The Operation

The entire surgery is performed through punctures in the skin 5 mm long or less. Each incision is carrefully planned to minimise the visibility of the resulting final small scar eg. in a natural skin crease. A dilute adrrenaline containing anaesthetic solution is infiltrated into the fatty deposits to be treated. A liposuction tube or cannula is passed through the unwanted fatty deposits whilst connected to high vacuum. Initially the deeper layers are treated and then progressively smaller cannulas are used as the skin surface is approached. The dilute fluid, or tumescent fluid, has many effects. Firstly, it numbs the area being treated. Secondly, it contains adrenaline to constrict the blood vessels to decrease bleeding and post-operative bruising. The fluid also swells the fatty compartment, thereby allowing the surgeon to pass the small cannula through more times. As each of these passes does not go down exactly the same track, the net result is to remove the fat in a sheet like manner, meaning the final result is smoother with less chance of grooves and ridges. This is SAL liposuction (suction assisted lipectomy).

During the 1990s ultrasound-assisted lipoplasty (UAL) became popular. This system is similar in many respects to SAL (described above) except the incisions required are larger and the cannula vibrates millions of times per second, liquefying the fat prior to it being removed by suction. UAL has the advantage of being better suited to more fibrous areas (eg the back and the male breast), but comes with the disadvantage that the system generates enough heat that the skin can easily be burnt or the blood supply damaged.

More recently PAL (power assisted lipectomy) was introduced to New Zealand. This system combines traditional SAL with a mechanical device to move the cannula approximately 2 mm backwards and forwards up to 4000 times per minute. With this mechanical advantage, fibrous areas that were traditionally difficult to treat with SAL are now readily treated without the disadvantage of the potential complications of UAL. This system reducess the pressure Dr Masters must apply during liposuction and allows him to spend more time and concentration on guiding the cannula tip rather than forcing it through the tissues.

Once the fat removal is complete, hidden dissolving stitches are used to close each small incisions. The patient is then placed in a custom-made post-operative pressure garment that they will wear for approximately three weeks.