Commentary on “Laser-Assisted Liposuction”

Abstract

li ni cs .c om During the past decade, in an era of remarkable advances in technology and cybernetics, surgeons have developed co-adjuvant tools for liposuction procedures that do not harm the patient. Before adopting any new technology, however, we must be sure the technique meets three essential criteria: that it does no harm, that it improves outcomes, and that it improves the quality and duration of patients’ recovery. Less invasive surgical procedures result in less surgical trauma and decrease the physiologic inflammatory response. In their article, Drs. Goldman and Gotkin review the procedure called ‘‘laser-assisted liposuction.’’ They claim that the ‘‘SmartLipo’’ laser reduces the patient’s downtime after the procedure and enhances the ultimate cosmetic result. This liposuction technique, they say, reduces blood loss and minimizes the side effects of anesthetics and the complications related to the procedure. The technique also improves skin contraction and redraping after surgery. Drs. Goldman and Gotkin conclude that surgeons can use this small-caliber, minimally invasive technology superficially, without leaving a ‘‘footprint’’ in the patient’s tissue, while inducing neocollagenesis and skin contraction that greatly benefit the patient. What is uncertain from Drs. Goldman and Gotkin’s article is the amount of fat that can be extracted with this technique and the amount of blood that is found in the supernatant when the procedure is done. Because adipose cells are very fragile, lipolysis can be done simply, with minimal trauma, using traditional procedures such as the cannula or with other procedures such as ultrasound and the application of internal or external lasers. The main goal of developing surgical co-adjuvant tools is not to provide an easy, faster way to remove fat but instead is to help the surgeon access places where the fat is difficult to remove, such as those surrounded by a large amount of connective tissue. The connective tissue and retinaculum cutis supply blood to the skin and flaps that keep the tissues alive. Because the cellular membrane