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Aljerian A, Abi-Rafeh J, Hemmerling T, Gilardino MS. Complications of Aesthetic Liposuction Performed in Isolation: A Systematic Literature Review and Meta-Analysis. Plast Surg (Oakv) 2024; 32:19-32. [PMID: 38433796 PMCID: PMC10902471 DOI: 10.1177/22925503221078693] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/05/2024] Open
Abstract
Introduction: Aesthetic liposuction represents one of the most commonly performed cosmetic procedures worldwide. The purpose of this article is to examine and synthesize reported complication rates and explore the analytical prospect of possible patient or procedure-related predictive factors associated with specific complications. Methods: A systematic review was performed using the Pubmed, Cochrane, and Embase databases in line with specific criteria set to ensure an accurate assessment of complication rates; extracted data was synthesized through a random-effects model and meta-analysis of proportions. Results: A total of 60 studies were included in the meta-analysis, representing 21,776 patients undergoing aesthetic liposuction. Most studies followed an observational design. The overall complication rate was 12% (95% confidence interval [CI] 8%, 16%). When stratifying according to specific complications, the incidence of contour irregularities was determined to be 2% (95% CI 1%, 2%), seroma 2% (95% CI 1%; 2%), hematoma 1% (95% CI 0%, 1%), surgical site infection 1% (95% CI 1%, 2%), fibrosis or induration 1% (95% CI 1%, 2%), and pigmentary changes 1% (95% CI 1%, 1%), among others. A meta-regression to identify patient- or procedure-related factors associated with greater complication rates proved infeasible given the nature of the available data. Conclusion: Overall, liposuction demonstrated a relatively low complication rate profile, however, a considerable degree of heterogeneity exists within the examined literature preventing the recognition of predictive risk factors. While this calls for efforts to establish consensus on unified methods of outcomes reporting, the present meta-analysis can serve to provide practitioners with an evidence-based reference to improve informed consent and inform clinical guidelines, specifically pertaining to the incidence of commonly encountered complications in aesthetic liposuction, of which presently available survey studies and database queries remain devoid.
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Affiliation(s)
- Albaraa Aljerian
- Division of Plastic and Reconstructive Surgery, McGill University, Montreal, Quebec, Canada
- Division of Experimental Surgery, McGill University, Montreal, Quebec, Canada
| | - Jad Abi-Rafeh
- Division of Plastic and Reconstructive Surgery, McGill University, Montreal, Quebec, Canada
| | - Thomas Hemmerling
- Division of Experimental Surgery, McGill University, Montreal, Quebec, Canada
- Department of Anesthesia, McGill University, Montreal, Quebec, Canada
| | - Mirko S. Gilardino
- Division of Plastic and Reconstructive Surgery, McGill University, Montreal, Quebec, Canada
- Division of Experimental Surgery, McGill University, Montreal, Quebec, Canada
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Shapira E, Plonski L, Menashe S, Ofek A, Rosenthal A, Brambilla M, Goldenberg G, Haimowitz S, Heller L. High-Quality Lipoaspirate Following 1470-nm Radial Emitting Laser-Assisted Liposuction. Ann Plast Surg 2022; 89:e60-e68. [PMID: 36416705 PMCID: PMC9704815 DOI: 10.1097/sap.0000000000003316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 05/29/2022] [Accepted: 09/11/2022] [Indexed: 11/24/2022]
Abstract
