Modern Lipo

Summary: When it comes to ultrasonic liposuction, there are two primary options: internal (surgical) application and external (transcutaneous) application. Some surgeons are skeptical of this more recent technology, while others report a high level of success in the use of either or both types of ultrasonic liposuction. Which approach offers the most consistent, reliable results from an objective standpoint?


Internal Ultrasound-Assisted Liposuction

The mechanics of liposuction are already familiar: small incisions are made near the target area, through which tumescent fluid is injected. After filtration, vigorous manual motion is needed to break apart the fat cells prior to aspiration. The difference in ultrasound assisted liposuction (UAL) is that a special probe is attached to the cannula that emits ultrasonic waves. During surgery, the sound waves emulsify the fat cells to further facilitate their removal.

There are several benefits to choosing UAL compared to traditional (tumescent) lipo:

  • Tissue-Selective Capabilities: UAL specifically targets adipose tissue, making treatment in more fibrous areas like the back or male chest much more accessible than they have been historically.
  • Less Invasive: The tissue-selective nature of UAL also allows surgeons to use less physical force during surgery, reducing bleeding and post-operative swelling and bruising.
  • Greater Finesse: Refined body contouring is easier with the help of ultrasonic energy rather than using aggressive physical tactics.

External Ultrasound-Assisted Liposuction

External UAL (sometimes differentiated as e-UAL) also uses ultrasonic energy to break apart adipose tissue prior to removal via liposuction. However, in e-UAL, the sound waves are transmitted transcutaneously rather than internally.

After injection with tumescent fluid, an external probe is applied to the epidermis of the target area, concentrating sound energy directly to the underlying fat cells. Just as with internal UAL, this process liquefies the fat cells for easier aspiration. The external application of ultrasonic energy does not preclude surgical removal of the adipose tissue through aspiration.

Other Ultrasonic Body Sculpting Applications

There are also external ultrasonic body sculpting methods that are completely nonsurgical and do not incorporate liposuction at all, yet are sometimes referred to as external ultrasonic liposuction. Although this is a completely inaccurate description of these methods, they are mentioned here for definitive clarification.

External ultrasonic body sculpting methods can be separated into two categories:

  • Focused: Known best under the LipoSonix® brand name, high-intensity focused ultrasound (HIFU) targets a concentrated burst of sound energy at the treatment area, applied transcutaneously.
  • Non-focused: Also applied transcutaneously, the use of diffuse ultrasonic energy allows for a broader treatment area as well as a more comfortable experience for the patient. VASERshape™ is an example of non-focused ultrasonic body sculpting.

In both HIFU and non-focused applications, the ruptured fat cells are not removed through external methods, but are instead eliminated through the body’s natural metabolic processes gradually over a period of several months.

Comparing Results

Despite individual testimonials to the contrary, nonsurgical liposuction alternatives, whether focused or non-focused, run a distant second in terms of overall results. While improvement may be seen, it’s simply not at the same level as surgical body sculpting.

As for comparing internal vs. external surgical UAL, both have been clinically proven to deliver excellent body sculpting capabilities in the hands of a trained and experienced surgeon. Both may be incorporated with additional types of lipo as well as other contouring surgeries. The choice between the two typically comes down to surgical preference and the cosmetic goals of the individual patient.

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Modern Lipo Statistics 2016


liposuction procedures performed in the United States in the year 2015


on average, between 8 and 12 pounds of fat can be removed using liposuction


Fat graft butt lift using liposuction performed in the U.S. in the year 2015