Ultrasound-assisted 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.

A randomized intraindividual comparative study evaluating the effects of two ultrasound-assisted liposuction devices on the abdomen

BackgroundUltrasound-assisted liposuction (UAL) has become popular because of its favorable outcomes in terms of fat emulsification, blood loss reduction, and skin tightening. This study aimed to compare the effects of two UAL devices on the abdomen by assessing postsurgery skin biomechanical properties. MethodsThis single-blind, prospective study (2020-2022) involved 13 liposuction procedures performed on patients without chronic diseases. Each patient's abdomen was divided vertically from the xiphoid to the perineum. Vibration amplification of sound energy at resonance (VASER)-assisted liposuction (Solta Medical, Inc., Hayward, CA) was performed on one half, while the other half underwent liposuction with high-frequency ultrasound energy (HEUS)-assisted technology. Skin biomechanical measurements, including distensibility, net elasticity, biological elasticity, hydration, erythema, melanin, and skin firmness, were taken at 12 and 24 months postsurgery, focusing on the anterior abdomen, 8cm to the right and left of the umbilicus. ResultsAnalysis of the above skin biomechanical measurements revealed no significant differences between the HEUS and VASER devices, except for skin firmness, which showed a notable increase following HEUS surgery. Patient-perceived clinical differences were assessed via nonvalidated questionnaires, revealing no distinctions between devices. ConclusionBiomechanical skin results post-UAL surgery with these devices on the abdomen were not significantly different, although HEUS revealed increased skin firmness. This suggests that HEUS-assisted technology, akin to other devices, is a viable option for UAL procedures.

Refinement techniques for male chest definition using ultrasound-assisted liposuction, a 4-year-experience

Refinement techniques for male chest definition using ultrasound-assisted liposuction, a 4-year-experience

Evaluation of Blood Loss in Third-Generation Internal Ultrasound-Assisted Liposuction.

In large-volume liposuction procedures, one of the most important limitations of total lipoaspirate volume is blood loss. In this study, we aimed to determine the amount of blood loss in individuals who underwent a third-generation internal ultrasound-assisted liposuction (UAL). Eleven female and eleven male participants with a mean age of 35.31 (range 20-47) were included in this prospective study. The third-generation internal UAL was performed on multiple anatomical regions using the VASER® Internal Ultrasound Device (Sound Surgical Technologies; Louisville, CO). The demographic characteristics of the participants, the amount of aspirate collected, and hemoglobin (Hgb) and hematocrit (Htc) values before and after the third-generation internal UAL were evaluated. The mean third-generation internal UAL time was 74.81 ± 17.95 minutes, and the mean aspiration amount was 5,122.27 ± 1,597.43ml. The aspirated amount was 6.64% ± 2.20 of body weight. The mean Hgb value was 13.87 ± 1.99 before the third-generation internal UAL and 11.26 ± 2.16 (g/dL) after the third-generation internal UAL (z = 4.108, p < 0.001). The mean reduction in Hgb levels with the third-generation internal UAL was 2.61 ± 1.73 and 0.53 ± 0.36 per liter of aspirate taken. The mean Htc value after the third-generation internal UAL was 33.91 ± 6.03 and was significantly lower than the mean Htc value before the third-generation internal UAL, 41.39 ± 5.13 (z = -3.946, p < 0.001). The mean reduction in Htc with the third-generation internal UAL was 7.48 ± 5.42, and the Htc value decreased by 1.50 ± 1.13 per liter of aspirate ingested. The amount of aspirated supernatant was responsible for 44.4% of the change in Hgb and 30.9% of the change in Htc after the third-generation internal UAL. Knowing the reduction rates in Hgb and Htc with the third-generation internal UAL is useful to plan the amount of aspirate to be taken, the amount of blood loss that may occur with the third-generation internal UAL, and the postoperative care of the patients. 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 .

