Vortrag Dr. Schikorski in Tokio
M. M. Schikorski
Dept. of Surgery, KKH-Elmshorn, Germany

6. -8. April 2000

Two Years of Experience with the SONOCA-Lipo, a new neurosurgically derived ultrasonic device for Liposuction

We are using a standardized combination of Ultrasonic Assisted Lipectomy (UAL) and modified Suction Assisted Lipectomy (SAL): the Combined Procedure. There is a difference of the end point of UAL which has to be respected and the estimated aesthetic end point. By physically reasons Ultrasound Assisted Lipectomy is not able to reach the aesthetic end-point of liposuction, so you have to continue conventionally. SAL has not to be performed in the typical rough manner with quick and hard strokes. Due to primary UAL no vacuum as high as 0.9 bar is needed. This will avoid the risks of rough suction and tissue disadvantages of a high vacuum.
If Ultrasound is used to stimulate the shrinking of the skin as Münker describes you can often avoid the resection of the surplus of skin. For skin stimulation there is no increased risk of skin damage by the use of modern ultrasonic devices and non cutting tips of the sonotrodes. Modern devices will not create increased heat due to an absolutely stable oscillatory frequency. On the other hand heat can be produced by iatrogenic mistakes in the kind of working.
For normal aesthetic liposuction up to 4 liters of fat aspirate we solely perform the procedure in Tumescent Local Anesthesia (TLA) without a constant tissue irrigation. Due to the non-heating modern ultrasonic dissectors, constant irrigation as a cooling agent is not needed during aesthetic UAL. However, irrigation will be necessary in Large Volume and Mega Liposuctions. We experienced that there is an enormous improvement of the superficial analgesic quality by additional use of Ropivacain-S, a new long lasting local anaesthetic of the amid type. We will give you the formula of our TLA-Plus solution and we will demonstrate the tools we use for our methods : the SONOCA-Lipo from Söring/Germany and our newly designed slow motion cannulas.
At last Ultrasonic skin stimulation leads to increased shrinking of the skin, compared with conventional superficial liposuction, with very good results, more and more often, without the need of skin resection. The Combined Procedure will possibly take the place of the more risky and less aesthetic resective methods. This also applies for slim people with relaxation of the cutis.