Answer:
Superficial liposuction is a technique whereby the superficial subdermal layer of fat is removed to enhance skin retraction and correct irregularities (peau d’orange) of the skin. Suction of the subdermal layer of fat reduces the thickness and consistency of the superficial fat and enhances the possibility of skin retraction. Subdermal superficial liposuction was first introduced in 1989, and is used as an adjunct to traditional liposuction. In areas where large volumes of fat have stretched the overlying skin, traditional liposuction in conjunction with superficial liposuction results in better skin retraction and improved overall clinical results, even in flaccid and aged skin.
Technically, superficial liposuction employs the use of small cannulas (1.8-2 mm) of various designs. Different types of cannulae used include: perforating cannulae with a sharp tip in order to minimize tissue trauma and greater ease of handling; the Mercedes cannulae which has three orifices, in order to maximize efficiency of aspiration, and is best used in the deeper layers of the abdomen and saddle bag areas to minimize the risk of producing depressions; the Robles cannula, which has a sharp beveled tip of small caliber, used for fine-tuning at the end of the procedure.
Superficial liposuction can be done either: 1) with no infiltration (dry technique), in which no solution is infiltrated, however, this is generally considered to be traumatic and causes undue blood loss and no analgesia; 2) wet liposuction, using infiltration of a solution containing a diluent (isotonic solution), an analgesic (0.25-1% lidocaine final dilution if done under local anesthesia) and a vasoconstrictor (1:500,000 dilution for each 500 ml of infiltating solution); or 3) with anesthetic hyperinfiltration as is used for the standard tumescent technique. The superwet technique is recommended for UAL.