Traditional Liposuction Research Articles

Comparison of Different Techniques: Ultrasonic, Laser, and Traditional Liposuction with a Discussion on New Directions and the Future of Liposuction Techniques

Liposuction is one of the most commonly performed procedures in aesthetic surgery, with an increasing variety of available methods that enhance both the effectiveness and safety of this treatment. The aim of this paper is to analyze and compare three primary techniques: ultrasonic, laser, and traditional liposuction, as well as to highlight potential directions for the development of this procedure. Based on available literature and research findings, both the effectiveness and potential risks associated with each of these methods will be assessed, allowing for the identification of optimal solutions tailored to the individual needs of patients.

Investigating Alterations in Blood Parameters Pre-lipolysis and Post-lipolysis Surgical Intervention

Background: Laser lipolysis is one of the most prevalent liposuction techniques and is widely preferred in cosmetic surgical procedures globally. Compared to traditional liposuction, some investigations have demonstrated a reduction in complications when using the laser lipolysis technique. However, the amount of research in this area remains limited. Objectives: This study aims to investigate changes in pre- and post-operative blood parameters, including hemoglobin level, hematocrit, WBC count, and platelet level. Additionally, the research explores potential complications following laser lipolysis. Methods: This retrospective study, conducted at the Isfahan Clinical Center (Najaf Abad Branch), included 100 patients (without previous hematological disorders) who underwent laser lipolysis. Demographic information about the patients was collected. Blood parameters (hemoglobin, hematocrit, WBC, and platelets) were measured before and 24 hours after the operation. Laser liposuction was performed using a 1064-nm Nd laser. Postoperative care instructions were provided. Statistical analysis included t-tests and mixed linear regression using SPSS 20 software for data analysis, with a significance level of P < 0.005. Results: Significant alterations were observed in hemoglobin, WBC, and platelet levels. Hemoglobin and platelet levels showed a notable reduction of 16.9% and 7.9%, respectively. Conversely, the WBC count increased by 100.5%. Conclusions: Our study found a significant decrease in hemoglobin levels following laser lipolysis surgery, likely due to intraoperative bleeding. Further research is recommended to compare hemoglobin level changes using different laser types.

Correlation between BMI, amount of aspirated fat and post-operative complications in VASER liposuction: A single centre experience

BackgroundVASER liposuction is an innovative technique that allows surgeons to selectively remove fat and shape desired areas of the body, resulting in more precise and controlled outcomes compared to traditional liposuction techniques. VASER liposuction offers several advantages, including targeted action that reduces trauma to surrounding tissues, limiting pain, swelling, and recovery time. PurposeThis article compares complication rates among patients undergoing VASER liposuction in relation to their BMI and the amount of fat aspirated. MethodsThe authors reviewed the medical records of all patients who underwent VASER liposuction at Scalera Clinic in Naples, dividing them into two groups: the first with BMI <24.9 kg/m2 and the second with BMI >25.0 kg/ m2. ResultsThe authors examined 117 patients operated on within a year (2022/2023), with 48 having a BMI <24.9 kg/ m2 and 69 showing a BMI >25.0 kg/ m2. It was observed that in patients with a BMI >25 kg/ m2, the most common complications were contusion, hematomas, and abnormal skin retraction, while no complications were observed in the normal-weight patients. ConclusionsTo minimize post-operative complications and maximize results, it is advisable to select patients based on BMI assessment, the anatomy of the treated body area, and the volume of fat to be removed. This approach aims to ensure that patients are suitable for the procedure and that the achieved results align with their aesthetic expectations.

Redefining Abdominal Contours: An Analysis of Medium Definition Liposuction Abdominoplasty.

