Liposuction Equipment

Everything there is to know about liposuction equipment

Liposuction is an aesthetic plastic surgery procedure developed over three decades ago. It is currently one of the most performed cosmetic surgeries that correct flaws regarding body physique and figure by treating or extracting localized fat deposits. These subcutaneous adipose tissues are deposited in predictable body parts such as the stomach. It applies to both men and women and is useful for patients who do not suffer from generalized obesity. 

The most common liposuction machine is an electrosurgical suction pump. However, various techniques have been introduced, including ultrasound-assisted, laser-assisted, radiofrequency-assisted, water-assisted, and power-assisted liposuction procedures. The varying techniques impact the earliest liposuction equipment, causing slightly different pieces of equipment.  

History of liposuction equipment 

The removal of subcutaneous fats has been reported as far back as 1921. However, appreciable safety was not recorded until the publication of an academic paper on tumescent anesthesia by Jeffery Klein in 1987. A father and son team (The Fischers) introduced the suction technique for fat removal, which got widespread adoption through a renowned gynecologist, Illouz, who further explained the wet method of using a hypotonic solution to lyse fat cells. This significantly improved the suction process, and Illouz successfully performed the suction technique several times. 

Other techniques have been developed since then. Ultrasound-assisted liposuction (UAL) got introduced in the 1980s. Several improvements occurred up till the introduction of VASER (Vibration Amplification of Sound Energy at Resonance). 

Water-assisted liposuction (WAL) was developed in 2001 by a group of German surgeons. The technique was relatively known in the medical world but not for this use. In 2003, a German liposuction equipment manufacturer developed a technology known as body jet (aqua lipo) based on WAL. Also, in 2009, a leading manufacturer in the US developed Smart lipo, a technology based on the light-assisted liposuction (LAL) technique. 

Indications to use a liposuction machine

A liposuction procedure can be required for several reasons. It may be to deliver a primary therapeutic effect or an ancillary procedure to improve the patient situation. It could be entirely for aesthetic results too. However, more often than not, liposuction pulls off more than one of the uses/benefits mentioned above.

The indications for liposuction/ liposuction machine include:

  • Lipectomy- This is the surgical removal of unwanted body fat. Many medical situations can warrant lipectomy. 
    • Lipedema- This is a disorder characterized by the symmetric enlargement of the legs due to subcutaneous fat deposits. 
    • Obesity metabolic syndrome- This is a disorder of body metabolism, causing obesity, which may be generalized or prominently localized.
    • Madelung-Launois-Bensaude syndrome- This is a rare benign disease characterized by multiple, non-encapsulated, and symmetric masses of fatty tissues. It typically involves the neck, hence also known as neck lipomatosis. 
    • Lower limb arthritis- Obesity is a significant risk factor of osteoarthritis.
    • Lipomas- These are fatty lumps growing under the skin. They are mostly benign and slow-growing but can also be cancerous.
    • Dercum disease- This is a condition common in post-menopausal women, mostly obese women of middle age, characterized by multiple and painful fatty lipomas. 
    • Lipodystrophy- This is a condition of abnormal fat distribution in the body. It can be in the form of fat loss (lipoatrophy) or abnormal fat accumulation. The disease can be inherited genetically or acquired.
    • Melkersson-Rosenthal syndrome- This is a rare neurological disorder that can manifest with facial swelling, lip swelling, fissured tongue, and so on. 
  • Debulking- Debulking is the removal of a large chunk of a tumor, as much as possible, without the intention of total eradication. Debulking can be performed with a liposuction machine. Conditions applicable for debulking include:
    • Lymphedema- This is edema of the extremities caused by a lymphatic system blockage. This could be as a result of lymph node removal or chemotherapy. 
    • Lymphangioma/ cystic lymphangioma- This is a congenital condition resulting in the edema of the head, neck, and mouth.
    • Limb gigantism and macrodactyly (a rare condition of abnormally large infant’s fingers and toes)
    • Insulin-induced lipo hypertrophy 
    • HIV-associated cervicodorsal lipodystrophy, which occurs after long term infection with HIV
    • Contour refinement of flaps
  • Reconstructive surgeries, including flap mobilization for closure, scar revision surgeries, etc. can be performed with a liposuction machine. 
  • Other therapeutic indications such as extraction of fillers, extravasation injuries (a complication of intravenous therapy), 
    • Tracheostomy, urostomy, and colostomy- fat accumulation around sites can cause difficulty
    • Gynecomastia, macromastia, and gigantomastia- abnormally large breasts due to different causes
    • Axillary lymphadenectomy- lymph nodes removed from the underarm or axilla
    • Axillary hyperhidrosis and osmidrosis- Abnormally excessive sweating, 
    • Superficialization of arteriovenous abscess

Complications of liposuction machine

Complications of the liposuction machine often occur through whichever of the techniques is being utilized. There have been remarkable technological advances in the design of aspirator suction devices, such that they rarely cause complications. Before introducing blunt canular technology, suction-assisted liposuction yielded complications such as excessive bleeding, contour irregularities, the formation of seroma, skin necrosis, etc. 

