What is LSSA?

Yes, those are the areas where LSSA is primarily used. It is considered for localized fat that persists despite weight loss, such as a submental double chin, jowls drooping beside the mouth corners, and the cheeks or deep buccal fat. On the face, even a reduction of 1–2 cc per area can change the contour, so precise control is more important than removing a large amount indiscriminately.

Localized fat that does not reduce easily with weight loss often involves a concentration of fat cells in that area. In such cases, an approach that reduces the number of fat cells themselves may be helpful. The degree of change varies individually depending on the amount of fat and skin condition.

However, a poorly defined jawline may not be due to fat. If the cause is skin laxity, tension in the platysma muscle, skeletal structure, or chronic swelling, reducing fat may not produce the expected change. In fact, if skin elasticity is poor, removing fat alone may leave excess skin. In such cases, combining a lifting procedure or botulinum toxin type A to reduce muscle tension may be a better approach. Identifying the cause is the first step.

A notable difference from other methods is that it directly treats the fat layer without a large incision or sutures. The entry point is about the size of a needle hole, so the risk of scarring is relatively low. It is performed under local anesthesia, and the procedure time is short, about 15–30 minutes per area. The thin probe makes it easier to treat in layers even on the face, where nerves are dense, which is why it is considered for facial areas.

Ultrasound-assisted liposuction has been relatively well studied academically. A survey of 660 cases performed under local anesthesia reported a complication rate of 1.36%, and a series of 261 cases with third-generation ultrasound liposuction reported 4.6%. However, these figures are from devices using the same principle, not from LSSA itself. It has also been noted that evidence for a skin-tightening effect superior to conventional liposuction is still insufficient. It is realistic to consider any tightening as a secondary expectation. The appropriate method depends on individual factors such as the amount and location of fat and skin condition.

The most common side effects are swelling, bruising, soreness, and temporary numbness or tingling. These usually subside within a few days to two weeks, but recovery speed varies greatly among individuals.

Rare but important risks include burns due to the heat generated, uneven fat removal leading to contour irregularities or asymmetry, seroma (fluid accumulation), hematoma, infection, pigmentation or small scars at the entry points, and sensory changes from nerve irritation.

In individuals with thin skin or already reduced elasticity, fat reduction may make sagging more noticeable. The outcome of this procedure depends not only on the device's performance but also significantly on the practitioner's judgment in assessing anatomical layers and adjusting power. Since the face contains facial nerves and blood vessels, it is advisable to receive a full explanation of potential side effects before making a decision.

LSSA is performed after local anesthesia called tumescent anesthesia. Filling the fat layer with anesthetic fluid reduces pain transmission and swells the tissue, making it easier to manipulate the probe. A feature of this method is that general anesthesia is not required.

During the procedure, many describe the sensation as more of a pushing, vibrating, or heavy pressure rather than pain. However, most people feel a stinging and stretching sensation when the anesthetic fluid is injected, and pain thresholds vary individually. If you feel a hot or sharp pain during the procedure, it is important not to endure it and to inform the practitioner immediately, as this can be a signal to prevent burns.

After the procedure, you may experience a feeling of soreness similar to post-exercise muscle pain and tenderness when pressing the area for a few days. This is usually manageable with prescribed pain relievers, but if the pain gradually worsens or is accompanied by warmth or redness, there may be a possibility of infection, and you should seek medical attention.

Swelling is usually limited to slight swelling around days 2 to 3 after the procedure, which gradually subsides over 1 to 2 weeks. Depending on the area, a compression band may be recommended for a few days. It generally takes about 3 months for the tissue to settle and the final contour to become apparent. Cleansing and daily activities can be resumed relatively quickly, but this varies depending on the extent of the procedure and individual differences.

The removed fat cells are known not to regenerate. However, the remaining fat cells can enlarge, causing the area to thicken again, so it is difficult to say the results are 'permanent.' Significant weight gain can also alter the outcome, so weight management after the procedure is necessary.

Some people are satisfied with a single session, while others with a larger amount of fat or a wider area may discuss additional procedures or combining different methods. We recommend consulting with a specialist to determine whether this method is suitable for you, after assessing the amount and location of fat, skin elasticity, any medications you are taking, and underlying medical conditions.