Ultrasonic Liposuction Research Articles

Enhancing Buttock Contours: A Safer Approach to Gluteal Augmentation with Ultrasonic Liposuction, Submuscular Implants, and Ultrasound-Guided Fat Grafting.

Background: The global popularity of gluteal augmentation has risen significantly, driven by the desire for enhanced buttocks size and shape to align with individual patient preferences. This increased demand has prompted extensive research into diverse techniques and their safety. Methods: A retrospective analysis was conducted to evaluate the outcomes of a gluteal augmentation technique involving ultrasound-assisted liposuction, submuscular implants, and ultrasound-guided fat grafting. Our study involved a review of the medical records of 50 consecutive patients who underwent this procedure between February 2020 and July 2023. Results: Data related to patient demographics, the quantity of fat grafts, and any complications were analyzed. Additionally, a brief survey was conducted to evaluate patient satisfaction. The Polytech implants were used in forty-four patients, and Sebbin implants in six. The implant size varied from 285 to 560. Most of the Polytech implants were 390 cc (25/44; 56.8%). Two patients had a minor infection at the incision sites and subsequent wound dehiscence. No revision surgeries were needed. Conclusions: The presented technique incorporates ultrasonic liposuction, submuscular silicone implants, and ultrasound-guided fat grafting to achieve safe and aesthetic gluteal enhancements. This method is especially suitable for patients looking to augment both the central and lateral areas of the buttocks, particularly when they lack adequate fat tissue for augmentation through fat grafting. With the addition of ultrasound guidance, the fat grafting step is significantly safer.

Extensive Ultrasonic Liposuction in Gynecomastia: An Alternative Approach without Surgical Gland Excision

Aim: Skin and gland removals made on the chest wall may result in noticeable scars that can be challenging for patients to tolerate. This study aimed to define an extensive ultrasonic liposuction approach without surgical excision for gynecomastia. We also investigated its effectiveness in reducing complications and improving cosmetic outcomes. Materials and Methods: Gynecomastia patients with Rohrich grades II and III were evaluated according to skin quality. 46 patients who met these criteria underwent ultrasonic liposuction performed by the senior author between February 2021 and April 2023. These patients were compared with 58 who underwent surgery using suction-assisted liposuction combined with peri areolar mastopexy and glandular excision. Results: Our study found that patients who underwent extensive ultrasonic liposuction had a complication rate of 8.7%. Of the total number of patients, only one experienced a seroma complication, and three experienced residual breast tissue/ptosis. None of the patients required revision surgery. In comparison, the control group that underwent peri-areolar mastopexy and glandular excision had a higher complication rate (10.3%). Conclusion: We used the basic principles of plastic surgery for wound contraction. Distributing the wound healing mechanisms to a broad surface allowed us to achieve better cosmetics without forming a noticeable scar on the chest wall. Keywords: Breast Ptosis, Extensive Liposuction, Gynecomastia Surgery, Ultrasonic Liposuction, Vaser Liposuction

Buttock Augmentation with Ultrasonic Liposuction and Ultrasound-Guided Fat Grafting: A Retrospective Analysis Based on 185 Patients.

Background: The popularity of gluteal augmentation has surged in recent decades, primarily due to satisfactory aesthetic results. Objectives: The primary goal of this retrospective analysis was to present the key characteristics of a large patient cohort from Europe, comprising 185 female patients who underwent gluteal augmentation with ultrasound-guided fat grafting. Methods: A retrospective analysis was conducted on 185 female patients who underwent gluteal augmentation with ultrasonic liposuction and fat grafting from February 2020 to July 2023. The procedures were performed in accordance with the latest safety recommendations. Results: Information concerning the patient demographic, volume of fat graft, and complications was analyzed. Additionally, patient satisfaction was evaluated through a questionnaire. The mean Body Mass Index (BMI) of the patients was 23.00 kg/m2 (SD = 2.62). Furthermore, the volume of transferred fat graft ranged from 500.00 mL to 800.00 mL, with a mean of 596.75 mL (SD = 67.29). The most frequent complication was the formation of seroma (5.41%). All complications were treated successfully. Conclusions: Using ultrasonic liposuction and ultrasound-guided fat grafting to enhance buttock contours is a reliable technique. Nevertheless, it is crucial to exert caution and take all necessary steps to reduce the risk of potentially life-threatening complications.

Skin Biomechanical Characteristics Differences in Ultrasonic Liposuction Devices Used in Liposuction

Skin Biomechanical Characteristics Differences in Ultrasonic Liposuction Devices Used in Liposuction

The Effect of Ultrasonic Liposuction Energy Levels on Fat Graft Viability.

