What is external ultrasound-assisted liposuction?

External ultrasound-assisted liposuction (EUAL) is a technique by which the fat cells around the abdomen or thighs are disrupted. EUAL uses high-frequency ultrasonic fields to prepare the fat cells for surgical removal by liposuction.
The advantages of using high-frequency and high-intensity external ultrasound before liposuction are as follows:
- Enhanced fat extraction
- Decreased patient discomfort
- Decreased blood loss
- Negotiates scar tissue that other kinds of liposuction can’t penetrate
Other methods of liposuction are:
- Suction-assisted liposuction: This is the traditional method of liposuction in which the surgeon removes fat cells by inserting tube (cannula) connected to a vacuum pressure unit. The surgeon directs the cannula through tiny incisions into areas to be suctioned.
- Power-assisted liposuction: In this technique, a cannula with a back-and-forth motion tip passes through the tissue to suck out fat and scar tissue.
Why is EUAL done?
- EUAL is beneficial in patients with fat concentrated around arms, thighs, hips, and buttocks.
- EUAL, in conjunction with other procedures, may help in treating extremely obese patients.
- EUAL is also helpful in removing more fibrous areas, which cannot be removed by liposuction alone.
- It helps access fat through scar tissue.
- EUAL is also helpful in reducing large male breasts (gynecomastia).
- It's safe in body contouring.
- EUAL is effective in liposuction of thighs.
Who should not undergo EUAL?
- Patients with poor general health and chronic conditions should avoid this surgery.
- Patients with an extreme level of obesity should not undergo this surgery.
How is the EUAL procedure performed?
Before the procedure
- Consult the surgeon and discuss your goals, the options, risks, benefits, and costs.
- Your doctor will ask to restrict certain foods and limit alcohol consumption.
- You will describe your medications, including over-the-counter medications, herbal medications, and dietary supplements.
- You must undergo some laboratory tests to detect any underlying problems.
- Your surgeon will describe the procedure and get your informed consent.
- The areas to be addressed will be marked by the surgeon.
- Antibiotics are administered one hour before the surgery.
During the procedure
- Your surgeon might administer local or general anesthesia, depending on the areas to be corrected.
- The site is sterilized with povidone-iodine or betadine.
- Your surgeon will use a EUAL machine to disrupt the fat cells in the areas to be corrected.
- A transducer attached to the machine is placed on the site, which is moved in continuous circular strokes to apply the energy.
After the procedure
- Your doctor may prescribe acetaminophen and antibiotics for a few days after the surgery.
- You may note some leakage after the surgery.
- For high-impact sports you must wait for two weeks.
- Patients should wear compression garments continuously for two to four weeks.
- The practitioner may ask you to do light exercises or walking within a few days of the procedure.
What are the risks involved in EUAL surgery?
The following rare complications may be observed with EUAL:
- Skin burning
- Bruising
- Built-up of fluid in the areas of surgery
- Skin necrosis (cell death)
- Fibrosis (scarring and thickening of tissue which makes it harder)
- Pigmentation alteration and
- A person’s ability to function may be severely affected.
- Performing liposuction around the neck or upper chest can create depressions or cavities
- Blockage of blood vessels caused by air bubbles

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