BACKGROUND Laser-assisted liposuction (LAL) has been used to maximize viable adipocyte yields in lipoaspirates, although optimizing tissue processing methods is still a challenge. A high-quality lipoaspirate has been a key factor for extended graft longevity. OBJECTIVE To assess the viability and potency of stromal vascular fraction (SVF) cells and adipose-derived stem cells (ASCs) in fat samples from lipoaspirates harvested with a novel 1470-nm diode, radial emitting LAL platform. Two processing methods, enzymatic and nonenzymatic, were compared. METHODS Laser-assisted liposuction lipoaspirates harvested from 10 subjects were examined for cell viability after processing by enzymatic or nonenzymatic methods. Isolated SVF cells were cultured with an ASC-permissive medium to assess their viability and proliferation capacity by cell proliferation assay. Flow cytometric analysis with ASC-specific markers, gene expression levels, and immunofluorescence for ASC transcription factors were also conducted. RESULTS Lipoaspirates showed high SVF cell viability of 97% ± 0.02% and 98% ± 0.01%, averaged SVF cell count of 8.7 × 10 6 ± 3.9 × 10 6 and 9.4 × 10 6 ± 4.2 × 10 6 cells per mL, and averaged ASC count of 1 × 10 6 ± 2.2 × 10 5 and 1.2 × 10 6 ± 5 × 10 5 cells per mL in nonenzymatic and enzymatic methods, respectively. The ASC-specific markers, gene expression levels, and immunofluorescence for ASC transcription factors confirmed the adipose origin of the cells. CONCLUSIONS The laser lipoaspirates provide a high yield of viable and potent SVF cells and ASCs through both nonenzymatic and enzymatic processes. Improved purity of the harvested lipoaspirate and high ASC content are expected to result in extended graft longevity. Furthermore, eliminating enzymatic digestion may provide advantages, such as reducing process time, cost, and regulatory constraints.
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Affiliation(s)
- Eyal Shapira
- From the Department of Plastic Surgery, Shamir Medical Center, Zerifin, Israel
| | - Lori Plonski
- From the Department of Plastic Surgery, Shamir Medical Center, Zerifin, Israel
| | - Shaked Menashe
- From the Department of Plastic Surgery, Shamir Medical Center, Zerifin, Israel
| | - Andre Ofek
- From the Department of Plastic Surgery, Shamir Medical Center, Zerifin, Israel
| | - Adaya Rosenthal
- From the Department of Plastic Surgery, Shamir Medical Center, Zerifin, Israel
| | - Massimiliano Brambilla
- Department of the Health of the Woman, Child and Neonate, Fondazione IRCSS Ospedale Maggiore, Milan, Italy
| | - Gary Goldenberg
- Department of Dermatology, Icahn School of Medicine at Mount Sinai Hospital, Mount Sinai, NY
| | - Sahar Haimowitz
- Prostate Cancer Research Laboratory, Department of Urology, Tel Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Lior Heller
- From the Department of Plastic Surgery, Shamir Medical Center, Zerifin, Israel
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Safety, Efficacy, and Tolerability of Simultaneous Bilateral Cryolipolysis Using a Rapid Cycling Contoured Cup Applicator for Noninvasive Fat Reduction in the Enlarged Male Breast: A Pilot Study. Dermatol Surg 2022; 48:642-647. [PMID: 35363633 DOI: 10.1097/dss.0000000000003443] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BACKGROUND A previous study using a parallel cooling plate cryolipolysis applicator demonstrated the efficacy of cryolipolysis for pseudogynecomastia. Although the procedure was safe and effective, treatment times were prolonged and anesthetic was needed to reduce treatment discomfort. OBJECTIVE To evaluate the safety, efficacy, and tolerability of a short cycle, reduced vacuum contoured cup cryolipolysis applicator for the treatment of pseudogynecomastia. MATERIALS AND METHODS Twelve male subjects received simultaneous bilateral treatment consisting of a 35-minute cryolipolysis cycle, followed by a short manual massage, and a second 35-minute cycle with 50% treatment area overlap in a single treatment visit. At the 6-week follow-up, a second treatment was performed with up to 2 overlapping cycles per side. Efficacy was assessed after the second treatment using transcutaneous ultrasound, standardized clinical photography, and subject surveys. RESULTS Ultrasound analysis showed a mean fat layer reduction of 5.1 ± 2.3 mm (p < .001). Blinded, independent reviewers correctly identified 97% of baseline/treatment photography results. Surveys revealed 100% subject satisfaction with 91% reporting visible fat reduction and 100% stating they would recommend treatment. Transient side effects included mild intratreatment discomfort, paresthesia, and tenderness. CONCLUSION A rapid cycling, reduced vacuum cryolipolysis applicator provides rapid, safe, effective, and tolerable treatment of pseudogynecomastia.
