Many of my patients have asked about how VASER (internal ultrasound ‘VASER’ assisted lipoplasty) is different from Smart Lipo and Slim Lipo (Internal Laser-Assisted Lipoplasty). This article, written by a biomedical engineer compares these and several other technologies to reduce subcutaneous fat. I think that the article is well written and informative. When I was looking for a technology, I compared both laser technologies and VASER and came to the same conclusions as the suthor of this paper. In summary, the article describes the superiority of the VASER technology over the other technologies. – Mark D. Epstein, M.D., F.A.C.S.

Body Sculpting Surgery: Technologies and Techniques

by William W. Cimino, Ph.D.

‘Lipoplasty’ is the all-encompassing term that refers to body contouring by sculpting or removal of fatty tissue. The major groups of different technologies and techniques for lipoplasty are described below, along with a short assessment of their respective advantages and applicable volume considerations.

Suction-Based Technologies

Liposuction or Suction-Assisted Lipoplasty (SAL)

• Power-Assisted Lipoplasty (PAL) Ultrasound-Based Technologies
• 
  Internal Ultrasound-Assisted Lipoplasty (IUAL)
• 
  VASER-Assisted Lipoplasty (VAL)
• 
  External Ultrasound-Assisted Lipoplasty (EUAL)

• Transdermal Ultrasound-Assisted Lipoplasty (TUAL) Laser-Based Technologies
• External Laser-Assisted Lipoplasty (ELAL)
• Internal Laser-Assisted Lipoplasty (ILAL) Chemical-Based Technologies

Mesotherapy

Suction-Based Technologies

Liposuction/Suction-Assisted Lipoplasty (SAL)

Liposuction, with all of its many variations, is the predominant form of body contouring surgery today. These variations include liposculpture, tumescent liposuction, suction lipectomy, syringe lipoplasty, and micro-cannula technique. All of these suction-based techniques can be included in a general category commonly referred to as Suction-Assisted Lipoplasty, or ‘SAL’.

SAL is a two-step process that requires the infusion of a wetting solution into the fatty tissues followed by the insertion of a suction cannula that is attached to a suction source. The cannula avulses (tears) and aspirates the fatty tissue fragments which are deposited into a waste canister.

This technology has been around in basic form for more than 30 years and has undergone improvement and refinement during that period. Major advances for the SAL technique include the introduction of the side-ported cannula, the introduction of wetting solutions with drugs for pain and control of bleeding, and overall reduction in cannula size.

Suction-based technologies are not tissue selective. Any tissues, such as nerves, vessels, or collagen structures in the fatty layer that get pulled into the ports on the suction cannula will be torn or avulsed. The technology is reliable, and has been used and studied extensively.

SAL has been used for small to very large volumes of fat removal in lipoplasty.

Power-Assisted Lipoplasty (PAL)

Power-Assisted Lipoplasty (PAL) is essentially a liposuction cannula (SAL) with the addition of a motor-driven reciprocating handle. The primary advantage of this technology is that it makes passage of the suction cannula through the tissues easier for the surgeon but represents no clinical improvement in outcomes or safety relative to SAL for the patient¹.

Surgeons may develop arthritis, ulnar palsy, or carpal tunnel syndrome as a result of the motor-induced vibration². Like SAL, PAL is not tissue selective – any tissues, such as nerves, vessels, or collagen structures, in the fatty layer that get pulled into the ports on the suction cannula will be torn or avulsed.

PAL is generally used for medium to large volumes of fat removal in lipoplasty as it may be too aggressive for smaller, more delicate areas.

