Below, Thomas Su, MD, a cosmetic surgeon and owner of Tampa, Fla.-based Artistic Lipo, reveals his personal approach to liposuction—awake-only liposuction, and why he believes it’s a better option than the traditional technique. He shares how awake-only liposuction is revolutionizing the field of body contouring, and why he thinks it’s the wave of the future.

Plastic Surgery Practice: How does awake-only liposuction with UCHD, or ultra-complete high-definition, compare to traditional liposuction techniques in terms of safety and risk?

Thomas Su, MD: Because awake-only liposuction uses only local anesthesia, the safety is much better compared to having to be put to sleep. General anesthesia—where a patient is put to sleep—carries an increased cardiovascular risk, as well as potential neurologic problems.

PSPCan you explain the process of remaining awake and alert during the UCHD liposuction procedure? How is patient comfort ensured?

Su: UCHD liposuction is a term I created to describe the high level of completeness—as well as the artistic reveal of muscle contours—possible compared to traditional, conservative liposuction, which creates much less change. 

For us to achieve this, the patient is also required to hold their muscles tensed throughout much of the contouring, thus requiring the patient to be fully awake. This allows the doctor to feel the firm, tensed muscle and use it to improve his/her control in more accurately sculpting the contours. While there is a variable degree of discomfort in using this technique, most patients tolerate it well. We can also add more anesthetic to keep patients comfortable.  

PSP: What makes UCHD liposuction a transformative solution for body contouring and sculpting?

Su: UCHD is liposuction taken to a higher level of artistic mastery. Liposuction can remove a small amount, or a very large amount of fat, depending on the patient and objective of the surgeon.

Imagine a sculpture being created from a block of stone. Traditional liposuction is like the rough outline of a sculpture just getting started, while UCHD is the sculpture at completeness, with all the stone being removed and all the shape and contour being fully revealed. This is a level of completeness that is not encouraged or strived for by traditional lipo surgeons, but it creates a much more beautiful result. UCHD does require more practice and a much more skilled surgeon. 

PSPCould you elaborate on the concept of being an “active partner” in the body transformation process with UCHD liposuction? What role does the patient play?

Su: I created the term ‘interactive liposuction’ to describe a technique that I believe I’m the first to publicize. It’s a necessary component to UCHD. It’s liposuction where the patient takes an active role in moving their body into different, optimal positions and holds their muscles tensed in certain ways to assist the surgeon and improve the liposuction results. Interactive liposuction is a breakthrough because getting incomplete or lumpy, bumpy results is a common reason for dissatisfaction in liposuction.

Having a hard surface of a tensed muscle below the fat allows the surgeon to hold the fat and guide the lipo cannula through the fat more accurately and apply pressure to it more effectively, allowing for much smoother results. It also allows the surgeon to safely sculpt closer to the muscle because they have a better sense of where the muscle is. Like we discussed, patients are asleep in traditional liposuction—and sedatives are often used in most awake liposuction procedures, which causes drowsiness. Interactive liposuction requires a patient to be fully awake—with minimal, if any, sedatives—[a feat that is not] possible with general anesthesia.

PSP: What specific advantages does the UCHD technique offer in terms of creating ‘sculpted’ shapes and curves?

Su: It’s nearly impossible to follow some of the fine curvature of different body areas and muscle contours unless you can feel them. A relaxed body makes it difficult, if not impossible, to feel the muscle surface and follow it accurately and safely. Using interactive lipo and sculpting in a UCHD manner allows a surgeon to achieve a beautiful, sculpted look.

PSP: Are there any limitations to the areas of the body that can be treated with awake-only liposuction using UCHD?

Su: All areas of the body can be treated with awake lipo and sculpted in UCHD, including the entire waist/abdomen, 360-degrees for the arms, 360-degrees for the thighs, 360-degrees for the knees, 360-degrees for the calves, and the chin/neck.

PSP: Typically, how long is the recovery period for patients undergoing UCHD liposuction?

Su: On average, it can take three months for swelling to disappear—with the lower legs taking up to six months to fully recover. Patients, however, can go back to most sedentary activities within a few days of treatment. They should wait at least one month before working out areas that were treated, though.