Consensus-based Recommendations for Vibration Amplification of Sound Energy at Resonance Ultrasound-assisted Liposuction

Background: Ultrasound-assisted liposuction (UAL) is a popular and minimally invasive cosmetic procedure. Third-generation devices such as the vibration amplification of sound energy at resonance (VASER)lipo system are used for body contouring with enhanced tissue specificity. Despite the widespread use of VASER UAL, published guidelines and recent expert consensus recommendations are lacking. The objective of this study is to develop an expert consensus on the recommendations for use of VASER UAL. Methods: In a modified Delphi process, a panel of five US-based, expert plastic surgeons participated in three rounds of consensus building that spanned 4 months to align on guidance statements for the use of VASER as an adjunct to liposuction. Results: After the experts responded to an online questionnaire that assessed device settings, postoperative instructions, side effects or complications, and best practices, 32 initial consensus statements were developed. By round 3, these consensus statements for VASER UAL had been reduced and refined to a total of 18. Conclusions: To improve patient outcomes, clinicians must understand key factors and best practices when using VASER UAL, including device settings, provider technique, managing side effects, potential complications, and postoperative care. The consensus statements developed herein aim to provide clinicians with expert-backed recommendations for the use of VASER UAL.

Surgical Correction of Massive Gynecomastia Using Power-Assisted Liposuction and Direct Gland Resection

Introduction: The surgical treatments of mild to moderate gynecomastia has evolved towards less invasive techniques, such as power-assisted liposuction, suction-assisted lipectomy or ultrasound-assisted liposuction. Excisional techniques are still indicated for the most severe cases characterized by skin excess and ptosis. The aim of this study was to present a method of using power-assisted liposuction combined with gland resection to treat gynecomastia with severe hypertrophy. Materials and Methods: We conducted a chart review of 27 consecutive patients treated for massive gynecomastia between 2014 and 2018. Power-assisted liposuction was performed to remove the fatty breast tissue. Incisions for liposuction were placed at lateral inframammary fold and upper anterior axillary pillar. An inferior hemiperiareolar incision was then performed to allow direct resection of fibroglaundular breast tissue. A final liposuction in all directions was performed again to recontour the breast. No skin was resected and drains were always inserted in each breast. Compression vest was worn for 6 weeks after surgery. Results: In average, 749 mg of fat and fibroglandular tissue were removed from each breast. No complications were reported. At 1 year follow-up, ideal aesthetic results, with minimal scars, adequate virilization of the chest contour and full satisfaction of surgeon and patient were observed in 24 patients, while 3 patients presented residual skin excess. Conclusion: In average, 749 mg of fat and fibroglandular tissue were removed from each breast. No complications were reported. At 1 year follow-up, ideal aesthetic results, with minimal scars, adequate virilization of the chest contour and full satisfaction of surgeon and patient were observed in 24 patients, while 3 patients presented residual skin excess.

A 16-Year Review of Clinical Practice Patterns in Liposuction Based on Continuous Certification by the American Board of Plastic Surgery.

The American Board of Plastic Surgery has collected data on cosmetic surgery tracers as part of the Continuous Certification process since 2005. The current study was performed to analyze evolving trends in liposuction from the American Board of Plastic Surgery database. Tracer data from 2005 through 2021 were reviewed and grouped into an early cohort (EC) (2005-2014) and a recent cohort (RC) (2015-2021). Fisher exact tests and two-sample t tests were used to compare patient demographics, techniques, and complications. A total of 2810 suction-assisted liposuction cases were included (1150 EC, 1660 RC). In-office procedures increased (36% EC versus 41% RC). The use of general anesthesia remained the same (63% EC versus 62% RC). The use of power-assisted liposuction increased (24% EC versus 40% RC) and use of ultrasound-assisted liposuction decreased (5% versus 2%). With respect to body areas treated, liposuction of the abdomen (64% EC versus 69% RC), flanks (60% EC versus 64% RC), and back (22% EC versus 34% RC) increased; treatments of thighs (36% EC versus 23% RC), and knees (8% EC versus 5% RC) decreased. Intraoperative position changes are more common (30% EC versus 37% RC), as is liposuction of multiple areas in one case (28% EC versus 36% RC). The volume of lipoaspirate also increased (1150 cc EC versus 1660 cc RC). This study highlights evolving trends in liposuction over 16 years. Liposuction is becoming more common as an outpatient procedure performed concomitantly with other procedures. Despite multiple emerging technologies, the popularity of power-assisted liposuction is increasing. Although adverse events have not significantly increased with these changes, the authors stress careful preoperative evaluation of patients to identify factors that increase the risk of complications.