Ultrasound-Based Technologies

Internal Ultrasound-Assisted Lipoplasty (IUAL)

Internal Ultrasound-Assisted Lipoplasty (IUAL) uses an ultrasonically vibrating cannula to emulsify (liquefy) adipose tissue during the aspiration process. IUAL technology was introduced with the promise that the ultrasonic technology would provide a level of tissue selectivity due to the emulsification process and thereby improve outcomes relative to those obtained using SAL. However, clinical experience and outcomes with IUAL vary considerably. Some surgeons report no significant clinical change in outcomes^5,6. Some surgeons report an improvement in outcomes^3,4. Others report increased complications or tissue damage relative to SAL⁷. This wide variation in results is in large part explained by the design of the technology which aspirates protective fluids/ tissue while the ultrasonic energy is active, by application of excess power to the tissues, and by the initial insufficient clinical understanding of the technology, all of which prevented consistent and uniform effectiveness⁹.

IUAL is called internal UAL to differentiate it from external UAL (EUAL, explained below). Most IUAL is a two-step process similar to SAL: infusion of a wetting solution into the fatty tissues followed by a combined emulsification and aspiration phase using a hollow ultrasonically powered cannula.

IUAL has been used generally for medium to very large volumes of fat removal in lipoplasty as it may be too aggressive for smaller, more delicate areas.

VASER^®-Assisted Lipoplasty (VAL)

VASER-Assisted Lipoplasty (VAL) represents a third-generation internal ultrasound system that incorporates significant design improvements over the previous two generations of internal ultrasound devices.

VASER technology is the ultrasonic component of an integrated lipoplasty system. The VASER System uses small-diameter, solid, multi-ringed probes to deliver a minimal level of ultrasonic vibrating energy to specifically target and emulsify fatty tissues. Smaller diameter probes and pulsed delivery of the ultrasonic vibratory energy further reduce delivered energy by as much as 50% compared to continuous wave ultrasound used in first and second generations of internal ultrasound-assisted lipoplasty⁸.

By emulsifying the fatty tissue prior to extraction, aspiration can be performed with less avulsion, and hence less tearing of the tissues. The VAL procedure does not utilize standard SAL to remove the emulsified tissues and fluids -rather, specially designed aspiration cannulae, call VentX^® Cannulae, are used to remove the emulsified fluids and minimize avulsion and other tissue trauma associated with standard SAL aspiration devices.

This third-generation ultrasound technology was specifically designed to preserve and spare as much of the tissue matrix as possible, yet still remove the desired amount of fatty tissue. This approach helps minimize post-operative pain and bruising and also addresses the limitations inherent in earlier generation IUAL devices^10,11. VAL was compared to IUAL in a clinical study and found to significantly reduce potential complications relative to the earlier generations of IUAL⁹.

VAL has been used on volumes from the very smallest (face/neck) to very large volumes.

External Ultrasound-Assisted Lipoplasty (EUAL)

External Ultrasound-Assisted Lipoplasty (EUAL) is the application of non-focused ultrasonic energy in the 1-3 MHz range to the skin of the patient prior to the use of standard SAL techniques. The theory is that the externally applied ultrasonic waves disrupt or soften the fatty tissue so that subsequent suction aspiration is easier. However, there has been no scientific substantiation that this additional step, prior to SAL, improves outcomes or safety.

Because SAL is used to remove any fat targeted by the EUAL technique, the outcomes are generally consistent with SAL outcomes. EUAL surgery may involve significantly more time if larger volumes are to be pre-treated with the EUAL device. This technology is not in widespread use today, primarily because the combination of EUAL and SAL has not been shown to be clinically superior to SAL alone.

Because SAL must be used in conjunction with the EUAL device, addressable volumes are the same as SAL, from small to very large, strictly a function of the SAL step.

Transdermal Ultrasound-Assisted Lipoplasty (TUAL)

Transdermal Ultrasound-Assisted Lipoplasty (TUAL) is the application of focused ultrasonic energy directly to the skin of the patient to disrupt the fatty tissue below the skin and does not require removal of the ruptured cells with a suction cannula (SAL). This technology is not currently available for use in the United States, as it has not yet gained Food and Drug Administration (FDA) clearance.