The use of fat obtained from ultrasound-assisted liposuction is popular. However, no study has considered the effect of different energy levels on fat grafts. We hypothesized that different ultrasonic energy levels could change the fat graft viability. Both flanks of 15 CD1 nude mice (30 experimental areas) were used, with experimental areas randomly distributed into five groups. Using different energy settings, fat grafts were obtained from a patient's abdominoplasty material and applied to the mouse flank regions. Device settings were intermittent mode with 50% vibration amplitude in group 1, continuous mode with 50% vibration amplitude in group 2, intermittent mode with 90% vibration amplitude in group 3, and continuous mode with 90% vibration amplitude in group 4. The control group was grafted with fat obtained via the conventional method. After 6 weeks, all mice were sacrificed, and fat grafts were excised. Sections were stained with hematoxylin-eosin, Masson's trichrome, and anti-perilipin A antibody. The perilipin A immunostaining result was lowest in group 4, indicating the lowest viable cell count (p < 0.01). There was no significant difference between groups for the other parameters (p > 0.05). High ultrasonic energy may affect fat graft survival. If fat injection is planned, avoiding high energy settings (our recommendation is not to exceed 16 Watts.) should be considered. We also recommend increasing the vibration amplitude rather than switching from intermittent to continuous mode in body parts that are relatively resistant to liposuction. This journal requires that authors assign a level of evidence to each submission to which Evidence-Based Medicine rankings are applicable. This excludes Review Articles, Book Reviews, and manuscripts that concern Basic Science, Animal Studies, Cadaver Studies, and Experimental Studies. 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 .

Influence of ultrasonic liposuction on cellulite reduction. Diet as part of therapy

Cellulite, popularly known as orange peel, has become an affliction of around 80-95% of the world’s population. Until now, it was believed that it occurs only in women, but after many years of research it turned out that it can also occur in men. The aim of the study was to evaluate the effectiveness of ultrasonic liposuction in anti-cellulite therapy based on the conducted study. The causes, symptoms and preventive measures were presented. Currently, cellulite is seen mainly as an aesthetic problem. However, it has been proven that at a more advanced stage it can lead to serious lesions. There are many methods of cellulite therapy available, but due to the complexity of the problem, systematic and multi-target activities are important, taking into account diet and physical activity.

Complications of Cryolipolysis: Paradoxical Adipose Hyperplasia (PAH) and Beyond.

Cryolipolysis is a fairly popular procedure performed in North America, Europe, and many other countries. Although it is considered a rather safe procedure, there are underreported side effects such as paradoxical adipose hyperplasia (PAH), contour irregularities, skin and soft tissue atrophy, and asymmetries. Our knowledge regarding the prevalence and treatment of such complications is limited. We hereby report a case series of 5 patients treated for various complications of cryolipolysis, including PAH, that persisted for more than 12 months after their last treatment. Five patients with various complications of cryolipolysis (4 patients with PAH and 1 with atrophy and indentations) presented in our private office between 2015 and 2018. Three of the 4 patients with PAH were treated at other facilities with ultrasonic liposuction, laser lipolysis, and radiofrequency skin tightening devices respectively. The fourth patient developed PAH after liposuction at another facility. The fifth patient developed several areas of indentations and atrophy and received mesotherapy and lymphatic massages at another facility. All 5 patients were subsequently treated in our office by means of a customized approach specific to their underlying complications. Near-normal results were achieved in all 5 patients. None of our patients showed any recurrences of their initial complication for which they were treated. All 5 patients were extremely satisfied with their results. Cryolipolysis, just like any other form of lipolysis, has certain specific adverse effects associated with it, including but not limited to PAH. Complications of cryolipolysis must be individually recognized and treated accordingly.

Gynecomastia Management: An Evolution and Refinement in Technique at UT Southwestern Medical Center.

Gynecomastia is a benign proliferation of male breast glandular tissue. Gynecomastia can affect men at any stage of life. Traditional treatment options involved excisional surgeries with periareolar or T-shaped scars, which can leave more visible scars on the chest. The technique presented represents a technique used by the senior author, which relies on ultrasonic liposuction and pull-through technique to remove breast tissue. A retrospective chart review was performed, including all patients who were treated, from 2000 to 2013 by the senior author, for gynecomastia. A deidentified database was created to record patient characteristics, including age, height, weight, ptosis, stage of gynecomastia, and gynecomastia classification. Surgical approaches, complications, and revisions were also recorded. Our experience includes 75 patients with all grades of gynecomastia from 2000 to 2013. These cases span the evolution of our technique to include direct pull-through excision with ultrasound-assisted liposuction. The distribution of the grades I, II, III, and IV ptosis was 30.6%, 36 %, 22.6%, and 10.6% respectively. There were no complications in this series. Only one patient with grade III ptosis required revision surgery. This technique provides a safe and aesthetically pleasing way to treat gynecomastia with a low need for revision.

