In the reality TV show “The Doctors,” a woman under local anesthesia giggles on the operating table while fat from her saddlebags is being removed. A photograph taken the day after the procedure shows the patient with shapelier legs.
The segment introduced a new liposuction procedure called nutational infrasonic liposculpture or NIL, which, according to the “The Doctors,” “uses a special device that produces a rotational motion called nutation. This motion creates a sensation that tricks the nerves from signaling pain.”
It’s called Tickle Lipo, said the show’s cosmetic surgeon Sandra Lee. “The patients giggle while we do it.”
American plastic surgeon and TV host Dr. Andrew Ordon, who has been doing liposuction since the 1980s, said the new procedure has come a long way.
The most common method for liposuction uses a large cannula (a tube connected to a machine that siphons the fat) that is manually pushed back and forth and thus involves “more elbow grease” for the surgeon.
Dr. Ordon noted that what makes Tickle Lipo different is that apart from the nutational motion of the cannula, it uses small-bore cannulas, which makes the procedure less painful.
Dr. Lee added that the unique movement of the cannula helps prevent injury to the blood vessels, preserves connective tissue and allows for excellent skin retraction or tightening.
AAA Pharma Inc., a local medical equipment and pharmaceutical distributor, has made NIL available in the Philippines. AAA Pharma president Hiro Budhrani said, “The technology comes from a Belgian company, Euromi, a manufacturer of medical devices. NIL has been available in the international market since 1998, and is on its fourth generation of technical perfection. It is approved by the US Food and Drug Administration and has ISO certification.”
Faster recovery
StemGenics Center for Age Management and Regenerative Medicine is the first clinic to acquire NIL/Tickle Lipo in the Philippines.
Plastic surgeon Dr. Lito Alava said, “What makes Tickle Lipo different is that the cannula is driven by compressed air pressure. The nutational movement, spinning and pulsing, extracts more fat without harming the surrounding tissues. The result is less pain, less swelling and faster recovery. In common liposuction, you need to be more forceful. Tickle Lipo reduces the work during the procedure, making it easier on the surgeon and the patient.”
Technically, the cannula’s motion generates an infrasonic (very low sound waves) frequency. “Instead of directly hitting nerves, it sort of brushes against them in a cyclical manner. This motion confuses the nerves so it is not perceived in the brain as pain, but rather as a tickle,” said Alava.
Fellow plastic surgeon Dr. Evangeline Sison added: “There’s lesser trauma, which means less bruising for our patients. The device has an active safety system that is triggered when the cannula is used too forcefully. It will automatically stop. It goes through the target area with least resistance. If the tip of the cannula reaches a certain structure such as the tough connective tissues beneath the skin, it stops. The cannula glides toward the fatty area so you can siphon it. You just have to guide it.”
One of the merits is the adjustable speed. “If you need to harvest fat (for stem cell therapies and fat transfers), you can decrease the speed and vacuum pressure to more gentle settings and get viable amounts of fat. Some liposuction technologies have no speed control, so there is more pressure and more trauma. Others use laser heat or ultrasound energy, which can traumatize fat and skin. Tickle Lipo doesn’t use heat but rather just low sonic energy,” said Sison.
Alava added that the strong pressure exerted in siphoning the fat in common liposuction can sometimes cause dimpling or indentations on the skin. “With this technology, the chances of getting the rippled look is diminished because the fat removal is smoother.”
Regardless of the technology, success in body contouring is based on the patient selection and the doctor’s expertise. The ideal patient must be fit and have good skin elasticity but with some problem areas.
“The surgeon must have aesthetic sense especially in body symmetry, and he should exercise sound judgment. If not, you won’t be able to preserve the desired or aesthetic curvature of the area. Machines merely help to achieve that objective,” said Alava.
Ultimate beneficiary
Dr. Eduardo Santos, president and chief medical officer at the StemGenics Center, said, “Since we do fat-derived stem cell procedures, research has shown that the NIL technology on a per volume basis of fat is able to harvest two to three times more regenerative stem cells compared to the traditional technique. That’s the main reason we acquired this technology. With more regenerative cells, including stem cells, the ultimate beneficiary is the patient.”
The doctor added that patients get results earlier than usual, and he surmised that this is because NIL technology allows for a more robust harvest of regenerative cells.
Most of the clinical cases address anti-aging and wellness concerns, where patients may report increased energy levels, better quality of sleep, increased libido, younger-looking skin and better hair health.
But there is also a disease market, where patients with conditions such as early Alzheimer’s Disease, Parkinson’s Disease, diabetes, autism, autoimmune conditions, post-stroke and post-heart attack patients could benefit. It is in these clinical situations where the current bulk of stem cell research is being conducted.
“Most Filipinos still prefer the comfort of intravenous sedation even if the stem cell protocol requires extracting only 200 cc of fat,” he said.
Call StemGenics Center at 9427836. NIL/Tickle Lipo is distributed by AAA Pharma Inc., tel. 7268715 and 7277822.