Safety and clinical outcomes of contemporary liposuction techniques: evidence from a systematic review

Cosmetic liposuction is among the most frequently performed aesthetic procedures worldwide, with multiple technique refinements developed to improve efficiency, recovery, and safety. These include suction-assisted (SAL), power-assisted (PAL), ultrasound-assisted (UAL), laser-assisted (LAL), water-assisted (WAL), and radiofrequency-assisted liposuction (RFAL). Comparative evidence focused exclusively on isolated cosmetic cases remains limited. A systematic search of PubMed, EMBASE, and Web of Science was conducted to identify clinical studies on isolated cosmetic liposuction published between 2000 and 2025. Randomized trials, cohort studies, and extensive case series were included. The primary outcome was the incidence of procedure-related complications. Secondary outcomes, including efficacy, patient satisfaction, recovery, skin tightening, and durability, were synthesized qualitatively because of heterogeneity in outcome reporting. Thirteen studies met the inclusion criteria. Only one included study provided fully extractable numerical safety data for overall complications, seroma, and infection. Therefore, these safety outcomes are presented descriptively rather than as pooled meta-analytic estimates. The available evidence indicated low reported rates of overall complications, seroma, and infection, while serious complications remained rare (<0.1%). Qualitative synthesis showed that all modalities achieved comparable fat reduction and contour improvement. Studies generally reported improved operative efficiency with PAL, reduced early postoperative pain and blood loss with WAL, and modest short-term skin tightening with LAL/RFAL. Patient satisfaction was consistently high (≥80%) across techniques. Contemporary cosmetic liposuction techniques demonstrate favorable safety profiles, while evidence regarding efficacy, recovery, patient satisfaction, skin tightening, and durability should be interpreted cautiously because it was derived primarily from heterogeneous qualitative evidence.