Prospective Clinical Study of 551 Cases of Liposuction and Abdominoplasty Performed Individually and in Combination

Despite the popularity of these procedures, there are limited published prospective studies evaluating liposuction and abdominoplasty. Lipoabdominoplasty is a subject of recent attention. Several investigators have recommended alternative techniques that preserve the Scarpa fascia in an effort to reduce complications, particularly the risk of seromas. Over a 5-year period, 551 consecutive patients were treated with ultrasonic liposuction alone (n = 384), liposuction/abdominoplasty (n = 150), or abdominoplasty alone (n = 17). In lipoabdominoplasties, the abdomen and flanks were first treated with liposuction. A traditional flap dissection was used for all abdominoplasties. Scalpel dissection was used rather than electrodissection. A supine "jackknife" position was used in surgery to provide maximum hip flexion, allowing a secure deep fascial repair. The complication rate after liposuction was 4.2% vs 50% for patients treated with an abdominoplasty. Approximately half of the abdominoplasty complications were minor scar deformities, including widened umbilical scars (17.3%) that were revised. The seroma rate after abdominoplasties was 5.4%; there were no seromas after liposuction alone. Lipoabdominoplasty may be performed safely, so that patients may benefit from both modalities. The seroma rate is reduced by avoiding electrodissection, making Scarpa fascia preservation a moot point. A deep fascial repair keeps the abdominoplasty scar within the bikini line. Deep venous thrombosis and other complications may be minimized with precautions that do not include anticoagulation.

Gynecomastia Associated With Herniated Nipples

Gynecomastia is a common disorder observed in male plastic surgery patients. Treatment options may include observation, surgical excision, or liposuction techniques. Congenital herniated nipple is a more rare condition, especially in male patients. We present the case of a 12-year-old boy with bilateral gynecomastia and herniated nipple-areolar complexes. A staged repair was undertaken in this patient with grade 2 gynecomastia. The first operation was ultrasonic liposuction bilaterally, yielding 200 mL of aspirate from the left and 400 mL on the right, to correct the gynecomastia. The second procedure, performed 6 months later, was a bilateral periareolar mastopexy to repair the herniated nipple-areolar complexes. The result of the first procedure was flattened and symmetrical breast tissue bilaterally, essentially a correction of the gynecomastia. The herniated nipples were still present, however. Bilateral periareolar mastopexies were then performed with resulting reduction of the herniations. There were no complications with either procedure, and a good cosmetic result was achieved. A staged surgical approach was successful in correcting both conditions with an excellent aesthetic result and the advantage of decreased risk for nipple complications.

Prospective Clinical Study Reveals Significant Reduction in Triglyceride Level and White Blood Cell Count after Liposuction and Abdominoplasty and No Change in Cholesterol Levels

Triglyceride levels of 150 mg/dL or greater are known to be associated with an increased cardiovascular risk and metabolic syndrome. This study investigated the effect of liposuction and abdominoplasty on lipid levels, complete blood count, and other parameters. A prospective study was undertaken among 322 consecutive patients (270 women and 52 men) who presented for liposuction (n = 229), abdominoplasty with liposuction (n = 87), and abdominoplasty without liposuction (n = 6). The mean body mass index was 26.6 kg/m2 (range, 18.6 to 44.1 kg/m2). Ultrasonic liposuction using a superwet infusion technique was used in all cases, usually treating the lower body in women (64.4 percent) and the trunk in men (86.5 percent). Mean weight loss 3 months after liposuction was 2.2 lbs for liposuction alone (p < 0.001) and 4.2 lbs for liposuction and abdominoplasty (p < 0.05). Mean fasting triglyceride level decreased 25.7 percent after liposuction (p < 0.001). The triglyceride level decreased 43.0 percent (n = 56, p < 0.001) after liposuction in patients with preoperative levels of 150 mg/dl or greater. There was a significant decrease in white cell count after both liposuction and liposuction/abdominoplasty (p < 0.001). There were no significant changes in total, low-density lipoprotein, or high-density lipoprotein cholesterol. Fasting glucose was unchanged. A significant (p < 0.001) reduction in triglyceride level in patients with elevated preoperative levels and a significant decrease in leukocyte count (p < 0.001) are favorable metabolic effects of liposuction and liposuction/abdominoplasty. Cholesterol levels are unaffected. Therapeutic, IV.