This study elucidates the application of Medium Definition Liposuction Abdominoplasty, a novel technique for achieving well-defined abdominal contours. The technique focuses on revealing the patient's inherent muscular volume and form by creating thinner flaps compared to traditional liposuction methodologies. Objective evaluations of the abdominal wall's configuration were systematically executed both pre- and post-intervention for each participant. Digital image measurements facilitated by an image software constituted the basis for these assessments. The Body Fat Index was computed using precise measurements from seven distinct anatomical sites, with two measurements taken at each site and subsequently averaged. Over a span of 63 months, 300 patients underwent this combined procedure, resulting in discernible enhancements in the configuration of their abdominal walls in 97.6% of cases. However, complications such as partial diminution of tension in the muscular wall (2%), distal flap necrosis (0.6%), and minor muscular hernia (0.3%) were observed. The employment of combined muscle plication emerges as an efficacious methodology in meticulously rectifying alterations inherent within the muscular aponeurotic abdominal wall. This technique ensures the preservation of the original anatomical structure and functional dynamics, thereby circumventing the manifestation of local distortions that may arise from inadequate or excessive corrections. The study introduces a novel technique, Medium Definition Liposuction Abdominoplasty, for achieving well-defined abdominal contours. This technique focuses on revealing the patient's inherent muscular volume and form by creating thinner flaps compared to traditional liposuction methodologies. Objective evaluations of the abdominal wall's configuration were systematically executed both pre- and post-intervention for each participant. The Body Fat Index was computed using precise measurements from seven distinct anatomical sites. Over a span of 63 months, 300 patients underwent this combined procedure, resulting in discernible enhancements in the configuration of their abdominal walls in 97.6% of cases. This technique ensures the preservation of the original anatomical structure and functional dynamics, thereby circumventing the manifestation of local distortions that may arise from inadequate or excessive corrections. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

High-Definition Liposuction Contouring of the Arms in Males and Females

Liposuction is one of the most common esthetic procedures performed in both males and females. High-definition liposuction has become more sought after recently, especially to define the arms and abdominal musculature. This is a case report of high-definition liposuction of the arms to create markings and techniques to obtain a muscular and sculpted appearance of the arms. Between July 2022 and October 2023, 6 patients were selected for high-definition liposuction to bilateral arms. Specific pre-operative markings were made to outline the deltoid, biceps, and triceps. Traditional liposuction with focus on liposculpture of these markings was done to define the muscles of the arms. Results showed that with proper selection, pre-operative markings, and adequate technique of liposculpture, the muscles of the arms can be defined to meet patient expectations and give a more athletic appearance.

Comparison of the Treatment Outcome of the Traditional Liposuction [Tl] Technique Versus the Combination of Vaser and Microaire [V&amp;M] Technique for the Treatment of Lipedema of the Arms. A Single Center Experience

Comparison of the Treatment Outcome of the Traditional Liposuction [Tl] Technique Versus the Combination of Vaser and Microaire [V&amp;M] Technique for the Treatment of Lipedema of the Arms. A Single Center Experience

High-Definition Abdominal Body Scale

Introduction: High-definition liposuction (HDL) has been coined to identify liposuction results that are superior to traditional liposuction. The HDL Body scale has been previously described to help objectify changes required to achieve HDL results (that range from 2 to 10 score) with the ultimate goal of achieving a near perfect 9 or 10 body score. Materials/Methods: We present the High-Definition (HD) Abdominal Body Scale that is intended to assist with attaining HD abdominal contouring outcomes. High-definition abdominal contouring outcomes require comprehensive correction of abdominal contour concerns as well as creation of abdominal muscle highlights and natural shadows. HD Abdominal Body Scale assigns scores ranging from 2 to 10 with the ultimate goal of achieving a near perfect 9 or 10 body score indicative of HD outcomes. Results: The HD Abdominal Body Scale and subsequent surgical algorithm for HD abdominal contouring and case studies are presented. Discussion: Considerations for achieving HD abdominal contouring outcomes include assessing degree of fat excess, integrity of abdominal muscles, amount of skin redundancy, as well as quality and extent of skin texture changes. Evaluation of these factors provides the premise for determining HD abdominal contouring scores. HD abdominal contouring scores are used to establish proper patient selection, appropriate surgical design, and objective assessment of outcomes. Conclusion: This article presents an abdominal HDL Body Scale that helps expand patient populations who are candidates for HD body contouring. Surgeons’ outcomes may be improved using the HDL body scale and surgical algorithm presented.

The Application of Subcutaneous Radiofrequency After Liposuction for the Lower Face and Neck Contouring Under Local Anesthesia.