Histological Evaluation of Skin Tissue Treated With Vibration Amplification of Sound Energy at Resonance

Currently, ultrasound-assisted liposuction has been widely used under empirical criteria. To date, no exhaustive description of the histological effects that are exerted during Vibration Amplification of Sound Energy at Resonance (VASER) application has been reported. Here, we describe the histological alterations in the skin of lipectomy flaps after using the VASER technology at different power settings.Four lipectomy flaps were resected and treated with VASER at 50% or 100% power for 1 minute in duplicate. Therefore, each experimental condition was tested on 8 tissue samples. We described the histopathological alterations in the epidermis, dermis, and hypodermis. The observations were performed by 2 independent morphologists unrelated to the lipectomy and treatment procedures. In the histopathological analysis, we did not find significant differences in the histopathological alterations of the epidermis, dermis, and hypodermis using both power settings. However, the dermis of the flaps subjected to 100% power showed considerable collagen fibers degradation and more adipocytes with ruptured membranes in comparison with the flaps treated with 50% power. Although we did not find significant differences between the 2 power conditions tested in this study, more histological alterations in the dermis were observed with the maximum power setting even at a “safe” distance reported in the conventional technique. However, this study was the first approach to determine the histological effects of VASER application, therefore, these results must be corroborated in further studies with a greater number of lipectomies, as well as more specific histopathological analyses. Finally, the data shown in this study reflect the importance of optimizing VASER procedures to increase the safety and efficacy of this technique.

Ultrasound-Assisted Liposuction (UAL) Arm Contouring in Non-Post-Bariatric Patients: No Rush for Brachioplasty

BackgroundA witnessed rise in patients’ requests for arm contouring reflects the parallel public’s pursuit of slimmed bodies and rapid advancement in weight reduction methods. Brachioplasty with its known complications is still the traditional method of management, but nearly all patients feel worried about the length and appearance of the scar and seek other non-excisional alternatives. The authors wanted to share their experience in arm contouring in non-post-bariatric patients using ultrasound-assisted liposuction (UAL).Patients and MethodsOver 16 month period, 28 female patients complaining of arm lipodystrophy (classes IIA, IIB, III) underwent UAL contouring under general anesthesia. Preoperative and postoperative mid-arm circumferences were measured and recorded. Outcome evaluation was done by the complication incidence, patient satisfaction survey, and independent surgeon evaluation of patients' photographs.ResultsThere were no complications in the study group. The outcome evaluation survey has shown high patient satisfaction. The outcome survey demonstrated that 85.71% of the patients were very satisfied, while 14.29 % were satisfied with the procedure and all of them recommend the procedure to others. On the other hand, the independent surgeon evaluation showed that 92.86% of the results were excellent and 7.14 % were very good.ConclusionOur work has shown how versatile is the UAL in contouring a wide spectrum of arm lipodystrophy stages in non-post-bariatric patients and presents a non-excisional alternative for arm aesthetic refinements without a rush for brachioplasty with its unpleasant complications.Level of Evidence IVThis 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.

Safety of Combined Use of Ultrasound and Power-Assisted Liposuction in Local Anesthesia

Background: Ultrasound-assisted liposuction (UAL) and power-assisted liposuction (PAL) have been independently shown to homogeneously aspirate higher amounts of fat, better protect tissue, and reduce hematoma formation when compared with standard liposuction (SL). Most liposuction surgeons use either one of these devices. In this study, we aimed to evaluate the safety of combining both methods in local anesthesia in a series of consecutive patients. Materials and Methods: Between March 2020 and March 2022, 956 patients underwent ultrasound UAL, followed by PAL in local anesthesia. There were 623 females and 333 males (mean age = 40.3, range = 21-67 years). Intraoperative and postoperative data were collected, and side-effects were noted. Results: Mean operation time was 83 minutes. There were no severe complications, and no hospitalizations were required. Minor complications included seroma (9), post-liposuction hyperemia (7), and hyperpigmentation (3). Eighteen patients required touch-up. Conclusion: Combining UAL and PAL in local anesthesia shows a safety profile similar to SL, provided these energy devices are used by experienced surgeons. After a learning curve, surgery time is comparable to SL.

Quality and Vitality of Autologous Fat Grafts Harvested by Different Techniques: A Clinical Comparison Study.

