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Suction Assisted lipectomy (SAL) was first used in the 1920's when a uterine curette was used to remove fat. The technique was developed by early workers in Europe and introduced to widespread use in North America in the 1980's. In the 80's fat was aspirated (removed) using fairly large cannulas (special suction tubes) without any attempt to first liquefy the fat. General anesthesia was common. Quite naturally, the early technique often was accompanied by unwanted side effects or complications. Tissue injuries were also quite widespread.
This technique involves injecting the area to be suctioned with a special fluid/anesthesia combination prior to suctioning. This is called Tumescent Liposuction. The fluid constricts the surrounding blood vessels, making the procedure nearly bloodless, while minimizing the pain. The rest of procedure is performed in the same way as traditional Liposuction.
Tumescent fluid contains anesthetic and vasoconstrictive substances, including adrenaline and lidocaine. In order to obtain the desired benefit of fat softening and local numbness, large volumes of tumescent solution were frequently injected. Large amounts of lidocaine may lead to fluid and electrolyte disturbances with cardiac depression and even overt heart failure. Adrenaline may produce adverse reactions, such as cardiac arrhythmias, persistent tachycardia and blood pressure elevation.
Dr. Chugay uses smaller amounts of tumescent fluid, in quantities that, over the years, have been accepted as safe. However, neither the anesthetic effect, nor the fat liquefaction is diminished. Utilizing IV sedation magnifies the anesthetic effect; the softening effect is achieved by utilizing an external ultrasonic device. Thus, with lesser and safer amount of tumescent fluid, Dr. Chugay is able to achieve more liquefaction and adequate anesthetic effect.
Dr. Chugay injects less tumescent fluid than what is done in regular practice because he utilizes ultrasonic waves to liquefy the fat, thus making it easier to extract it.