Radiofrequency-assisted liposuction (RFAL) is a new choice in energy-assisted body-contouring techniques. The purpose of this study is to observe the clinical effect and safety of RFAL on lower face and neck contouring under local anesthesia, and different outcome compared with traditional liposuction. From November 2016 to November 2020, a total of 72 patients with fat accumulation and skin laxity in lower face and neck, including 42 patients underwent subcutaneous radiofrequency after liposuction (group A) and 30 patients underwent traditional liposuction only (group B). The patient's parameters recorded involved age, sex, body mass index, the volume of fat aspirated, energy delivered, operative time, and complications. They were photographed for comparison before and after treatment. At 3 and 6 months after the operation, improvement in skin tightening and patient satisfaction was surveyed postoperatively and assessed by third-party surgeons. At 6 months after the operation, evaluations scores of the contouring outcome had significant difference between 2 groups (3.0±0.9 versus 2.5±1.0, P =0.045). There was no significant difference at 3 months (2.8±1.0 versus 2.6±1.0, P =0.265). Although the satisfaction rate of group A was higher than that of group B both at 3 months (76.2% versus 66.7%) and 6 months (80.9% versus 60.0%), there were no significant differences in average score ( P >0.05). No significant complications or adverse events requiring further medical or surgical intervention after treatment. Subcutaneous radiofrequency after Liposuction is a safe and effective treatment that can achieve significant improvement of the fat accumulation and skin laxity of the lower face and neck under local anesthesia.

Safety and Efficacy of Third-Generation Ultrasound-Assisted Liposuction: A Series of 261 Cases.

The introduction of third-generation ultrasound-assisted liposuction (3rd UAL) allows for a less invasive modality of both deep and superficial lipectomy while offering improved skin retraction and reduced rate of complications. This study examined the efficacy and safety profile of this technology over 15 years of clinical experience. A consecutive series of patients treated from 2005-2020 by the senior author were reviewed for demographic and anthropometric measurements, intraoperative settings, surgical outcomes, and complications via retrospective chart review. Body-Q survey was used to assess patient satisfaction. A total of 261 patients underwent 3rd UAL in 783 areas. There were 238 female and 23 male patients with an average age of 43.5years and BMI of 27.4kg/m2. The most frequently treated areas were the trunk and lower limbs. An average of 2840mL of wetting solution was used with an average of 2284mL of lipocrit aspirate. About 65% of the cases were done in conjunction with another procedure. Overall complication rate was 4.6%, contour irregularity (1.9%), seroma (0.8%), cellulitis (0.8%), pigmentation changes (0.4%), and electrolyte imbalance (0.4%), with a minimum follow-up of 6 months. 78% of patient would undergo the procedure again and 86% would recommend it. Third-generation ultrasound-assisted liposuction can be used effectively and safely, either alone, or in conjunction with other plastic surgery procedures. VASER liposuction allows surgeons to address superficial fat plane and enhanced skin tightening. Rate of complications are lower than that of traditional liposuction with equivalent or higher patient satisfaction. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Brazilian Buttock Lift for the Weight-Loss Patient

Introduction: Performing optimal gluteal augmentation using traditional methods in moderate to severe weight-loss patients poses a surgical challenge as such patients typically present with (1) significant skin redundancy, (2) soft tissues containing higher density of connective tissues, and (3) buttock ptosis. Materials and Methods: Excess skin redundancy and buttock check ptosis require consideration of supplemental excisional tucking to achieve optimal results. In addition, subcutaneous tissues that maintain more connective tissue pose difficulty with fat removal using traditional liposuction techniques. As such, we present a novel surgical technique to optimally augment and shape the buttock in patients who have undergone weight-loss. Results: This procedure uses a modified lateral thigh and buttock tuck excision not only to lift the buttock cheek complex but also to create a dermal fat flap that is transposed into the upper buttock pole to achieve upper buttock fullness. The remainder of the excised tissue undergoes novel ex-vivo liposuction, which allows for simultaneous repair of the created excision line while fat is being harvested. Discussion: We present a new Brazilian buttock lift (BBL) procedure for weight-loss patients using a novel modified lateral thigh and buttock tuck with a dermal fat flap as well as ex-vivo liposuction and fat transfer. The described ex-vivo liposuction technique provides several advantages that include (1) limiting operative time, (2) allowing for maximal fat removal while avoiding unnecessary trauma to the patient, and (3) providing improved quality of fat that is less blood tinged. The lateral thigh and buttock tuck with dermal fat flap is used to eliminate buttock ptosis and augment the upper buttock. The ex-vivo harvested fat to the middle and lower buttock to complete buttock augmentation for the Brazilian buttock lift in a seamless fashion. Conclusions: In summary, we present a novel Brazilian buttock lift technique to augment the buttock in weight-loss patients that maximizes both patient safety and efficacy.