Unpredictable outcomes with autologous fat grafting due to reabsorption processes present a major challenge for healthcare providers and patients. A higher number of viable adipocytes is considered to result in a higher volume being retained. Although various adverse factors have been extensively researched, other potential parameters have been less investigated or even neglected. The aim of this study was to investigate the harvesting process of adipose tissue as the primary cause of cell damage and to determine the risk factors associated with low cell survival. Thirty-nine male and female subjects undergoing planned elective liposuction or abdominoplasty were enrolled. Forty-seven lipoaspirates harvested by different liposuction techniques were analyzed. RNA isolation and real-time polymerase chain reaction was performed to elucidate differences in the expression of various adipocyte markers. Furthermore, scanning electron microscopy was performed on various samples to determine the cell damage caused by the different techniques. A statistically significant lower expression of peroxisome proliferator-activated receptor γ was detected in subjects with a higher BMI. A trend towards a lower expression of perilipin 1 in lipoaspirates harvested by a super wet + ultrasound technique, compared with dry and super wet techniques, was shown. The lowest level of cell damage determined from scanning electron microscopy images was in lipoaspirates harvested by the super wet + ultrasound technique, and this level was statistically significantly different from those obtained by the 2 other techniques. Optimization of the outcome in autologous fat grafting may be feasible by targeting and optimizing the harvesting process as a main risk factor for impaired adipocyte viability. Ultrasound-assisted liposuction might be considered a suitable harvesting technique.

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 .

Breast Fat Grafting: Comparing Filtration-Centrifugation to Filtration-Washing Fat Processing

Breast Fat Grafting: Comparing 2 fat processing methods and learned clinical experience. Introduction: Since alloplastic breast implants suffer from numerous potential complications and revision surgery, some practitioners and patients seek alternative treatment. Autologous fat grafting has gained popularity due to its safety and scientific advances yielding increased survival. Materials and Methods: Laboratory evaluation of fat specimens compared to ultrasound-assisted and suction-assisted fat harvesting is presented. The filtration-washing device (PureGraft) versus the filtration-centrifugation device (LipoKit) were compared using both clinical evaluation, laboratory analysis, and diagnostic ultrasound to assess fat thickness before and after surgical placement. Results: The study evaluated 12 women electing breast fat transfer, 6 undergoing PureGraft for processing (mean 29.2 years, Mean BMI 25.5), with 3 of these using suction-assisted harvested fat and 3 using ultrasound-assisted harvested fat. The initial group had 6 patients (mean 28.5 years, Mean BMI 25.1) that had undergone LipoKit fat processing, with 3 of these using suction-assisted harvested fat and 3 using ultrasound-assisted harvested fat. Fat placed ranged between 100 cc and 240 cc per breast in the subcutaneous plane, with a mean of 171.7 cc for LipoKit and 169.2 cc for the PureGraft group. LipoKit fat processing revealed fat grafted breasts to be 40% thicker via diagnostic ultrasound at 10 weeks and 29% thicker at a mean of 7 months and 10 days. The ultrasound-assisted fat harvesting using LipoKit found a mean fat viability of 91.5% compared to 81.8% with PureGraft. Suction-assisted fat harvesting using LipoKit found a mean fat viability of 92.1% compared to 91.5% with PureGraft. Discussion: Our clinical study revealed that in the patient population that elected breast fat grafting as the method of augmentation, there was a high patient satisfaction rate. The filtration-centrifugation system has several advantages: (1) centrifugation forces injuries the larger, more mature, less likely to survive adipocytes (2) the process removes the oil content much more efficiently and in greater quantities than PureGraft, (3) more efficiently and in greater quantities extracts the wetting fluid (4) absence of washing inhibits the removal of lipoaspirate containing growth factors and cytokines, (5) Compacts the fat, and finally (6) Concentrates adipose-derived stem cells and stromal vascular fraction progenitor support cells. There was no difference in fat viability comparing suction-assisted to ultrasound-assisted liposuction fat harvesting. Conclusions: Breast fat grafting using the Filtration-Centrifugation device (LipoKit) revealed superior volume results compared to the Filtration-Washing device (PureGraft), with no difference with suction or ultrasound fat harvesting.

