LIPOsuction

. . . . . . . . . . . .

Low Frequency Liposuction –

The Power Cannula

by Nicanor Isse, M.D.

Low frequency liposuction (also called the power cannula) uses a mechanical vibrating cannula, with a frequency about 100 times per second, in contrast with the internal ultrasound that uses a frequency about 20,000 times per second.

The mechanical action is originating from a box, away from the patient. Then it is transmitted to a snail engine located on the handle of the cannula, where the frequency is reduced in order to decrease vibration of it. A reciprocated action is originating in this hand piece, moving a cannula approximately 3 mm. back and forth. The vibrating action of the cannula, plus the normal surgeon motion of the handle, allows the fatty tissue to be separated and suctioned out of the patients body into a container. I have used this machine in several cases, with the following findings:

Intra-operative findings: Due to the low frequency vibration of the cannula, the process of liposuction became easier, with gentle penetration of the cannula through the tissue

Intra-operative endoscopic examination of the "tunnels" shows integrity of the neurovascular bundles and fibrous septi surrounding the fat lobules. This is manifested clinically with less bleeding.

It is important to mention that the sizes of the cannula used were around 3 to 5 mm. Working on harder areas such as the breast, epigastrium and the back also become easier.

Superficial liposuction can be done without difficulty allowing a very good skin retraction. Liposuction around the umbilicus can be easily done. I have performed procedures under local (Tumescent anesthesia) of the lower abdomen. It was tolerated very well by the patient, appears to be less painful during the procedure, due to the fact that small cannulas and mechanical vibrations (low frequency) are used combined.

Because the surgeon's efforts are less, work can be done more comfortably with reduced operative time about 30 percent, except for a relative minimal vibration on the handle, which can be annoying after a couple hours of work. This condition, however, has improved especially with the newer version of the cannulas.

Clinically, the patient’s recovery appears to be more pleasant, less painful, although this term is very difficult to evaluate, due to the patient’s variations.

In summary, I can say that low frequency liposuction is a very good alternative to internal ultrasound. It is easier to use, no risks of burning of the skin, more superficial, more control work ran be done and it works very well on fibrous areas.

According to Dr. Edward Baccari, when he uses the power cannula, the results are more impressive - less bruising and pain. Prior to using this specific cannula, he was having problems with getting good results on the buttocks area.

The main difference with the power cannula compared to others is with the oscillation - it rotates in a vertical direction, said Dr. Baccari. Also, the power cannula doesn't take out any of the smaller blood vessels or nerves. Again, there's less bruising involved, he said.

"The power cannula works extremely well on the buttocks and the abdomen," said Dr. Baccari. "It works like a charm."

Before using the power cannula, Dr. Baccari used external ultrasound which, he said, didn't produce the same results. However, when the fat comes out from using the external, one receives better quality of fat, which can be used for reinjection. The fat that results from the power cannula is much coarser.

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

ABOUT the author

Dr Nicanar Isse completed his surgery and plastic surgery residency program at Wilmington Medical Center. Thomas Jefferson Affiliated Center In Wilmington Delaware. Following this, he obtained his Certification by the American Board of Plastic and Reconstructive Surgery. After completion of his plastic surgical training, he established his private practice devoted exclusively to plastic surgery n Los Angeles. CA. Dr. Isse holds a teaching position on the clinical faculty of the University of California Los Angeles School of Medicine, where he established the first Endoscopic Lab for the resident program. He else is a Clinical Instructor in surgery, Plastic Surgery Department, at the University of Southern California School of Medicine. He is a published co-editor-author of the book Endoscopically Assisted Plastic Surgery and author of many medical textbooks and journals.

62 Plastic Surgery Products MARCH 1999