Fragmented Fat Transfer for Massive Weight Loss Gluteal Contouring.

A recently introduced novel fragmentation technique has made it possible to convert fat tissue from apronectomy into large-scale viable lipograft, providing a glimpse of an alternative to traditional liposuction and its harvesting limitations. The purpose of this study was to assess the initial clinical evidence on fragmented fat transfer to restore volume and enhance deflated gluteal contours in a sample of massive weight loss patients. The authors retrospectively reviewed medical records of 20 women who received autologous buttock fat grafts that were harvested and fragmented following belt lipectomies and/or fleur-de-lis abdominoplasties. The average total volume subcutaneously grafted into the buttocks was 720 ml (bilateral), ranging from 500 ml to 960 ml. No local gluteal complications, such as seroma, infection, fat necrosis, or subcutaneous nodulations, were reported. Photographic observation of postoperative results over a 6- to 14-month follow-up period showed clear enhancement of body contouring in all patients, especially in those in whom fat transfer was combined with circumferential lifts. Fat fragmentation has proved useful and effective in providing great amounts of viable fat graft in a safe, simple, and reproducible technique without noticeable complications. The method eliminates the organic response to the insult of liposuction while using the entirety of formerly discarded apronectomy tissue to provide fine, transferable, autologous fat without increasing operative time. Although preliminary, the authors' clinical findings with this new technique support further studies of fragmented fat as an alternative to liposuction in gluteal fat grafting. Additional potential applications, including in wound healing and regenerative medicine, are worth exploring. . Therapeutic, IV.

High-Definition Liposuction Body Scale: Expanding Indications for High-Definition Liposuction

High definition liposuction (HDL) has been coined to identify liposuction results that are superior to traditional liposuction. HDL results are appreciated when body contours are transformed with the ultimate goal of achieving a near perfect 9 or 10 body. High definition liposuction is considered a “game changer” in the body contouring arena as it gives plastic surgeons the ability to precisely sculpt the patient’s body in a 360 degree circumferential manner to previously unattainable results. Until recently, indications for high definition body contouring were reserved for patients with minimal fat excess and skin redundancy. Several factors must be accounted for to achieve high definition liposuction results, and these include appropriate patient selection and a customized and strategically sound operative plan. We introduce the High definition liposuction (HDL) body scale that assigns body scores ranging from 2 to 10 by taking into account degree of fat excess, amount of skin redundancy, as well as quality and extent of skin texture changes. The HDL body scale was created to expand indications for a larger patient population by assisting surgeons to establish preoperative start points, guide patient selection, design a customized, sound surgical plan, and objectifying outcomes. The HDL body scale and subsequent surgical algorithm, and case studies are presented. Using the HDL body scale, surgeons may improve and expand patient populations who can benefit from HDL outcomes.

Assessment of Skin Redraping After Liposuction In Treatment of Gynecomastia Grade III Simon`s Classification