The Ultralift: A Simple, Safe, Effective Facelift Technique

Background: Experience with smaller ultrasonic liposuction cannulas for neck and lower facial contouring has led to the incorporation of this technique into face-lifting procedures. Combining ultrasonic liposuction of the neck and a subcutaneous face-lift with the superficial musculoaponeurotic system plication (hereby called the Ultralift) provides a benefit greater than either technique alone. Objective: To determine if incorporating ultrasonic liposuction of the submental, jowl, and lateral neck regions is a safe and effective adjunct to a face-lift. Methods: The Vaser lipoplasty system was used to emulsify fat in the submental, jowl, and lateral neck regions. The fat was then evacuated with a VentX cannula, and the face-lift was then performed. Results: A retrospective chart review was performed on all patients who underwent the Ultralift procedure. This technique has been used on 47 patients. Patient ages ranged from 39 to 78 years, with an average age of 57 years. Follow-up ranged from 4 months to 4 years. There were no hematomas, seromas, skin burns, sloughs, or persistent nerve injuries. Conclusions: Ultrasonic liposuction combined with face-lifting is an effective and safe method of facial rejuvenation.

Endoscopic and ultrasonic removal of a lipoma on the forehead with no facial scarring: Practicality of patient's early return to work

We used endoscopy and ultrasonic liposuction to remove lipomas from the forehead to facilitate early return to work. The tumours were approached through a pair of small remote scalp incisions behind the frontal hairline, which continued to subperiosteal dissection, thereby avoiding injury to the supraorbital or supratrochlear neurovascular bundles. The deep surfaces of the lipomas were identified easily through the periosteum by well-illuminated and magnified endoscopic views, and protruded through the periosteal incisions. An ultrasonic cannula was introduced to emulsify and aspirate the lipomas. Parts of the lipomas were extracted by forceps as solid specimens for histopathological evaluation. Preservation of the neurovascular bundles and complete resection of the tumours in the bloodless operative fields were confirmed by direct endoscopic monitoring. Of five patients treated, three returned to their jobs within two postoperative days, with no protective dressings on their faces. There have, to our knowledge, been few reports describing this combination of endoscopy and ultrasonic treatment of forehead lipomas.

Ultrasonic Liposuction in the Treatment of Gynecomastia

Ultrasonic Liposuction in the Treatment of Gynecomastia

Scientific Basis for the Use of Hypotonic Solutions with Ultrasonic Liposuction

A number of plastic surgeons have advocated using hypotonic solution in ultrasound lipoplasty, theorizing that induced adipocyte swelling increases membrane susceptibility to ultrasonic disruption. Additionally, it has been theorized that potassium increases membrane permeability. This study aimed to determine the effect of solution osmolality on adipocyte diameter, the time course of hypotonic solution action, and the effect of potassium addition on adipocyte diameter. Base solutions with three different osmolalities were prepared: normal saline (NS) (154 mOsm/l), 1/2NS (77 mOsm/l), and 1/4NS (38.5 mOsm/l). Each solution was modified to contain 0, 5, and 10 mEq/l of potassium and adjusted to starting osmolality. Adipocytes of six patients were suspended in the nine solutions, and diameters were determined at 0, 15, 30, and 45 min. Diameters were measured using imaging software (Kodak ID 3.6). At time 0, the average adipocyte diameter was 79 +/- 8 microm, and no difference was seen in any of the solutions. Cells in the NS group showed no significant increase in diameter over 45 min. The 1/2NS group achieved an 8% +/- 1.9% increase in diameter at 45 min (p < 0.05). The 1/4NS group showed an increase by 14% +/- 2.4% (p < 0.01) at 15 min, and 15% +/- 2.3% (p < 0.01) at 45 min. Potassium had no independent effect on cell diameter. Hypotonic solution can significantly increase human adipocyte diameter. The findings showed that 1/2NS had a significant effect within 15 min. Tumescent solutions with an osmolality of 1/4NS may be useful in facilitating ultrasonic lipoplasty.