Transdermal ultrasound is a single-step process which involves application of the ultrasonic energy directly to the skin without the prior infusion of wetting solution as required in all other techniques. The body’s natural processes remove the damaged tissues over a period of time after the ultrasound application.

This technology is used to treat only small volumes in a single patient visit, on the order of 250–300 milliliters (cc’s) per treatment. The treatable volume is limited because this approach requires that the patient’s body remove or process the dead or damaged tissue. Because the treated fatty tissues are not removed at the time of surgery, results are not seen until several months after the procedure. Many treatments are required over an extended period of time if more significant volumes are to be addressed.

Laser-Based Technologies

External Laser-Assisted Lipoplasty (ELAL)

External Laser-Assisted Lipoplasty, also called Low-Level Laser-Assisted Lipoplasty, is the application of low-level laser energy to the skin of the patient prior to the use of standard SAL techniques. The theory is that the application of the low-level laser energy causes the fatty cells to produce a transitory pore in their cell membranes, which allows the fat inside the cells to pass to the outside of the cells¹². This claim was subsequently studied for validation, and results showed that the ELAL therapy did not influence the fat cell structure as reported¹³. This technology is not in widespread use today, primarily because the combination of ELAL and SAL has not been shown to be clinically superior to SAL alone¹³.

Because SAL is used to remove any fat targeted by the ELAL technique, the outcomes are generally consistent with SAL outcomes, as are addressable volumes, from small to large, strictly a function of the SAL step.

Internal Laser-Assisted Lipoplasty (ILAL)

Internal Laser-Assisted Lipoplasty (ILAL) uses a small-diameter laser fiber to deliver laser energy directly to

the fatty tissues through an incision in the skin. The laser is reported to operate through photomechanical and photothermal effects¹⁵. In short, these processes cause destruction of cells via coagulation and vaporization due to localized heating and rapid thermal expansion. ILAL was first introduced in the mid to late 1990′s¹⁵ and did not gain wide adoption or use. It has been reintroduced and is marketed as SmartLipo™ and Cool Lipo™.

A contra-lateral study comparing SAL on one side of the patient to ILAL (SmartLipo) on the other side of the patient showed no significant difference in outcomes¹⁴. The American Society for Aesthetic Plastic Surgery issued a guidance statement for this technology stating “Although SmartLipo received FDA clearance in late 2006, alarm bells rang for many experts when discussing this procedure based on the recent publication of data showing that this procedure was no better than traditional liposuction, and that it may present some risks to the liver and kidneys due to the way it releases free fatty acids when destroying the fat cells”¹⁶. The surgical technique for ILAL is a three-step process: (1) infusion of wetting solution followed by (2)application of the laser energy to the fatty tissue then (3) aspiration of the emulsified tissues using SAL. It has been proposed that the suction phase is not required for ILAL but surgeons are generally not willing to risk leaving the laser-affected volumes of damaged or dead tissue in the body. ILAL is therefore applicable only to small volumes as a standalone technology if no SAL step is used. If ILAL is combined with SAL to remove larger volumes, then outcomes consistent with SAL can be expected¹⁴. In this case (ILAL with SAL) the laser is used to treat only a small percentage of the removed tissues.

Chemical-Based Technologies

Mesotherapy

Mesotherapy is the use of a large number of injections of non-FDA approved drug mixtures, most often including phosphatidylcholine. The drug mixture is injected directly through the skin and into the fatty layer using several hundred needle injections to distribute the drugs throughout the fatty layer.

The mesotherapy theory provides that the drug mixture causes the breakdown (cell rupture and cell death) of the fat cells, which are then absorbed by the body. The American Society of Aesthetic Plastic Surgery recently released a position statement on mesotherapy which warns patients, stating: “efficacy and safety are not known, the procedure and the drug mixtures are not approved by the FDA, and that the procedure is often offered by unqualified personnel”¹⁷. Mesotherapy is marketed as LipoDissolve^®, LipoStabil^®, and LipoShape^®.

1. Fodor PB, Vogt PA. Power-assisted lipoplasty (PAL): A clinical pilot study comparing PAL to traditional lipoplasty (TL). Aesthetic Plast Surg., Nov.-Dec.,23(6):379-85, 1999.
2. Shiffman, MA. Editor’s Commentary in Liposuction: Principles and Practice. Editors M.A. Shiffman M.D., and A. DiGiuseppe M.D. Springer-Verlag, Berlin, Germany, 2006; p 405.
3. Kloehn RA. Liposuction with “sonic sculpture”: six years experience with more than 600 patients. Aesth Surg. J. 1996;16:123-8.
4. Zocchi ML. Ultrasonic assisted lipoplasty: Technical refinements and clinical evaluations. Clin. Plast. Surg. 1996;23(4) 575-598.
5. Fodor PB, Watson J. Personal experience with ultrasound-assisted lipoplasty: A pilot study comparing ultrasound-assisted lipoplasty with traditional lipoplasty. Plast. Reconstr. Surg. April 1998;101(4):1103-1116;discussion 1117-9.
6. Karmo FR, Milan MF, Silbergleit A. Blood loss in major liposuction procedures: a comparison study using suction-assisted versus ultrasonically assisted lipoplasty. Plast. Reconstr. Surg. 2001;108(1):241-7; (discussion 248-9).
7. Cardenas-Camarena L, Andino-Ulloa R, Mora RC, Fajardo-Barajas D. Laboratory and histopathologic comparative study of internal ultrasound-assisted lipoplasty and tumescent lipoplasty. Plastic & Reconstructive Surgery. Sep. 2002;110(4):1158-1164.
8. Cimino WW. Ultrasonic Surgery: Power Quantification and Efficiency Optimization. Aesth Surg. J. 2001;21: 233-240.
9. Jewell ML, Fodor PB, De Souza Pinto EB, Al Shammari MA. Clinical application of VASER-assisted lipoplasty: A pilot clinical study. Aesth. Surg. J. 2002;22:131-146.
10. Cimino W.W. “Ultrasound-Assisted Lipoplasty: Past, Present, and Future”, Liposuction: Principles and Practice, Editors M.A. Shiffman, M.D. and A. Di Giuseppe, M.D., Springer-Verlag, Berlin, Germany, 2006, p 225-228.
11. Cimino WW. VASER-Assisted Lipoplasty: Technology and Technique. Liposuction: Principles and Practice, Editors M.A. Shiffman,

M.D. and A. Di Giuseppe, M.D., Springer-Verlag, Berlin, Germany, 2006, p 239-244.

1. Neira R, Arroyave J, Ramirez H, Ortiz CL, Solarte E, Sequeda F,Gutierrez MI. Fat liquefaction: effect of low-level laser energy on adipose tissue. Plast Reconstr Surg. 2002 Sep 1;110(3):912-22; discussion 923-5.
1. Brown SA, Rohrich RJ, Kenkel J, Young VL, Hoopman J, Coimbra M. Effect of low-level laser therapy on abdominal adipocytes
2. before lipoplasty procedures. Plast Reconstr Surg. 2004 May;113(6):1796-804; discussion 1805-6.
2. Prado A, Andrades P, Danilla S, Leniz P, Castillo P, Gaete F. A Prospective, Randomized, Double-Blind, Controlled Clinical Trial Comparing Laser-Assisted Lipoplasty with Suction-Assisted Lipoplasty. Plast. Reconstr. Surg. 118(4):1032-1045, September 15, 2006.
3. Schavelzon, D., Blugerman, G., Chomyszyn, A., “Laserlipolysis”, Liposuction: Principles and Practice, Editors M.A. Shiffman, M.D. and A. Di Giuseppe, M.D., Springer-Verlag, Berlin, Germany, 2006, p 321-325.
4. ASAPS website commentary: http://www.surgery.org/press/news-print.php?iid=476&section=news-lipoplasty

5. http://www.surgery.org/press/news-release.php?iid=475

by Mark D. Epstein, M.D., F.A.C.S.

In my busy aesthetic surgical practice, I see many patients desiring to rejuvenate their facial appearance, but they are not sure as to what they need. They ask me if they should get Botox or fillers which is less invasive than surgery, or go with surgery for a more long-lasting result. What I will share here is my approach, which is integrated from both plastic surgery and dermatology.

The key to a successful facial rejuvenation is no different that that for any medical problem; accurate assessment or diagnosis of the problem followed by correct treatment. I have defined six key areas to assess.

1. Skin quality – Years of chronic sun exposure as well as environmental and genetic factors can induce fine lines and wrinkles, pigment changes, loss of elasticity and overall complexion problems. Here the treatment is to address the skin with topical agents. Botox, fillers and surgery have really no role here. Our aesthetician can refresh the facial skin using various types of peels and other topical agents. This does require compliance, but the reward is fresher, more radiant and youthful skin. Think of it not as a short term treatment to fix a problem, but rather as ongoing maintenance just as is proper diet and exercise.

2. Dynamic lines – These are wrinkles produced in the skin as a direct result of the contraction of underlying facial muscles. Examples include horizontal forehead lines, vertical glabellar (the area of the lower forehead between the eyebrows) lines, crows-feet(the area just outside the eyes) and vertical lip lines. Treatment requires the muscles to be relaxed. Botox is the best way to achieve this. Thorough understanding of facial muscle anatomy and function is required to selectively relax these muscles to give a more youthful appearance without producing a mask-like or surprised appearance.

3. Static lines – These are lines produced not by facial muscles but by a combination of loss of facial fat with aging and also stretching of skin and sagging due to gravity over time. Examples of these lines include the nasolabial folds (the oblique lines between the cheeks and the upper lip extending all the way down from the nose to the corners of the mouth) and the marionette (puppet) lines, which are extensions of the nasolabial folds further down the face. Although surgery can be helpful here, a very popular and effective way to treat these lines is to restore the lost volume to the face. This is done with fillers. Examples of fillers include Collagen, Restylane, Juvederm, Perlane and Radiesse. The longevity of the result varies among the different types of fillers used. For a more complete discussion of Botox and fillers, please visit www.epsteinplasticsurgery.com.

4. Loss of facial volume – As we age, even as a small child, there is loss of fat under the skin which can become pronounced when we are in adulthood. The cheeks hollow and a “tear-trough”may develop under the eyes at the junction of the lower eyelids and cheeks. Fillers work very nicely here, but surgery can improve these areas as well.

5. Sagging of facial structures – Gravity, loss of facial skin and muscle tone result in the descent of important facial features such as the eyebrows, malar area (the prominent part of the cheeks under the eyes) and the development of jowls. In this case surgery is usually the best option (browlift, facelift) although Botox can do a nice job of elevating the tail of the eyebrow and fillers can sometimes reduce the depression between the jowls and chin, giving the “illusion” of a smoother, more unified jaw line.

6. Redundant skin – Loss of skin elasticity and gravity as well as genetic factors weigh heavily on the development of redundant or excess skin. This develops over the entire face. During surgery, the skin is re-draped over the deeper facial structures permitting removal of the excess skin. Although Botox and fillers have no role in correcting redundant skin, they may be useful adjuncts after surgery to restore lost facial volume and correct wrinkle lines due to facial muscle activity

Our practice offers the services of myself, a plastic surgeon, as well as that of Elyse S. Rafal, M.D., a dermatologist (both of us board-certfied) as well as Irene Maher, an aesthetician. All of us would love the opportunity to meet with you for a complimentary evaluation.

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by Mark D. Epstein, M.D., F.A.C.S.

So you’ve decided to take the first step towards surgical enhancement or rejuvenation. You want to arrange a consultation with a plastic surgeon. How do you begin? Plastic surgery has now become extremely popular and mainstream. How do you make sense of the frequent advertisements and recommendations of others? I would like to give the reader some guidelines as to how to proceed.

Board certification – The American Board of Medical Specialties (ABMS) recognizes 24 medical specialties, and the American Board of Plastic Surgery is one of them. All other boards with the words “plastic surgery” in its name are not boards recognized by ABMS. Some plastic surgeons, as I am, are certified by more than one (ABMS) board (i.e. general surgery) prior to receiving training in plastic surgery.

Specialty – Many physicians and other health care providers are performing cosmetic surgery with varying qualifications. There are weekend courses, preceptorships and other brief ways of “learning” cosmetic surgery. Only a physician trained in an accredited plastic surgery residency is formally trained in cosmetic surgery of the face, breast, body and extremities. If you choose a non-plastic surgeon for a cosmetic surgical procedure, inquire as to the qualifications of that individual to perform that particular type of procedure.

Recommendations – A recommendation from a friend or relative who has undergone a particular type of procedure can provide invaluable information. If possible, it is always helpful to take advantage of this recommendation. In our office, we often refer perspective patients to speak with our many happy patients.

Internet – Plastic surgery web sites contain a plethora of useful information. Spend time reading the factual content on the site. Is it relevant and useful? Also, good quality before and after color photographs provide a unique opportunity to survey the quality of the surgeon’s work. I am particularly proud of our website and I invite you to visit us at www.epsteinplasticsurgery.com.

The office and personnel – Is surgery performed in an office based surgical facility? Is the facility accredited? By what organization? We are very proud of the fact that we are accredited by JCAHO ,the same organization that provides accreditation to hospitals. How were you treated on the telephone? Were the office personnel friendly, courteous and helpful? Did they make you feel special? Were you greeted properly? Were you made to feel at home? In our office, we pride ourselves on treating patients the way we ourselves want to be treated.

The consultation – Was the surgeon warm and friendly? Did he/she spend adequate time with you? (A breast augmentation consultation in our office usually lasts at least 30 -45 minutes). Did the surgeon perform a comprehensive physical examination? Was he/she able to understand your concerns and desires as well as propose and explain an appropriate plan of treatment? Did he/she listen to your questions? Did the surgeon make you comfortable about undergoing cosmetic surgery? Ask if he or she has patients that would be willing to speak with you.

Please feel free to have a complimentary consultation at our office. I promise that you will not be disappointed. I am committed to delivering the best cosmetic outcome possible. Furthermore, safety is a prime concern. We pride ourselves on performing cosmetic surgery in a highly individualized fashion within a warm, caring and nurturing environment.

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by Mark D. Epstein, M.D., F.A.C.S.

On November 17, 2006, the FDA approved the use of silicone breast implants for breast augmentation and reconstruction. All breast implants have a solid silicone shell. Saline implants are filled with saline (salt water) and silicone implants are filled with silicone gel. Up until recently, only saline implants were available for general use in breast augmentation.

Silicone gel implants were used for many years in this country, as well as in many countries around the world, until 1991 when the FDA enacted a moratorium on their use, pending the results of several studies designed to examine the safety of the device.

Based on the research collected in the US and the practical experience gained outside of the US for the past 25 years in over 60 countries, where both silicone and saline have been available to women and 90% of the markets prefer silicone, women generally find silicone breast implants to look and feel
more natural than saline implants.

The safety of silicone-filled breast implants is supported by extensive pre-clinical device testing, their use in approximately 1,000,000 women worldwide and nearly a decade of U.S. clinical experience involving more than 80,000 women.

Women in the United States now have the same options that women in other countries have had for so many years. As a skilled and dual board certified plastic surgeon I now can provide my patients with the newest option in breast aesthetics that provides women with the most natural look that is proportionate and individualized to their body types and aesthetic goals.

There are several myths about silicone gel breast implants which need to be dispelled.

Myth #1: "In general, silicone products are not safe for use in the body". Fact: For many years, silicone has been used in numerous medical devices including pacemakers, artificial joints, and even baby pacifiers.

Myth #2: "Silicone implants rupture due to normal activities or mammography. Fact: It is unlikely that silicone implants would rupture following routine physical activity or mammograms. Today’s breast implants have a thicker shell and an additional barrier layer that makes them stronger. They can withstand more than 25 times the force of a normal mammogram without failure. Breast implants, both saline and silicone are not lifetime devices. It is possible that they may fail at some point in a woman’s lifetime and may require replacement.

Myth #3: "Silicone gel implants cause cancer or diseases like rheumatoid arthritis and lupus". Fact: Silicone breast implants are among the most extensively studies medical devices in history, with thousands of published reports supporting their use. There has been no proven connection between silicone implants and cancer or other diseases.

Myth #4: "Silicone breast implants can adversely affect a mother’s milk and interfere with breast feeding. Fact: Studies found no evidence of elevated silicone in mother’s milk or any other substance harmful to infants. All mothers with silicone breast implants are encouraged to breast feed.

Myth #5: "Breast augmentation surgery often results in unnatural and disproportionate results". Fact: Through proper pre- surgical planning, assessing not only the dimensions of the woman’s chest, but also her tissue dynamics, breast augmentation usually provides a result that is in line with a woman’s expectation of surgery.

The FDA’s decision confirms that silicone gel-filled breast implants are a safe and effective option for women seeking breast implant surgery. Now, with the FDA approval of Silicone-Filled Breast Implants, I am able to offer a broader range of options to all of my patients, many of whom desire to rejuvenate their breasts after child bearing, or enjoy a fuller shape for which nature has otherwise denied them.

Dr. Mark Epstein is a dual board certified plastic surgeon specializing in breast augmentation, with a special focus on improving the patient experience before and after surgery.

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by Mark D. Epstein, M.D., F.A.C.S.

All bodies are not created equal. For most of us, stubborn fatty deposits attach themselves to our hips, circle around our bellies, cling to our thighs, and even appear on our arms, backs, and chins. You’ve likely identified problem areas of your own that persist despite your diet and exercise efforts. If you’ve ever considered liposuction and thought it was too drastic, you may want to consider a new procedure that is transforming the body-sculpting patient experience.

It’s called VASER LipoSelection®. These days, patients are turning to this advanced procedure to combat their "trouble spots", especially those that may be genetic "gifts" or are seemingly resistant to the hours spent at the gym. By delivering consistent results with minimal pain and down time, VASER LipoSelection is becoming the new standard of care for body contouring.

The key to the VASER LipoSelection difference is tissue selectivity, provided by a patented device called the VASER® System. Simply put, traditional liposuction procedures are limited by their inability to differentiate between the bad (excess fat) and the good (nerves, blood vessels, connective tissues, etc.). While traditional procedures do remove fat, a considerable amount of damage can be done to other important tissues. This can cause bleeding, bruising, and swelling, and lead to a longer recovery. In addition, damaged collagen and connective tissues can compromise the final shape, leaving behind lumps and bumps where uneven amounts of fat have been removed. Ultrasound energy employed by the VASER System ruptures fat cells on contact, while minimally disturbing important tissues vital to optimal recovery and consistent results.

Only VASER technology provides the tissue selective LipoSelection procedure, which targets fatty deposits while minimally disturbing the rest of the
tissue matrix. As a result, VASER LipoSelection patients consistently report low to minimal pain, bruising, swelling, and down time. Physicians
report consistent, predictable results and an enhanced ability to sculpt and contour a patient’s physique. Most patients are able to return to their normal activities in a matter of days.

For more extensive information about the VASER system, please click here.

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