Background: Gynecomastia is the most common breast disorder in men. The usual treatment of grade III is surgical excision of the excess skin which may cause embarrassment and dissatisfying results Objective: To evaluate skin redraping after traditional liposuction in management of grade III gynecomastia Simon`s classification. Patients and methods: 20 patients with grade III gynecomastia with age group between 18 and 40 years old with mean 28.25 ± 4.18. It was a prospective observational cohort study. 11 cases underwent surgical gland excision through a semicircular infraareolar incision while 9 cases didn’t need to. The study was conducted at Alazhar university hospitals Results: The subjective results for all patients at 3 months assessment point. Four patients were very satisfied, eight satisfied, four neither satisfied nor dissatisfied while three patients dissatisfied. only one was very dissatisfied. The average sternal notch to nipple length pre and 3 months postoperative were respectively 27cm, 22cm. Our overall success rate is easily explained by several factors. The selection of young nonsmoker patient with no comorbid diseases or defective elasticity (varicosities or hernias), and the proper choice of the corset size and fiber as well as wearing it for the whole time of the study (3 months). The semicircular periareolar incision scars are not well defined as it become camouflaged by the color change between normal skin areola Conclusion: Conventional liposuction alone could be a reliable method to treat grade III gynecomastia in young patient with a good skin quality and helps in avoidance of undesirable scars.

ONE S.T.E.P. TECHNIQUETM IS EFFICIENT IN HARVESTING MESENCHYMAL STEM CELLS FROM HUMAN ADIPOSE TISSUE

<h3>Background</h3> Conventional (mechanical) laser-assisted liposuction (LAL) produce an intense photothermal effect that induces adipocyte destruction. Absorption of lasers varies in tissues by their different composition (fat, water, hemoglobin), and strongly depends on different laser wavelengths along with used dosimetric parameters. The 1210-nm wavelength lasers are described to have great affinity for human adipose tissue due to tissue´s high optical absorption coefficient at 1210 nm. Safety of LAL is well documented but few studies described the effect of LAL on human mesenchymal stem cells from adipose tissue (ASCs) and much less using 1210-nm lasers. Here we compare ASCs harvested by LAL with the those harvested by One S.T.E.P. techniqueTM - Selective Tissue Engineering Photostimulation (diode laser 1210 nm), which does not cause photo-thermal lipolysis effect in contrast to conventional laser-assisted method. <h3>Methods</h3> This study was approved by the Ethic Committee of the Institution. Fat tissue was obtained from 4 patients by traditional liposuction and from 4 patients in whom One S.T.E.P. techniqueTM was used. Cells were grown in DMEM with 10% FBS and antibiotics (100 µg/mL streptomycin,100 UI/mL penicillin) at 37°C in 5% CO₂ atmosphere. ASCs were characterized measuring specific antigen markers by flow cytometry. In vitro differentiation capability into osteoblasts, adipocytes, and chondrocytes were performed using defined media and evaluated by Alizarin Red, Oil red O and Alcian blue staining, respectively. <h3>Results</h3> Cells isolated from adipose tissue by both methods adhered to plastic and had a fibroblastoid morphology. Cells expressed CD29, CD90 and CD105 antigens, and lacked expression of CD14, CD34, CD45, CD80, CD117 and HLA-DR. These findings are in accordance with the definition of mesenchymal stem cells as defined by the ISCT. Moreover, cells were able to differentiate in chondrogenic, osteogenic, and adipogenic lineages under appropriated conditions. <h3>Conclusion</h3> Conventional laser lipolysis destroys both adipocytes and MSC through intense photothermal effect. The One STEP techniqueTM does not rely on lipolysis, and releases both preserved adipocytes and MSCs. In fact, here the use of One S.T.E.P techniqueTM for isolation of ASCs was shown to be an effective method to harvest ASCs cells, preserving their mesenchymal stem cell characteristics. Therefore, this method is potentially suitable for obtaining ASCs for using in regenerative medicine.

Does combine thread lifting with liposuction achieve superior outcomes over liposuction alone for neck lipodystrophy