Lipoabdominoplasty: Comparing Ultrasound-Assisted and Power-Assisted Techniques

Introduction: Optimizing the abdomen aesthetic appearance may combine liposculpture, abdominoplasty, and postsurgical noninvasive body sculpting. The abdominoplasty traditional technique highlights abdominal flap undermining. The Avelar or Saldana lipoabdominoplasty’s technique modifications use liposuction and the absence of undermining of the abdominal wall flap. This method maintains abdominal wall vascularization and lessens complications. Two commonly employed liposuction techniques are power-assisted and ultrasound-assisted liposuction. Combining power-assisted technology with the Separation, Aspiration, Fat Equalization (SAFE) liposuction process has improved aesthetic results and reduced complications. Separation, Aspiration, Fat Equalization liposuction process enrolls separation, aspiration, and fat equalization steps. Ultrasound-assisted liposuction advantages include high-definition body sculpting through maximum fat removal and skin tightening with less blood loss and viable fat for grafting. This clinical study evaluated a comprehensive surgical protocol for lipoabdominoplasty designed to minimize complications. In addition, the study assessed aesthetic outcome and complication differences comparing the use of ultrasound-assisted versus power-assisted liposuction. Materials and Methods: This is a retrospective study in a single surgeon’s private cosmetic practice in 2 practice locations in patients undergoing a modified lipoabdominoplasty technique over a 2-year period. Results: Modified lipoabdominoplasty combining power-assisted technology with SAFE liposuction (n = 30) compared to those using ultrasound-assisted liposuction (n = 20) revealed similar complication rates. Surgeon observation revealed better skin contour smoothness, more abdominal definition and skin tightening with less bruising when using ultrasound liposuction. The comprehensive surgical protocol designed to minimize perioperative complications was implemented on each patient and resulted in no medical errors and a low major and minor complication rate. Conclusions: The lipoabdominoplasty surgical protocol provides surgeon’s comprehensive preoperative, intraoperative, and postoperative guidelines to minimize complications. Higher body mass index increased the complication rate. The aesthetic outcome using ultrasound-assisted liposuction appeared to yield better aesthetic sculpted appearance with less bruising compared to power-assisted technology.

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 &lt; 0.01). There was no significant difference between groups for the other parameters (p &gt; 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 .

Current status and prospects of clinical application of liposuction

To review the characteristics and deficiencies of various liposuction methods to provide reference for choosing more suitable liposuction in clinic and ideas for the improvement and development of liposuction equipment. The literature related to liposuction in recent years was consulted, and the principle, indications as well as existing problems were reviewed. Liposuction can be divided into two categories according to the principles of fat separation. The first type relies on physical cutting to separate fat, including suction-assisted liposuction (SAL), power-assisted liposuction (PAL), and water-assisted liposuction (WAL). SAL and PAL are simple to operate and low in price, but the effect of liposuction mainly depends on the experience of the surgeon, and complications such as uneven appearance, hematoma, and ecchymosis may occur. WAL saves time and effort, but has lower cost performance. The second type relies on energy destruction to separate fat, including ultrasound-assisted liposuction, laser-assisted liposuction, and radiofrequency-assisted liposuction. This type of surgery has the advantages of less trauma, fast postoperative recovery, and skin tightening. However, the equipment is more expensive, and has a risk of skin burns. Liposuction can effectively reduce local fat accumulation, but it still has limitations. Equipment improvement and fat transplantation are important directions for liposuction's future development.

Adverse Events of Soft Tissue Coagulation Using a Helium-Based Plasma Technology Alone and in Combination With Ultrasound-Assisted Liposuction.

BackgroundProtein denaturation and collagen contraction occur when living tissue is heated to well-defined temperatures. The result is reduced volume and surface area of the heated tissue.ObjectivesTo evaluate the adverse events of procedures in which a helium-based plasma technology (HPT) was used with and without ultrasound-assisted liposuction for the coagulation of soft tissue.MethodsA multicenter retrospective chart review was performed in which patients (n = 192) were divided into 2 groups: one that received only soft tissue coagulation and the other that received both soft tissue coagulation and liposuction. Each of the 2 groups was subdivided into patients with and without adverse events, including seroma. Odds ratios for adverse events were calculated for both demographic and surgical subgroups. Seroma data were analyzed separately.ResultsNo serious adverse events were observed. Forty-six (24.0%) patients reported 51 total adverse events. Seroma was the most frequently occurring adverse event with 13 patients (6.8%) reporting 17 (33.3%) events in 12 body areas. In these cases, all areas were treated with both liposuction and soft tissue coagulation. Seroma was not observed in patients receiving soft tissue coagulation alone. Patients aged 61 to 76 years and males were more likely to experience seroma or other adverse event than younger patients or females, respectively.ConclusionsThe use of the HPT for soft tissue coagulation in combination with ultrasound for liposuction is associated with nonserious adverse events. The most frequently occurring adverse event, seroma, was not observed in patients treated with HPT alone.Level of Evidence: 3

