Body
What are the Different Kinds of Liposuction?
Liposuction names can describe different parts of the same procedure: the numbing solution, a motorized cannula, or an added energy device. In this episode, New York City board-certified plastic surgeon Darren M. Smith, MD, FACS explains the vocabulary and why a device name alone does not determine the right plan.
In this episode.
Episode summary
Liposuction names can describe different parts of the same procedure: the numbing solution, a motorized cannula, or an added energy device. In this episode, New York City board-certified plastic surgeon Darren M. Smith, MD, FACS explains the vocabulary and why a device name alone does not determine the right plan.
Originally published August 26, 2020. The device comparisons reflect Dr. Smith's experience at the time. He explicitly distinguishes those preferences from comparative research evidence.
Key takeaways
🔬 The underlying procedure removes fat through a cannula.
Dr. Smith first describes access incisions, numbing medication, and suction before explaining the additional terminology.
🔎 Tumescent and power-assisted describe different features.
One refers to the fluid placed in the treatment area; the other to mechanical movement of the cannula.
🔎 Energy devices are not interchangeable labels.
The recording discusses laser energy with SmartLipo, ultrasound with VASER, and radiofrequency approaches including BodyTite and J-Plasma.
🔬 Fat removal and skin laxity are separate planning questions.
Dr. Smith discusses why easier fat removal does not automatically establish how much skin tightening an individual will achieve.
🎯 Patient selection remains central.
He explains that substantial loose skin may exceed what an adjunctive tightening treatment can address.
Questions this episode answers
What does tumescent liposuction mean?
It refers to the solution injected into the treatment area as part of the procedure. In the recording, Dr. Smith explains how the term relates to the tissue becoming firm after that fluid is introduced.
What is power-assisted liposuction?
It uses a motorized cannula that moves rapidly to help the surgeon remove fat. Dr. Smith describes it as mechanical assistance within liposuction, rather than a separate approach to weight loss.
Will an energy device eliminate loose skin?
That cannot be assumed from the device name. The episode emphasizes the degree of laxity, patient selection, and the operator's experience. Its 2020 comparisons should not be read as a current ranking of every available device.
ℹ️ Current related reading
Liposuction technologies and the practice's current approach | Liposuction | BodyTite | Request a consultation
Educational information; the appropriate technique and expected outcome require an individual assessment. Show notes updated September 30, 2026.
Original show notes
Liposuction is one of the most popular procedures Dr. Darren Smith performs in his New York City plastic surgery practice. Sometimes all of the adjectives surrounding the procedure (tumescent lipo, smart lipo, power assisted lipo, etc.) can make the whole thing a bit mysterious. Listen here for an explanation.
Read the conversation.
[00:08] I'm board certified New York City plastic surgeon, Dr. Darren Smith, and this is plastic surgery before and after. Your source for the real deal about plastic surgery procedures, news about trends in aesthetic medicine, and candid sessions with industry insiders. We hope you enjoy today's episode. What are the different kinds of liposuction? So let's dive right in and... Start off by saying that as far as modern techniques go there really is only one kind of liposuction and all the fancy terms refer to add-on procedures that have pluses and minuses that might be right for some people and not right for others. And we'll go through that here. So when we talk about liposuction in today's modern plastic surgery practices, we are describing a procedure during which tiny three to four millimeter incisions are made. Numbing medicine is injected into the treatment area through those incisions. And then a long thin instrument called a cannula is used to suction away excess fat and achieve an improved body contour.
[01:19] Liposuction, as we've just described, can usually be performed either as a procedure under general anesthesia, so you're completely asleep and you have a machine helping you breathe. It can sometimes, for limited cases, be performed under local anesthesia so that you are numb in the treatment area, but you are completely awake and breathing on your own. And then there are also the cases, and these are actually quite common, that are performed in something of a middle ground between these two extremes, and this is called of twilight anesthesia or sedation, so that while you have numbing medicine in place, you are also given IV sedation by a board certified anesthesiologist to make you feel a little bit loopy and you are dissociated from the goings on and you are not as concerned with what's happening, so the liposuction is still a very comfortable process.
[02:11] I mentioned that as part of the liposuction procedure, numbing medicine is injected into the treatment area through these small incisions. The numbing medicine is called tumescent solution. And tumescent solution gets its name from the fact that the solution is injected until the treatment areas are firm or tumesced. So again, the numbing medicine is called tumescent solution. And that's why some people refer to liposuction as it's usually performed today in modern plastic surgery practices as tumescent liposuction. That's all there is to it. The next term that often comes up in describing liposuction procedures is power assisted liposuction. What this refers to is the fact that the liposuction device, the cannula, has a small motor attached to it that makes it vibrate back and forth in and out very quickly. And this essentially helps the surgeon suction out the excess fat more rapidly and with...
[03:15] less effort. So while power-assisted liposuction makes the surgeon's job easier, it also helps us achieve better results because instead of enduring a pretty physically grueling process of suctioning large volumes of fat, the power-assisted liposuction kind of does a lot of the hard work for us so we can focus more on the fine details of the procedure and achieve a truly excellent result. So those are the major pieces of vocabulary people use to describe a standard liposuction. There's liposuction and tumescent liposuction, which are the same thing, and power assisted liposuction, which is just liposuction with the addition of a motorized cannula to reduce the physical workload on the surgeon so that the surgeon can concentrate on achieving a really great contour.
