Liposuction yesterday and today: is there a perfect liposuction for every patient?

As a clinic for aesthetic surgery, we have been dealing with the question of which liposuction technique leads to the best results for more than ten years.

Originally, liposuction worked like this: A large amount of saline solution was injected into the tissue to be suctioned off, to which certain medications had previously been added. This solution caused the fat cells to burst and the remains could be suctioned out using a vacuum system. This system essentially consisted of a metal rod with holes in the front to which a vacuum was applied. This original technique, which is rarely used in modern clinics today, was known as tumescent liposuction.

Over the last 15 years, the technique has developed rapidly and various companies have launched modern systems on the market that are designed to make liposuction easier and improve the results. We have witnessed all of this development in our clinic and have been able to see and evaluate most of these devices in action.

A few examples: With water-jet assisted liposuction, the water is not completely injected into the tissue at the beginning, but is gradually injected and suctioned out at the same time.

With the vibration technique, the suction cannula vibrates the tissue, making it easier to reach the fat cells in their depots.

In ultrasonic liposuction, ultrasound waves are used to loosen the tissue and make it easier to reach the fat tissue for suction. This is just a small selection of the liposuction techniques available.

Various companies soon brought devices onto the market which, in addition to removing fatty tissue, were also designed to tighten the tissue. A common problem with liposuction is that the skin is left behind and has to regress on its own.

The challenge for the body in this situation can be compared to the regression of the skin after pregnancy or weight loss, for example. Here, the body often has problems shedding the excess skin on its own. The result is sagging skin, which often has to be removed by a tightening operation.

The idea of the developers of new devices was therefore to tighten the connective tissue directly during liposuction and thus avoid a later incision for skin tightening, at least for some patients.

Devices were introduced that used radiofrequency lipolysis or laser lipolysis to tighten the skin and tissue. More modern devices in recent years have also used inert gases such as helium or argon, which are ignited in the tissue and are intended to tighten the skin and connective tissue through the resulting temperature.

Even the most modern liposuction device in the world cannot replace good planning of the procedure and the right choice of technique. When does excess skin occur during liposuction? How much fat can be removed safely? Which areas should be avoided because the skin is more likely to sag or wrinkle there? When is liposuction with direct tightening better than liposuction alone?

All these questions can only be answered by the experience of a well-trained specialist. Only with this knowledge can he select the right techniques and acquire them for the clinic in which he works. This knowledge and expertise cannot be replaced by simply buying expensive equipment and then hoping that the result will be good.

To summarise, we always try to keep our clinic up to date and offer our patients the best combination of different techniques by constantly training our doctors and evaluating new techniques. One example: High Definition Lipo (HDL) is the combination of several techniques for liposuction and skin tightening to actively shape the body contour, emphasise muscle boundaries and achieve an optimal silhouette through so-called body shaping or body contouring. Not all clinics offer these modern procedures with the appropriate experience and in combination, and not all doctors have the necessary experience to optimally plan and perform such operations.

At the Praxisklinik am Rosengarten, we ensure good results through strict and long-established treatment principles. The aim of our treatment is always to fully fulfil the expectations of our patients and to work with them to find the best and most effective way to get closer to their dream body using professional expertise and modern techniques.

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