Ultrasonic Liposuction in the Treatment of Gynecomastia

Ultrasound-assisted liposuction is a technique that is widely used all over the body for minimal access lipectomy. Recently, it has been reported to be especially suitable for the treatment of gynecomastia. To date, however, there is only one published study that specifically addresses ultrasound-assisted liposuction as a treatment modality for gynecomastia. A review was undertaken of all the gynecomastia patients treated with ultrasound-assisted liposuction by a single surgeon over a 3-year period. Thirteen consecutive patients (aged 16 to 57 years) with bilateral, diffuse, soft to moderately firm gynecomastia were studied. There were no early postoperative complications of hematoma, seroma, infection, or thermal injury. Similarly, there were no treatment-induced asymmetries, contour deformities, or irregularities. One patient requested "touch-up" ultrasound-assisted liposuction for "residual" breast tissue several months after an initial satisfactory correction of chest contour. None of the patients required initial open-excision or skin-reduction procedures. Patients were asked to rate their cosmetic results in four categories on linear analogue scales with a maximal score of 10. The average scores were 9.1 for overall satisfaction, 9.2 for scars, 9.2 for shape, and 8.9 for improved self confidence. Ultrasound-assisted liposuction is an effective treatment modality in patients with homogenous soft to moderately firm gynecomastia, giving good cosmetic results and a high level of patient satisfaction.

Combined use of ultrasonic liposuction with the pull-through technique for the treatment of gynecomastia.

The authors present a method of treatment for gynecomastia that combines the use of two techniques of soft-tissue contouring. This method uses ultrasonic liposuction in conjunction with the pull-through technique of direct excision to effectively remove the fibrofatty tissue of the male breast and the fibrous breast bud through a single 1-cm incision. Fifteen patients were treated in this fashion, and each patient demonstrated a smooth, masculine breast contour with a well-concealed scar, which eliminates the stigma of breast surgery. The procedure is technically straightforward and provides consistent results. It is offered as an additional option for the treatment of gynecomastia.

Combined Use of Ultrasonic Liposuction with the Pull-Through Technique for the Treatment of Gynecomastia; Dennis C. Hammond, M.D., Jame F. Arnold, M.D., Amy M. Simon, M.D., and Philippe A. Capraro, M.D.

Received for publication November 12, 2002. Rod J. Rohrich, M.D. Department of Plastic Surgery University of Texas Southwestern Medical Center 5323 Harry Hines Boulevard, E7.212 Dallas, Texas 75390-9132 [email protected]

Low-Level Laser-Assisted Liposuction: A Multicenter Side-by-Side Comparison Study

Introduction: Liposuction has undergone many revisions since 1980, the most notable being the introduction of the tumescent technique of local anesthesia by Jeffery Klein, MD. Since then, in an effort to improve the aesthetics of the technique and the ease and safety of the procedure, other techniques have been introduced. These include superficial liposuction, UAL, external ultrasonic liposuction, mechanically assisted liposuction, and, most recently, laser-assisted liposuction. Materials and Methods: Four centers in the United States, operating under an 1RB protocol, performed liposuction with the tumescent technique of local anesthesia on specified cosmetic units of the body. One side was exposed to 635-nm laser therapy after tumescence was achieved, whereas the contralateral side was not. Observations were recorded during surgery and at 2 weeks postoperatively. Results: Observations of intraoperative technique did not show an advantage to laser-assisted liposuction. Observations of the postoperative course were equivocal, though there was evidence of reduction of edema in certain patients. Discussion: The addition of laser therapy to liposuction technique is based on years of experience demonstrating improved wound healing using a technique of low-level laser therapy. Although the recorded observations did not support an advantage to the addition of laser therapy, there was a paradoxical difference of opinion among patients and surgeons who participated in the study. These individuals believed that, compared with patients not treated with low-level laser therapy, there was at least a reduction in degree and duration of postoperative pain and induration. As low-level laser therapy may have systemic effects on wound healing, comparing treated and untreated contralateral sides may not be valid because both sides experienced improvements in postoperative course. Laser-assisted liposuction has a potential advantage, not supported by this study, in the intraoperative and postoperative course of liposuction surgery. New studies using double-blind techniques will need to be conducted.

External Ultrasonic Tumescent Liposuction vs. Conventional Tumescent Liposuction: A Gross and Microscopic Study

When compared to conventional tumescent liposuction (CTL), external ultrasonic tumescent liposuction (EUTL) has been presented as provoking less bleeding, giving improved aesthetic results, faster recovery of the patient, and less effort by the surgeon. CTL and EUTL were compared, with special attention to clinical, physical, chemical, and microscopic results. EUTL demonstrated higher amount of triglycerides in the aspirated fluid but lower amount of proteins than CTL. The percentage of damaged adipocytes was higher in EUTL, while in CTL the connective tissue and vessels were higher. Cosmetic results, recovery time, and complications were similar at both sides. The changes, observed were more microscopic, physical, and chemical than related to patients' cosmetic outcome. If the correct tumescence is used, EUTL is not better than CTL alone.