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Innocenti A, Melita D, Dreassi E. Incidence of Complications for Different Approaches in Gynecomastia Correction: A Systematic Review of the Literature. Aesthetic Plast Surg 2022; 46:1025-1041. [PMID: 35138423 PMCID: PMC9411245 DOI: 10.1007/s00266-022-02782-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2021] [Accepted: 01/09/2022] [Indexed: 11/12/2022]
Abstract
Background Gynecomastia is nowadays a very common disease, affecting a large cohort of patients with different ages. The aim of this literature review is to assess the incidence of complications with all proposed techniques and for combined procedures versus single approach procedures in gynecomastia correction. Materials and Methods A systematic review of the literature was performed to identify all reported techniques for gynecomastia correction covering a period from January 1, 1987 to November 1, 2020. For all selected papers, demographic data, proposed technique, and complications’ incidence have been recorded. Results A total number of 3970 results was obtained from database analysis. A final total number of 94 articles was obtained for 7294 patients analyzed. Patients have been divided into three groups: aspiration techniques, consisting in 874 patients (11,98%), surgical excision techniques, consisting in 2764 patients (37,90%), and combined techniques, consisting in 3656 patients (50,12%). Complications have been recorded for all groups, for a total number of 1407, of which 130 among “Aspiration techniques” group (14,87%), 847 among “Surgical excision techniques” group (30,64%), and 430 in “Combined techniques” group (11,76%). Conclusions Several techniques have been proposed in the literature to address gynecomastia, with the potential to greatly improve self-confidence and overall appearance of affected patients. The combined use of surgical excision and aspiration techniques seems to reduce the rate of complications compared to surgical excision alone, but the lack of unique classification and the presence of several surgical techniques still represents a bias in the literature review. Level of Evidence III 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.
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Heller L, Menashe S, Plonski L, Ofek A, Pozner JN. 1470-nm Radial fiber-assisted liposuction for body contouring and facial fat grafting. J Cosmet Dermatol 2022; 21:1514-1522. [PMID: 35106886 PMCID: PMC9303361 DOI: 10.1111/jocd.14767] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Revised: 12/31/2021] [Accepted: 01/06/2022] [Indexed: 12/01/2022]
Abstract
Background Laser‐assisted liposuction using 1470‐nm radial fiber emits light energy preferentially absorbed by water, yielding a rapid and localized contouring and tightening effect, with minimal scarring. When collected under appropriate conditions, extracted fat samples can be exploited as autologous filling material in liposculpturing procedures. Objectives To assess the 6‐month contouring efficacy of 1470 radial fiber‐assisted liposuction and the volumetric enhancement effect of the harvested tissue in facial fat grafting. Methods Twenty subjects underwent liposuction (BeautiFill, Alma Lasers, Inc.) of lower abdominal or outer thigh fat. In seven subjects, harvested samples were grafted into facial regions. Treatment safety, body weight, blinded evaluator‐assessed aesthetic improvements, and subject‐rated satisfaction were monitored for 6 months. Abdominal and facial fat thickness were assessed by magnetic resonance imaging (n = 5) within 3 months of treatment. Results One‐month posttreatment, most subjects ranked improvements good/excellent (88%) and skin tightening satisfactory/very satisfactory (92%), with >70% of subjects providing similar scores 6‐month posttreatment. Blinded evaluators noted improved/very much improved aesthetic appearance (87%). Harvested tissue injected as a facial filler (21.0 ± 5.2 ml) led to a 0.63 ± 0.12 mm increase in facial fat thickness, observed by MRI, within 3 months. Six months postfilling, the majority of subjects (83%) were satisfied with the outcome. All procedures were well‐tolerated. Conclusions A single 1470 nm radial fiber‐assisted abdominal and thigh liposuction session provided for effective and durable reduction of adipose tissue deposits, with appreciable skin tightening and aesthetic improvements. The gentle harvesting method yielded viable filler material, which was well‐retained in facial regions for up to 6 months.