Ultrasound-assisted methods brought about significant improvement. The problems associated with the method are high costs, larger incisions, and the risk of thermal burns.

Power-assisted liposuction techniques are noisy and cause vibratory inconvenience for the surgeon. This is in addition to the high cost and increased learning curve. 

Light-assisted methods are time-consuming and pose the risk of thermal burns. Nodules in the subcutaneous space have been reported after performing water-assisted techniques. 

Alternative equipment

There are some non-surgical and mildly invasive devices for fat reduction. They include Vanquish, Liposonix, and so on. However, a liposuction machine remains the chief option for surgical and big fat removal.

General specifications of liposuction equipment

The specifications of a typical electrosurgical suction pump are:

  • Maximum vacuum- 29+ inches Hg
  • Maximum flow- 7.5 CFM
  • Pump- 2×2 Piston, Horsepower – 2/3 hp
  • Sound level- 29 ± 3db
  • Voltage requirement- 110V or 220V 
  • Weight- 60 - 70 ponds

The typical specifications of power-assisted (PAL) liposuction machine are:

  • Canular stroke- 2mm
  • Canular frequency- 2700 – 5100 strokes/min
  • Pressure- 2.0 bar
  • Flow rate- Up to 450ml/min
  • Power requirement- 115 – 230V, 50 – 60Hz

The unique specifications of ultrasound-assisted liposuction equipment are:

  • Up to 40 kHz strong cavitation ultrasound, 1 MHz for face ultrasound 
  • Hydraulic systems screen
  • Integrated cooling systems

How liposuction equipment works

Liposuction equipment started with the use of a sharp curette and suction pump. Due to some complications, the sharp curette was replaced with a better alternative, blunt cannula. The cannula has a lateral opening and a blunt end with a round tip. The procedure involves making small incisions into the skin at the site of surgery. The blunt cannula helps access and aspirate the deep subcutaneous fats through the incisions. The blunt cannula gets connected to the surgical suction pump through a semirigid transparent tube. The procedure at a particular site is completed when the yellow solid fats, visible through the transparent tube, becomes bloody. The doctors typically use a cannula size of 5mm for large fat deposits. The sizes thus vary depending on the part of the body and amounts of fats. 

The procedure described above is the basis of all other techniques. They only employ different methods of handling and aspirating the fats. The UAL makes use of an ultrasound probe to achieve selective lipolysis. There is a transfer of electrical energy into mechanical/oscillatory energy, which facilitates lipolysis. After lipolysis, the regular suction-assisted procedure is performed. 

On the other hand, LAL uses laser technology to selectively lyse adipocytes through photo thermolysis, the liberation of adipocytes lipases, photocoagulation, and so on. 

PAL utilizes a rapidly vibrating cannula to reduce operator fatigue. The equipment is powered by a compressed gas tank or nitrogen gas. This method gained wide acceptance as it is easier and enables the operator to regulate vibration speeds. 

The WAL uses water to loosen up fat cells, thereby making aspiration better. The procedure is powered by a piston pump, which allows pressurized fluid to be delivered to the fatty layer through a closed tubing system. 

The choice of the technique involves certain patient considerations and the surgeon’s expertise. Liposuction equipment should be used only by a certified plastic or cosmetic surgeon. 

Market leaders

Top brands include:

  • NOUVAG AG- This is a leading manufacturer of electrosurgical suction pumps. The company is Switzerland based and was founded in 1971. 
  • Invasix- Invasix Aesthetic Solutions Ltd is a leading pioneer manufacturer in the production of radiofrequency liposuction equipment. The company is Israeli-based. 
  • Cynosure- Cynosure Inc. manufactures top laser technology equipment. The company is US-based. 

Other top brands of liposuction equipment include HK Surgical, MEDCO, CHEIRON, Euromi, Anand Medicaids, AART, etc. 

Conclusion

Liposuction is a medical technique of huge importance. It can yield both therapeutic and aesthetics in the majority of its indications. The introduction of plastic surgery brought so much joy and hopes to many people, especially in developed countries. From cosmetics to fashion and then corrective surgeries, aesthetics has always been an integral part of the human lifestyle. Liposuction equipment makes the latter possible to some extent. Liposuction also offers therapeutic benefits to many familial or genetic conditions, congenital conditions, tumors, and other abnormalities. 

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