[04:10] So now let's move into some of the other kind of fancy terms people apply to liposuction. And the ones that we're going to focus on here are smart lipo, vaser, V-A-S-E-R, liposuction, body tight, and J plasma. So all of these technologies have one thing in common. Their end goal is to heat the tissue to one, make the liposuction process easier for the surgeon to perform, and two, to tighten the skin of the treatment area so there is a reduced risk of skin laxity after performing the liposuction procedure. So just in terms of a brief rundown of how each of these technologies work, smart lipo relies on a laser to heat the surrounding tissue.
[05:07] and achieve some degree of skin tightening and to improve the surgeon's ability to suction the treatment area. The body type device uses radio frequency energy to heat the treatment area and achieve these goals. Vasor liposuction uses ultrasound energy to heat the tissue in the treatment area. And finally, J plasma. uses radio frequency energy to heat helium gas and cause tissue contraction and improve the surgeon's ability to get through the tissue with energy from that process. While body tight and J plasma Do both use radiofrequency energy? An important distinguishing feature here is that the JPlasma device is unipolar, meaning there is only a heat source under the skin, whereas the body-tight device uses bipolar radiofrequency energy. So the radiofrequency energy is essentially fired between a probe under the skin to one over the skin and vice versa. And temperature is very precisely controlled at both of those points to ensure both safety and efficacy. So there's a brief overview of how these different technologies work to produce heat that can enhance the results of a liposuction procedure. So let's look at how each of these technologies performs with regard to each of those goals, namely making the liposuction procedure easier to perform and more importantly achieving some degree of skin tightening.
[06:51] And full disclosure, this discussion is purely based on my personal experience. It is not based on data because frankly there is not any wonderful data to describe the efficacy of these various technologies with respect to the degree of skin tightening they can achieve and certainly not with respect to the degree to which they can make performing liposuction a bit easier for the surgeon. So in terms of the goal of making liposuction easier to perform and thereby facilitating a better result, the Vaser system. in my experience, really wins out here. The Vaser system uses ultrasound or a super fast vibrating wand to induce a state called cavitation, which essentially shakes fat cells free of surrounding connective tissue.
[07:51] And the result is that performing liposuction after the tissue has been treated with Vaser ultrasound is extremely easy. And while I don't think that Vaser liposuction is indicated or acquired in most liposuction cases, there are... two specific instances in which it can come in very handy and that is in the case of gynecomastia or male breast reduction. The vaser system really breaks up the tough fat in the male breast very nicely and makes it amenable to suction. And then also in secondary liposuction cases, when we go in and perform liposuction on people that have previously had liposuction, the VASER system comes in very handy because it really shakes up the fat cells that are attached to existing scar and makes them a lot easier to suction out with our liposuction cannula.
[08:49] In terms of the other goal of achieving some degree of skin tightening, the radiofrequency that is achieved with body tight, the bipolar radiofrequency device, does work very well. However, this is really a procedure that is very dependent on two things. One is the skill of the person performing the procedure and two is patient selection. So this is a technically difficult procedure to perform because like I mentioned, it is bipolar radio frequency energy. So both the internal and external pole need to be kept at fairly precise temperatures. for the right amount of time to achieve the desired result of tissue contraction. And this is something that can be a bit finicky and really requires great expertise with the body-tight device to truly master. The next component, patient selection, is so important because while body-tight radiofrequency skin tightening can be a truly great adjunct to liposuction if someone has skin laxity that is too extreme for the device, they're just not going to achieve a satisfying result. So again, you really need an experienced board certified plastic surgeon here to be able to identify the patients who will see the excellent results from the body type procedure when performed in conjunction with liposuction.
[10:22] In terms of the other two technologies, JPlasma and Smart Lipo, my experience with JPlasma is really primarily from speaking with colleagues and they have, for the most part, not been terribly impressed with this technology. And as far as Smart Lipo goes, this is, I'd say, a moderately useful technology. for skin tightening, but it would not be my go-to choice. I would almost always use either vaser liposuction or body tight in conjunction with liposuction for skin tightening before I would turn to smart lipo. But if smart lipo is the only option that's available, or if a patient has previously tried vaser... or body tight and wanted to try something new, then Smart Lipo might be a reasonable option to check out. So hopefully this run-through of available liposuction technologies will be helpful as you are reading about various options. And we always welcome any questions that might come up. You can reach us at contact at darrensmithmd.com. And we're looking forward to hearing from you.
[11:39] Thanks for listening, and don't forget to subscribe, share the show, and head over to DarrenSmithMD.com for more real-world plastic surgery talk.
Sources and context.
Original Captivate episode. Original release date: 2020-08-26. The recording is the source for the transcript and episode discussion. Later context in the written summary is identified separately.
Behind the conversation.
Darren M. Smith, MD, FACS