Bodytite

New Technologies in Liposuction and Body Contouring 

In the past several years new technologies have attracted considerable attention in the field of Liposuction. The most talked about has been Laser Assisted lysis. This refers to using Laser energy to help perform Liposuction. Different companies have attached different names to their devices, the first and best known being SmartLipo, manufactured by a company named Cynosure. Other types of Laser assisted Lipo include SlimLipo, SmartLipo and CoolLipo. While there are differences between these tools, they are all very similar, using a small (1mm) Laser fiber which releases energy at high temperature, basically melting the fat cells.

There are two potential advantages this offers in Liposuction. The first is that in areas where the fatty deposits are more dense and fibrous, such as the male breast, the upper abdomen, or sometimes the arm, the laser energy can melt through the dense tissue and thereby allow for better and more thorough removal of fat. Ultrasound assisted Liposuction also offers this advantage, with the only advantage of laser over ultrasound being that the laser fiber itself is small and remains cool; the ultrasound cannula is made up of titanium and heats up during the procedure, potentially leading to move irritation of the scar. The other advantage claimed by SmartLipo is skin tightening. This remains a very controversial claim. The method of tightening, if it occurs, is by tissue heating. The problem is that the fiber tip is extremely hot-over 400 degrees Fahrenheit, and the heating produced by such a small and hot tip is very erratic and irregular. Monitoring of heating is also very imprecise and therefore most experienced doctors using laser for Liposuction do not dare heat the tissues to the level that may cause tightening because the risk of full thickness burning of the skin, resulting in permanent scarring is so high. Indeed, often the most amazing claims concerning laser assisted Lipo are made by non plastic surgeons, usually doctors who have little or no prior Liposuction experience and have acquired SmartLipo or similar devices as a way of getting into the lucrative cosmetic surgery market. In this setting it is important that anyone considering Liposuction understand that the most important factor in achieving a safe and pleasing result from Liposuction is the skill level of the person performing the procedure. Such skill will generally come as a result of excellent training and experience.

The newest technology in Liposuction uses a different form of energy applied to the tissues, this being called bipolar radiofrequency. This form of Liposuction is called Radio Frequency Assisted Liposuction, or RFAL, with the only company currently in the field calling it BodyTite.

Just like after advanced technologies used in Liposuction, BodyTite involves the application of heat-producing energy during the procedure with the goal of breaking through more fibrous tissues and producing tissue tightening. There are several features of BodyTite that are unique and seem to be promising for improved results. Firstly, the radiofrequency energy produced in BodyTite passes from the probe, which is placed in the fat, to a second probe, which rests on the skin (see figure). This causes heating over a generalized area rather than a small spot, as is the case with SmartLipo. Second, the temperature of this heating loop is continuously monitored by sensors, which stop the energy production at any point where the tissues have reached a preset temperature. Early results with the BodyTite are very promising, with demonstration of tissue tightening in several areas, including abdomens, arms and necks, which did not seem possible with conventional liposuction alone. While approved for use in Europe and Canada, BodyTite use in the United States is currently considered investigational. Dr. Rapaport is one of a very select group of plastic surgeons using BodyTite in his New York accredited surgical facility. BodyTite is offered as an option to patients who need tightening but who prefer not to undergo more invasive procedures, that involve actual removal of loose skin, such as abdominoplasty (tummy tuck), brachialplasty (arm tuck) or neck lifting procedures. 

Anesthesia options in Liposuction 

There are 3 general options for anesthesia in people undergoing Liposuction: Local anesthesia, General anesthesia, or sedation anesthesia, also sometimes called twilight anesthesia..

All Liposuction, whether or not it involves advanced technology, such as BodyTite, laser, or ultrasound, involve the injection of dilute numbing medicine (lidocaine) and an ingredient which constricts blood vessels called epinephrine. The dilute lidocaine causes a general numbing of the area and the epinephrine constricts blood vessels so there is little bleeding during the procedure. When Lipo is performed under local anesthesia, it is this injection that makes the procedure tolerable. However, when Lipo is performed under pure local anesthesia, the lidocaine concentration must be higher to allow for adequate numbing. However, safely concerns relating to the risk of lidocaine toxicity and overdose limit the number and size of areas that can be treated by the local Lipo technique. Typically the local technique is best used to treat on or two relatively small areas. Additional areas can be treated on difficult days. The patient is generally premedicated with oral medication to relieve pain and promote relaxation (such as Percocet and Ativan). Dr Rapaport has been performing Liposuction procedures using local anesthesia for over 15 years. The sedation technique is the technique Dr. Rapaport uses for the majority only of his Liposuction procedures. It involves having a board certified anesthesiologist administer medications through an IV. The patient remains conscious, breathing on his or her own, responding and often talking throughout the procedure. The IV medications are extremely, short acting and allow the anesthesiologist to better assure patient comfort; following the procedure the patient feels alert and relaxed, typically with no memory at all of the procedure. This technique allows for a more standard numbing (lidocaine) concentration in the injected solution, and therefore more area can be treated. A typical Lipo under conscious sedation may treat the abdomen, hips, waist, and inner and outer thighs all is less than 2 hours in a safe outpatient setting.

Click Here to See Examples of Dr. Rapaport's Male Liposuction Work

Click Here to See Examples of Dr. Rapaport's Female Liposuction Work