BACKGROUND: Aging of the neck is multifactorial with various skin changes. For an aesthetically pleasing neck appearance, it is critical restoring a cervicomental angle of 105 to 120 degrees, and a distinct mandibular border. A multi-modality approach is required to rejuvenate the neck and address these multiple facets of aging. Many treatment options can be combined to address the aging changes of the neck.Submental fat can be addressed by traditional or assisted liposuction. However, some patients with poor skin tone may not achieve optimal outcomes. Thread lifting is a minimally invasive, office‐based procedure with fewer perioperative complications and gaining popularity as a substitute for surgical lifting.METHODS: This study aimed to answer whether combining thread-lift with traditional liposuction for rejuvenation of submental lipodystrophy will achieve a superior outcome in terms of patients’ satisfaction and aesthetic results or no? To answer this question, the authors conducted a retrospective comparative study on all cases with submental lipodystrophy (known as ‘double chin’) who underwent neck rejuvenation by either liposuction alone as group A, or liposuction combined with thread lifting as group B, to compare the results of both groups, and the subgroups based on the degree of neck lipodystrophy, in terms of patients’ satisfaction and aesthetic results. RESULTS: The overall complication rate was 20% for group A and 25% for group B. However, there were no major complications in both groups.While superior aesthetic results and patient satisfaction were obtained by combined liposuction and threading of cases with severe neck lipodystrophy, in cases of mild and moderate lipodystrophy no statistically significant difference was observed between both groups.Conclusion: Combined liposuction and thread lifting is effective and gives superior aesthetic results and patient satisfaction more than liposuction alone in cases with severe lipodystrophy especially for the cervicomental angle improvement. However, in mild and moderate cases of lipodystrophy, the additional thread-related complications, extra duration, and cost of thread lifting outweigh its benefits.

Skin Shrinkage with Vibration Amplification of Sound Energy at Resonance (VASER) Liposelection of Abdomen: Avoiding Abdominoplasty

Objective / Purpose of the Study: For abdominal reshaping / contouring, patient with excess abdominal skin and redundant fat quite often require abdominoplasty / tummy tuck. Inconsistent results achieved with traditional liposuction especially in the supraumbilical area. This study is to assess the role of abdominal VASER liposelection and if the abdominoplasty can be avoided.&#x0D; Material and Methods: This is retrospective cross sectional observational study conducted at Dundrum Medical Cosmetic Clinic, Dublin 16, Ireland. The study period includes two years from March 2009 to February 2011. In this study total number of consecutive 85 patients, operated by single surgeon were included with type I-IV patient category according to Matarasso classification system (1). There were 10 (11.8%) male and 75 (88.2%) female patient with mean age 42.4 years ± 10.95 years.&#x0D; Results: All of the 85 patients were treated with abdominal VASER liposelection. There were 75 female (88.2%) patients and 10 male (11.8%) patients in this study. Seven (8.2%) female patient require second session of VASER liposelection procedure 3 months after the first procedure and 3 (3.5%) female patient underwent third session to complete the abdominal contouring. None of the total 10 male patient required 2nd or 3rd session of abdominal VASER liposelection. The satisfaction level achieved 90 to 100 % by using visual analogue scoring system for all types I - IV abdomen. No early or late complication was noted in this study.&#x0D; Conclusion: This is a low risk, minimally invasive, scarless ambulatory technique performed under local anaesthetic, highly satisfactory to the patient as well as surgeon and is effective in all the categories of protuberant abdomen avoiding the local and systemic risk of abdominoplasty.

Prospective Analysis and Comparison of Periareolar Excision (Delivery) Technique and Pull-Through Technique for the Treatment of Gynecomastia.

Gynecomastia is one of the most common disorders affecting adolescent and adult males. It is a benign disorder but has severe psychological manifestations like low self-confidence, depression, anxiety and social phobia in patients suffering from gynecomastia. Different surgical techniques have been described utilizing a variety of incisions, excisions, lipectomy and liposuction methods. Very frequently, these methods are combined for the gynecomastia treatment with variable reported results. However, there is a lack of studies comparing these techniques. The present study was planned to compare cases of gynecomastia treated by liposuction with periareolar excision (delivery technique) and liposuction with a pull-through technique. A prospective randomized control study was conducted at a tertiary care hospital on 20 patients with gynecomastia. The patients were assigned to either liposuction with periareolar excision (delivery technique) or liposuction with pull-through technique. Anthropometric analysis and breast evaluation questionnaire (BEQ) scores were analyzed and compared before and after the surgery. The majority of the study subjects were between 21 and 30years of age. Low self-confidence was the main reason for surgery in most of the cases. Twelve patients had gynecomastia grade IIa and eight had grade IIb. Both groups had similar responses to BEQ scores before and after the surgery with no statistically significant difference. A statistically insignificant difference was observed between the groups on comparison of anthropometric analysis preoperatively and postoperatively. The mean lipoaspirate volume was 280ml for the pull-through technique and 367ml for the periareolar excision technique. No complications were observed in cases operated on by the pull-through technique, while two cases (10%) operated on by the periareolar excision had hematomas. Both techniques provide excellent cosmetic results with low risk of complications in both small and moderate breast enlargement with skin excess. The pull-through technique combines the benefits of direct excision of glandular tissues along with the minimally invasive nature of liposuction. Thus, performing the procedure via a single incision without the use of drains is a safer alternative to traditional liposuction with the periareolar excision technique. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.

