Differences between WAL and TAL liposuction

TAL, PAL, WAL, SAL, FLLA… It’s easy to get lost in all the terms and acronyms associated with liposuction techniques.

Here is some information to guide you between the liposuction techniques known as “TAL” and “WAL” liposuction.

TAL liposuction

TAL liposuction (also known as TLA) is a “standard technique” for infiltrating adipose tissue prior to the liposuction procedure.

TAL is an acronym for “Tumescent Local Anesthesia”. It involves injecting a “low-concentration local anesthetic solution” (with low doses of lidocaine and epinephrine) into the subcutaneous fat at a low rate under the skin, creating a temporary swelling which is then re-injected via a cannula (a cannula is a small tube injected to draw in or inject air or liquid into the body).

Liposuction WAL

Liposuction WAL which stands for Water-Assisted Liposuction System, is a technique created in 2011 by the manufacturer Human Med to treat lipedema in particular. Via a cannula (small tube) coupled with a small aspirator, small adjustable jets of water (hydrojet) inject a saline and anesthetic solution into the areas to be treated, while at the same time aspirating the fatty tissue.

The small jets of water injected into the “diseased fat” of the lipedema will dislodge, loosen and detach the fat cells, which will be progressively sucked up and land in the machine’s reservoirs.

Differences and advantages

The main difference between TAL and WAL is that in TAL surgery, fluids are injected under the skin BEFORE the surgeon aspirates them, whereas in WAL surgery, fluid injection and aspiration are SIMULTANEOUS.

The WAL technique allows greater respect for the patient’s lymphatic network, nerves and vessels, reducing damage and destruction to these. With the WAL technique, the total volume of water injected under the skin is lower (not all the anesthetic solution is injected at once), so limbs are less swollen and more easily “sculpted” by the surgeon.

Thanks to the WAL technique’s water jets with adjustable flow and speed, and injections rapidly followed by aspiration, the operation is much shorter and more controlled. The anaesthetics and other products present in the injected liquids do not have time to penetrate deep into the patient’s circulatory system, as they are rapidly aspirated, reducing the risk of discomfort and nausea.

Similarly, the severity and frequency of edema, contusions and swelling are reduced with the WAL liposuction technique: this is why Dr Nicolas Zwillinger recommends WAL liposuction in the treatment of Lipedema.

Differences between WAL and TAL liposuction: explanatory video