Ultra-Z ultrasonic lipolysis belongs to the latest-generation liposuction method. Its mechanism is to harness a high-frequency resonant ultrasonic lipolysis probe to rapidly vibrate and emulsify subcutaneous fats and then use the liposuction machine to remove emulsified fats. The working temperature of the Ultra-Z lipolysis machine is controlled at a range acceptable to the skin and soft tissue physiologically, which does not injure major nerves or vessels or even cause burn injury due to a high temperature. Besides, the thermal energy emitted during the process not only promotes blood coagulation and hemostasis of the capillaries to lower postoperative blood stasis but also facilitates protein condensation of subcutaneous tissues to deliver the additional effects of skin tightening or adhesion, thus achieving the dual objectives of fat removal and skin tightening, which is a feature not available in other liposuction methods (such as water jet or mechanical liposuction).

Besides, for the common purposes of obesity liposuction, Ultra-Z is applied for the sculpting of muscular textures and shapes due to its high-frequency lysis and emulsification of superficial fats. Ultra-Z is available in different diameters and lengths of lipolysis probes to conform to the superficial muscular texture and safely acts on the area only 0.5 cm below the skin layer without any physical limitations. It is widely used for regional muscle reshaping, such as the pectorals, biceps, abdominal six packs, or lower abdominal V-line, as such an extremely liposuction obtains certain degrees of muscle segmentation and prominence. Additionally, for superficial fats at other refractory parts, such as the chin, upper back, posterior waist, gluteal folds (smile line), or calf, this method can be used to obtain high degrees of fat reduction.

Such muscular sculpting is mainly aimed at maximally reducing superficial fats to bring out the esthetic lines of muscular textures, and for the thin skin area, it has to preserve only 0.3–0.5-cm thick skin at maximum to attain expected results. Therefore, despite the fact that Ultra-Z lipolysis can be applied to any muscular site, a flexible customized adjustment is also made based on the patient’s requirements, but the scope and safety of the surgery should be determined by the physician and patient after a joint discussion.

Surgical conditions

Duration

0.5hr

Type of anesthesia: IV sedation +local anesthesia or general anesthesia
Type of incision: A 0.5-cm incision of 2–3 cm around the abdomen
Recovery: 5–7 days
Removal of stitches: 7–10 days

General instructions

No food and water on the day of surgery

0hr

Avoid any muscular exercises for 2 weeks postoperatively.
Try to avoid vigorous exercises or weight training for 1 month postoperatively.
Continue muscular training exercise at the surgical site for 6 months postoperatively to attain better results.

Ideal candidates

Patients with a relatively slim figure who find it difficult to have a muscular line or texture
Those who are unable to attain satisfactory muscular lines by regular exercises
Those who are unable to restore the previous muscular figure due to aging or skin looseness
Those pursuing optimal weight loss and muscular lines

Possible complications

Skin depression
Irregular lines
Pigmentation (temporary)
Results short of expectation

Surgical advantages

The surgical hemorrhage is small, and the recovery is fast.
It rapidly reduces skin thickness and presents muscular lines.
It sculpts skinny or fit figures.
The customization degree is high as patients request the area and shape of muscular sculpting.

Surgical drawbacks

It is not applicable for patients with systemic obesity.
Patients have to undertake diet control or perform regular exercise after surgery to maintain results.
Surgical results are poor in patients with already loose or excessively aging muscles.
Muscular sculpting results in a rotund figure.
It may cause regional skin depression or atrophy.
Surgical results are irreversible.

Comparison between Ultra-Z ultrasonic liposuction and other liposuction methods

	PAL power-assisted liposuction	Ultra-Z liposuction	Water jet liposuction	Laser lipolysis
Ideal candidates	Generally obesity or deep fat deposits	Generally obesity, deep and superficial fat deposits, or regional muscle sculpting	Generally obesity or deep fat deposits	Regional or small-area obesity
Anesthesia method	General anesthesia or IV sedation	General anesthesia or IV sedation	General anesthesia or IV sedation	IV sedation + local anesthesia
Liposuction depth	Deep fats	Superficial/deep fats	Deep fats	Superficial fats
Liposuction mechanism	Mechanical suction	Ultrasonic and thermal effect	Water pressure	Thermal effect
Liposuction tube diameter	3–5 mm	1.2/1.9/2.9 mm	3.5–5 mm	1 mm
Action sites	Arms, waist, abdomen, thighs, fat areas over the whole body	Face, chin, arms, waist, abdomen, thighs, upper back, buttocks, calf, and muscular sculpting	Waist, abdomen, and thighs	Face, chin, and arms
Liposuction volume	Moderate (within approximately 3000 cc)	Most (within approximately 4000 cc)	Moderate (within approximately 3000 cc)	Least (less than 100 cc)
Intraoperative hemorrhage	Moderate	Mild	Mild	Mild
Skin tightening	No	Yes	No	No
Muscle sculpting	No	Yes	No	No
Skin unevenness	Probable	Very unlikely	Very unlikely	No
Postoperative edema	Moderate	Mild	Severe	Mild
Postoperative pain	Obvious	Mild	Mild	Mild
Surgery objective	Fat reduction	Fat reduction/ muscular sculpting	fat reduction	Regional fat reduction
Wearing a compression garment	3 months	1–2 months	2–3 months	No
Fat reuse	Yes	Yes	Yes	No