Frostbite following cryolipolysis: a case report

Cryolipolysis is a non-invasive body contouring procedure that aims to achieve focal clearance of subcutaneous fat by means of confined areas of cold exposure. Cryolipolysis is currently gaining popularity as an alternative to traditional liposuction due to its high efficacy and low incidence and duration of side effects. Common side effects include erythema, bruising, oedema, pain and diminished sensation, all of which are usually transient. Frostbite injuries following cryolipolysis are exceedingly rare. We report a case of severe frostbite following a cryolipolysis session that required surgical intervention with resultant permanent scarring.

Social Media Ratings of Minimally Invasive Fat Reduction Procedures: Benchmarking Against Traditional Liposuction.

Minimally invasive fat reduction procedures are rapidly growing in popularity. Evaluate online patient reviews to inform practice management. Data from RealSelf.com, a popular online aesthetics platform, were reviewed for all minimally invasive fat reduction procedures. Reviews were also aggregated based on the primary method of action (e.g., laser, radiofrequency, ultrasound, etc.) and compared with liposuction. A chi-square test was used to assess for differences with the Marascuilo procedure for pairwise comparisons. A total of 13 minimally invasive fat reduction procedures were identified encompassing 11,871 total reviews. Liposuction had 4,645 total reviews and a 66% patient satisfaction rate. Minimally invasive fat reduction procedures had 7,170 aggregate reviews and a global patient satisfaction of 58%. Liposuction had statistically significantly higher patient satisfaction than cryolipolysis (55% satisfied, n = 2,707 reviews), laser therapies (61% satisfied, n = 3,565 reviews), and injectables (49% satisfied, n = 319 reviews) (p < .05). Injectables and cryolipolysis had statistically significantly lower patient satisfaction than radiofrequency therapies (63% satisfied, n = 314 reviews) and laser therapies. Ultrasound therapies had 275 reviews and a 73% patient satisfaction rate. A large number of patient reviews suggest that minimally invasive fat reduction procedures have high patient satisfaction, although liposuction still had the highest total patient satisfaction score. However, there are significant pitfalls in interpreting patient reviews, as they do not provide important data such as a patient's medical history or physician experience and skill.

Laser-Assisted Liposuction (LAL) Versus Traditional Liposuction: Systematic Review

Liposuction is the most performed surgical procedure in Brazil and the second in the world. In recent years, new technologies have been developed in an attempt to improve liposuction, such as laser. The objective of this study is to evaluate the efficacy and safety of laser-assisted liposuction (LAL) compared to traditional liposuction through a systematic review of the literature. The search strategy used was the combination of the descriptors [lasers (MeSH Terms)] and (lipectomy [MeSH Terms]) in the PubMed database. Two independent researchers carried out the reading of the abstracts and selection of the studies according to the eligibility criteria. The risks of study bias were evaluated using an instrument similar to that used by the Cochrane Collaboration. Initially, 80 studies were obtained and, after evaluating the eligibility criteria, seven remained. Five of them observed that LAL has benefits when compared to traditional liposuction, and the main outcomes were compared with regard to histological analysis (2 products), further reduction of subcutaneous fat (2), better retraction of the skin (3), and higher personal satisfaction of the patient (2). The qualitative assessment identified high risks of bias in various areas in the studies. Although studies have concluded that LAL promotes greater fat reduction, better skin retraction, and greater patient satisfaction compared to traditional liposuction, the high bias impedes a more reliable conclusion. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .