Dr. Roche has practiced tumescent liposuction for decades. In this procedure, he begins by inserting a cannula (a slim, hollow tube) into small incisions near the area to be recontoured. The cannula is moved through the layers of tissue and extracts the necessary fat. Several techniques exist. The tumescent technique injects fluid into the areas to be treated. It begins the process before extraction. In UAL (Ultrasound-Assisted Lipoplasty), a specially designed cannula liquefies the fat and suctions it away. Except in the most extreme cases, procedures are performed on an outpatient basis. Dr. Roche will suggest the most appropriate form of anesthesia (epidural block, intravenous sedation or a local or general anesthesia).
The Advantages of Ultrasonic - Assisted Lipoplasty
In UAL (Ultrasonic – Assisted Lipoplasty), a specially designed cannula liquefies the fat and extracts it with suction. Ultrasonic Liposculpture offers many advantages over tumescent liposuction. This advancement has resulted in less postoperative bruising, swelling and discomfort as well as shorter recovery periods. Smoother results in conjunction with the many other benefits prompted Dr. Roche to introduce this procedure. His 20 years experience in surgery and the personal attention that he provides his patients have earned him the respect of his colleagues and the trust of his patients.
Ultrasonic liposuction is a relatively new technique introduced into the United States for the removal of unwanted localized areas of fat using ultrasonic assisted liposculpturing. In 1987, Dr. Michelle Zocchi first described the use of ultrasonic energy in assisting the performance of a liposculpture procedure. Since this time, numerous physicians in Europe and South America have adopted this technique quite successfully. The technique is relatively new to the United States. In ultrasonic assisted liposculpturing, an ultrasonic probe is inserted into the surgical site. Once this is accomplished, the fat is liquefied or rather emulsified by a physical process called “cavitation.” The cell membranes are disrupted allowing triglycerides and fatty acids to be released. According to Dr. Patrick Maxwell, “Using this cavitation process to selectively emulsify fat results in smoother effects and a process that is gentler for the patient. The procedure is much less taxing on the surgeon because of the emulsification of the fat. There appears to be a significantly decreased amount of resistance, therefore reducing the amount of trauma encountered with standard liposuction. Ultrasonic assistant liposuction is very useful in areas such as the trunk, lateral and medial thighs and in very fibrous areas such as the upper abdomen and the male breasts.”
The technique for ultrasonic assisted liposuction is somewhat similar to conventional liposuction in that you have to use similar anesthesia and post-operative dressings. The hallmark to all types of liposuction is, of course, the tumescent technique. The tumescent technique uses infiltration of the subcutaneous tissue or the fatty tissue with large volumes of saline with a low dose of epinephrine for vasoconstriction and a low dose of local anesthetic for post-operative pain relief. The tumescent technique has been used for many years for standard liposuction and is extremely important in ultrasonic assisted liposculpturing.
The former areas that were difficult to treat such as posterior hip and back are particularly well addressed with ultrasonic-assisted liposculpturing as is, male gynecomastia and “enlargement of the male breast.” Other areas that are well treated with ultrasonic-assisted liposculpturing are the central truncal areas, proximal extremities and the trochanteric or high hip areas. Dr. Roche has had extensive experience in routine liposuction surgery and has had training in the use and the technique on the new ultrasonic equipment.
The physics of ultrasonic liposuction are that ultrasonic sound waves are produced by transforming normal electrical energy into high-frequency energy, over 16,000 cycles per second. This energy is then transformed to mechanical vibration. The effect of this energy is to create selective destruction of adipocytes (fat cells) with the preservation of vessels, nerves and denser biological tissue. The effect of ultrasound on fat cells is that it causes an implosion of microcavities containing gas and vapor which causes a disruption of the cell membranes, as mentioned above, and in essence liquefies the fat.
Dr. Roche currently performs ultrasonic assisted liposculpturing and is a member of the American Society of Liposuction Surgery, Inc. Dr. Roche recently sponsored the local live surgery section meeting for the World Congress on Liposuction Surgery. We utilize the state of the art ultrasonic surgery system, Contour Genesis allowing our patients to receive the very best possible results.
Dr. Roche has performed traditional Liposuction for 18 years with great success to his patients. We have added the Tumescent technique and Ultrasonic Assisted to benefit our patients’ results.
After Liposuction Surgery
Following surgery, you will be wrapped in an elastic bandage to reduce swelling and keep the skin in place. In complex procedures, you will be monitored closely to make sure no complications occur. Staples are typically removed in a week’s time and patients return to work after several days.
As with any cosmetic surgical procedure, complications are rare, but include infection, a reaction to the anesthesia, blood clotting, and fluid loss. Less severe risks include a numbing of the skin and moderate changes in skin pigmentation. If you smoke, Dr. Roche will advise that you stop both two weeks prior to and following surgery. To maximize the success of surgery and minimize the risk of complications, always follow Dr. Roche‘s instructions for surgical preparation and postoperative care.
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