Evaluation of surgical versus VASER assisted liposuction in management of submental adiposity in moderate to severe skin laxity and significant lipodystrophy

Background Submental adiposity is one of visible signs of the aging process which affects the aesthetic look of the face and neck , and its management usually is difficult without surgery, nowadays we can achieve a good results in double chin without surgical lifting of neck by new technology (VASER liposuction) in many cases. Aim of the work: To Evaluation of surgical versus VASER assisted liposuction in management of submental adiposity in moderate to severe skin laxity and significant lipodystrophy. Patient and Methods: This study is prospective study was conducted on 30 male and female patients starting from September 2018 till march 2021, in Al-Azhar university hospitals presented with moderate or severe submental adiposity (double chin), were categorized in random fashion into two groups, Group (A) management by ultrasound assisted liposuction VASER (15 patient), Group (B) surgical management (neck lifting) (15 patient). Results: Regarding patient acceptance, among the VASER group, 6 patients (40%) reported good score, 5 patients (33.3%) reported very good score, 4 patients (26.7%) reported fair score. While 10 patients (66.7%) reported very good score, 3 patients (20%) reported excellent score and 2 patients (13.3%) reported good score. Conclusion: Surgical neck lifting is the best result , especially in old age however , VASER liposuction have a good results in young and middle age , especially in mild , moderate and some cases of sever lipodystrophy , the vaser liposuction is a good option for the patient whose a fried from the scar of surgery.

Abdominoplasty: My Preferred Techniques.

Abdominoplasty has been evolving since the 1960s with many technical innovations throughout the years. It has become one of the most frequent and common procedures done in aesthetic plastic surgery, with the ultimate goal of not only to remove the excess tissue in the abdominal area but also to achieve an aesthetic trunk silhouette. The prime objective of this article was to describe our preferred approach for a full cosmetic abdominoplasty. We summarized all the key technical aspects from our shared surgical approach for abdominoplasty. The article describes collective experiences from authors performing the surgery in South America, North America, and Asia. The key technical aspects identified were conservative muscle plication, customized excess tissue resection, and ultrasound-assisted liposuction to improve definition in the abdominal lines and body curves, combined with lipofilling. The aesthetic results are presented. Abdominoplasty should be customized to every patient's anatomy and desired cosmetic outcome, taking into consideration all the anatomical areas surrounding the abdominal wall.

Expected Reduction of The Nipple-Areolar Complex Over Time After Treatment of Gynecomastia with Ultrasound-Assisted Liposuction Mastectomy Compared to Subcutaneous Mastectomy Alone.

The enlarged nipple-areola-complex (NAC) is a characterizing aspect of gynecomastia. The purpose of this study was to multidimensionally quantify the reduction of the NAC after a subcutaneous mastectomy (SCM) with or without ultrasound-assisted liposuction (UAL). A retrospective assessment of patients who underwent SCM +/- UAL due to gynecomastia over a period of 11 years was conducted. The NAC diameters were measured before and after surgery. In addition, a survey (including the BREAST-Q) regarding patient-oriented outcome was performed. The study cohort consisted of 55 men and resulting 105 NACs (SCM n=63, SCM+UAL n=42). It could be shown that the reduction of the NAC considering all parameters (horizontal and vertical diameter and the area) was significantly larger (p=<0.001) in the SCM+UAL compared to the SCM only cohort. The mean reduction of the area in the SCM cohort was 1.60cm2 (SD 1.48) or 23.37% (SD 9.78) after 5.82 years and in the SCM+UAL cohort 2.60cm2 (SD 1.60) or 35.85% (SD 6,86) after 7.43years. As independent significant factors for reduction of the NAC, the resection weight and SCM+UAL combination were identified. There were no significant differences regarding the patients' satisfaction measured with the BODY-Q (p=0.222) and the ordinal scale (p=0.445) between the two cohorts. The SCM with UAL showed a larger reduction over time of the NAC compared to the SCM independent from the stage of gynecomastia. When planning the surgical treatment of gynecomastia, a technique and resection weight dependent reduction of the NAC over time must be considered. 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 .