Suction-assisted lipectomy (SAL) for body contouring:
infiltration and aspiration ratios revisited
Umar Daraz Khan
Received: 23 July 2012 / Accepted: 15 November 2012 / Published online: 29 December 2012
Springer-Verlag Berlin Heidelberg 2012
Background With the current advancement in technology,
different forms of techniques for liposuction are introduced.
However, suction-assisted lipectomy remains the gold stan-
dard. Suction-assisted liposuctions can be performed using
dry, wet, super-wet, and tumescent techniques based on the
use of infiltration volume. A retrospective analysis was
carried out to evaluate the outcome of regional body con-
touring using suction-assisted lipectomy.
Methods A retrospective analysis of prospectively collected
data of 110 patients who had suction-assisted lipectomy was
performed. All patients had their procedure performed by a
single surgeon between 2008 and 2009.
Results A total of 198 areas were identified in nine regions
of 110 patients. Of these patients, 33 were males and 77
females. The mean age of the male patients was 38.2 years
(range 19–59, SD±9.5), whereas the mean age of the
female patients was 41.2 years (range 19–68, SD±10.4).
The mean body mass index of the patients was 28.6±4.9.
The areas included the neck (n=19, inf/asp ratio 1.19),
arms (n=16, inf/asp ratio 0.45), chest (n =16, inf/asp ratio
0.75), abdomen (n =29, inf/asp ratio 0.41), inner thigh (n =
20, inf/asp ratio 0.49), outer thigh (n=30, inf/asp ratio
0.48), knee (n=12, inf/asp ratio 0.24), hips (n =34, inf/
asp ratio 0.56), and upper back (bra strap area) (n=22, inf/
asp ratio 0.65).
Conclusions The outcome suggests that body contouring
using suction-assisted lipectomy is an effective method
when performed using low volume of infiltrate.
Level of Evidence: Level IV, therapeutic study
Since the introduction of the blunt cannula by Illouz,
suction-assisted lipoplasty (SAL) has revolutionise the ho-
rizonofbodycontouringprocedures. Lipoplasty or
liposuction for body contouring is considered one of the
safest aesthetic procedures with reproducible results. It is
not surprising that 289,016 liposuction procedures were
performed in 2010 alone by the Board Certified Surgeons,
making it the second most common procedure in the USA
. The blunt lipoplasty procedure was initially started
without infiltration or wetting solution as ‘dry lipoplasty’.
However, dry lipoplasty was associated with high blood loss
(lipocrit ranged from 20 to 45 %) .
Later, Illouz started using 200 to 300 cc of wetting
solution regardless of the aspirate known as the wet
technique. The use of epinephrine in wetting solution
by Hetter and by using 1:1 infiltration aspiration ratio
brought down the lipocrit to 8–30 % [3, 4]. The intro-
duction of infiltrate or wetting solution in the ratio of
2:1 (super-wet technique) and 3:1 (tumescent technique)
with epinephrine further brought down the percentage of
lipocrit to 4–8%[3, 5
]. The rise in the number of
U. D. Khan (*)
Re-Shape Clinic, Kent, UK
Eur J Plast Surg (2013) 36:359–366