several reasons:

• It causes less trauma to the patient’s body. Traditional liposuction employs a high-powered vacuum to separate the fatty tissue from its place in the body. Much less power is needed to suction away the emulsified fat resulting from ultrasound treatment. Generally speaking, you can expect to experience less bleeding and therefore less visible bruising afterward.
• UAL allows your doctor to have more sensitive control of the contouring process. A doctor who includes UAL among the tools available may be able to be more precise in contouring your body. Many doctors report a feeling of more aesthetic control in those cases.
• UAL frees the surgeon from the arduous physical workout required by traditional liposuction when contouring body areas where large volumes of fat are to be removed. Sometimes these operations require hours of high-energy activity by the doctor. UAL-dissolved fat cells are not only easier to vacuum from the body, but also in many cases can be removed with more precision. Without as much need to vigorously thrust the traditional cannula into the fatty layer, the doctor potentially is able to devote more attention to the aesthetic aspects of the procedure, becoming more of a body sculptor.
• UAL is very helpful in both men and women when treating firm, fibrous areas such as the upper back. Men have particularly fibrous tissue in the chest and the “spare tire” area. When men gain weight, their breasts often become fatty. This very fibrous area is easier to treat with ultrasound-assisted liposuction.
• UAL’s ability to smooth out the fatty tissue makes it a helpful tool in revising previous liposuction procedures. Contour irregularities caused by previous liposuction may include areas of significant scar tissue which are more easily addressed with UAL.

Liposuction, whether utilizing UAL or not, may be performed in a surgeon’s office-based facility, in an outpatient surgery center, or in a hospital. If a large volume of fat is to be removed, or if an invasive procedure (such as tummy tuck or face lift) is being performed in combination with it, the doctor likely will require you to be in the hospital.

Ultrasound-assisted liposuction has been performed on many thousands of patients. Ultrasonic energy has been used for medical purposes for many years. Common uses of ultrasonic energy include prenatal fetal monitoring, removing cataracts, and cleaning teeth! All forms of modern liposuction normally are safe if you are in good physical and psychological health, the operating facility is properly equipped, and the doctor is trained and experienced. The same is true of UAL when the physician has completed an appropriate, hands-on training course.

UAL is a powerful tool. If your surgeon expects to use UAL as part of your body contouring plan, it is imperative that he or she has a high level of experience in its use. You should feel free to ask how many such procedures the doctor has performed, and to see before-and-after pictures of former patients.

While UAL is a useful tool to use in conjunction with traditional liposuction, your doctor may recommend other procedures to help meet your body contouring goals. For example, you may find that a tummy tuck (abdominoplasty) is appropriate either instead of or in conjunction with liposuction.

You should discuss the risks of liposuction, and specifically UAL, with your doctor. All such procedures carry the potential cosmetic complications of irregularities of the skin�s surface, areas of uneven pigmentation, and asymmetry. There are some relatively minor risks specifically involving ultrasound-assisted liposuction, including:

• UAL cannulas currently are greater in diameter and require a slightly longer incision. The incision is placed in a less-visible location when possible, requires a single stitch to close, and leaves a small scar. The size of the UAL cannula limits where it can be used. Smaller fatty areas such as the ankles and neck are better treated with traditional liposuction. Smaller UAL cannulas are expected to be introduced in the near future.
• UAL causes a slightly higher rate of temporary collections of fluid beneath the skin (seromas). These little pillows dissipate quickly or can be drawn off with a syringe at an office visit.
• There is a small risk of minor burns to the skin caused by the heat from the ultrasound device. This complication is extremely rare in the hands of an experienced UAL surgeon.

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