What is a Cannula?
The cannula is basically a stainless steel tube used in every liposuction procedure which is inserted below the skin to suction out the fat. There are numerous different types and sizes of liposuction cannula and, depending on the type of liposuction procedure they are being used for, they may be specialized for that procedure.
Your surgeon may also have his or her preference as far as to the size and type of cannula used as these factors may affect their ease of work. Remember, the more ease a surgeon has in performing a procedure, the better the results you will have and the lower the risk of complication-so it is all to benefit you.
It is helpful to understand the different types of cannula, what they are best for, so that you and your surgeon may make a decision which is beneficial for the both of you.
The Basic Structure of a Cannula
The cannula is a hollow metal tube, which is attached to a syringe or suction device at the proximal end (The syringe itself is also available in different sizes and types. Each of these will have an impact on the procedure as well). The front end which actually enters into the skin and fat is called the distal tip.
The Distal Tip: The basic distal tip will have one or more openings in which the fat will enter into to be removed. There are various types and shapes of distal tips, some specialized to the type of liposuction they are used. The name of the cannula is usually determined by the type of distal tip it has.
The design and shape of the distal tip affects:
- The ease in which it can be manoeuvred into the skin and within the fat
- The ability to disrupt and extract down fat
- The versatility of use within various parts of the body
Here are some samples of the common distal tips and their uses/advantages. Bear in mind that there will be various types and brands of each of these as there are new patented distal tip designs being introduced every day:
V-Dissector Liposuction Cannula
This cannula is specifically designed for extraction of superficial fat in more dense fibrous tissue and in facial areas.
Tumescent Infiltration Liposuction Cannula
Although this cannula could technically be used for fat suction it is used especially for the infusion of tumescent solution into the body. The arrangement of the openings allow for even distribution of the fluid into the fat tissue.
Standard Liposuction Cannula
This is the standard design in distal tips and is used in areas where there is softer fat tissue as it is one of the most gentle cannulas within this type of tissue.
Flared/Basket Liposuction Cannula
This is a very versatile lipo-sculpting tool. It can be used in fat transfer procedures and to treat skin irregularities in revision liposuction procedures as it is effective for fat harvesting and for injecting fat.
Round-Tip Liposuction Cannula
This cannula has a rounded tip with two ports and is especially effective within dense fibrous tissue while being cell friendly.
Pyramid Liposuction Cannula
This is a very popular cannula commonly used among surgeons due to its efficiency and versatility .It has three ports located 180 degrees from the thumb print.
Spatula/field flap Liposuction Cannula
This cannula is specifically designed with an elevated edge to open and expose soft tissue for more precise suctioning. It is used for liposuction around the face and neck.
Flap Liposuction Cannula
The Flap is primarily used for undermining (separating parts of tissue such as skin form fat tissue. Smaller diameters versions are used in facial procedures.
Serrated Liposuction Cannula
This is especially effective for extracting and aspirating fat in tougher and more fibrous fat tissue. Removes large portions of fat at a time.
Length of the cannula is measured from the top of the distal tip to the proximal end, where it is attached to syringe or suction device. These lengths usually vary from 15-32 cm, with the longer cannulas being used for areas such as the thighs and back.
Diameter of cannula
Micro-cannula- Cannulas which have an inside diameter (ID) less than or equal to 2.2 mm (the ID of a 12-gauge hypodermic needle) are called Micro-cannulas.
Sometimes 3mm are considered micro-cannula
Micro-cannulas are increasingly popular in liposuction today. In the past regular-sized and macro-cannulas were considered safer as they led to less bleeding as they were less able to penetrate thinner blood vessels. These days, the improvements in homeostasis address this problem, making it safer to use micro-cannulas.
Advantages of Micro-Cannula:
- Less Pain during Procedures using local anesthetic.
- More ease of work for surgeon .It offers better accuracy in terms of surgeon’s ability to manoeuvre more precisely through the tissue. Micro-cannulas also penetrate through skin and fat tissue a lot more easily.
- Less fat is removed per stroke which means more sculpting accuracy and less risk of irregularity or removing too much fat and fluid.
- Create adits (a small, round opening in the skin, which is created by 1.0-mm, 1.5-mm, or 2.0-mm skin biopsy punches) and micro-incisions instead of larger incisions. Larger incisions will mean sutures are needed, which means longer recovery time, follow-up appointments, higher risk of infection and limited entry points to reduce risks. Since adits and micro-incisions could mean less or no sutures, this means faster recovery time lower rate of post-op infections less surgery time. More adits and micro-incisions could also mean better drainage after the procedure, which means faster healing.
- Healing and recovery time is shortened as smaller tunnels are created within the fatty tissue.
Advantages of Regular Sized Cannula & Macro-Cannula:
- Less bleeding
- More fat is removed per stroke so the procedure is quicker. It is used in areas where larger amounts of fat need to be removed.
- Larger cannulas are not as frail and delicate as micro cannulas which require more care and a specific way of handling, so the risk of complication through broken bending cannula is reduced.
- As the surgeon is less involved with a larger cannula, it may be a less expensive procedure.
- Useful in fat transfer procedures as it improves fat graft survival rate (tends to keep fat cells more intact) which can potentially improve fat graft survival and reduce fat graft resorption (fat break down after it is transferred to a new area of body).
As always the size and type of cannula will depend on your specific needs and your surgeon’s discretion. Your surgeon will evaluate your needs and make recommendations. If necessary, a combination of cannula sizes and types may be used during the procedure.