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Affiliation(s)
- Lior Heller
- Department of Plastic Surgery, Shamir Medical Center, Zerifin, Israel
| | - Shaked Menashe
- Department of Plastic Surgery, Shamir Medical Center, Zerifin, Israel
| | - Lori Plonski
- Department of Plastic Surgery, Shamir Medical Center, Zerifin, Israel
| | - Andre Ofek
- Department of Plastic Surgery, Shamir Medical Center, Zerifin, Israel
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Approach to gynecomastia and pseudogynecomastia surgical techniques and its outcome: a systematic review. J Plast Reconstr Aesthet Surg 2022; 75:1704-1728. [DOI: 10.1016/j.bjps.2022.02.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Revised: 01/17/2022] [Accepted: 02/12/2022] [Indexed: 11/17/2022]
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Prasetyono TOH, Budhipramono AG, Andromeda I. Liposuction Assisted Gynecomastia Surgery With Minimal Periareolar Incision: a Systematic Review. Aesthetic Plast Surg 2022; 46:123-131. [PMID: 34379157 DOI: 10.1007/s00266-021-02520-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2021] [Accepted: 08/01/2021] [Indexed: 12/24/2022]
Abstract
BACKGROUND This study aims to analyse the quality of studies and revisit the liposuction assisted gynecomastia surgery performed through minimal incision. METHODS A systematic review, based on the literature in the PubMed, Scopus, Science Direct, and Cochrane, to the treatment of Simon's grade I and II gynecomastia was conducted using keywords "gynecomastia" AND "liposuction." Study appraisal was performed using MINORS to assess the methodological quality of the paper. RESULTS There were 18 out of 415 studies eligible to review. A total of 244 out of 1628 patients with the average age of 23.13 years. Liposuction facilitated the easy handling to remove the breast tissue via small incisional design; showed consistent improved quality of life in terms of satisfaction after surgery. However, the measuring method of satisfaction rate varied, resulting in difficulties to interpret the results. Complication rates were inconsistent throughout the studies, ranging from 0.06 to 26.67%. Reoperation rate of liposuction-assisted surgery is between 0.6 and 25%. There are only two studies of a total 25 patients that are considered as good in quality. The two studies, which discuss laser-assisted liposuction technique, show minor complication of seroma in two patients. While one study shows high patient's satisfaction rate; both studies indicate high surgeon's satisfaction rate. CONCLUSION Small incisional design for breast parenchymal removal in gynecomastia assisted by liposuction showed a good technical approach for consistent improvement in quality of life. However, only 2 studies reported good quality methods of non-randomized case series urging for a better quality of studies in the future. LEVEL OF EVIDENCE III 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 .
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Affiliation(s)
- Theddeus Octavianus Hari Prasetyono
- Division of Plastic Surgery, Department of Surgery, Cipto Mangunkusumo Hospital/ Faculty of Medicine, Universitas Indonesia, Medical Staff Wing, A building, 4th Floor, Jl. Diponegoro No. 71, Jakarta, 10430, Indonesia.
- ICTEC (Indonesian Clinical Training and Education Center), Cipto Mangunkusumo Hospital/ Faculty of Medicine, Universitas Indonesia, Jl. Diponegoro No. 71, Jakarta, 10430, Indonesia.
- Medical Technology Cluster, Faculty of Medicine Universitas Indonesia, Universitas Indonesia, Education Tower, 2nd Floor, Jl. Salemba Raya No. 6, Jakarta, 10430, Indonesia.
| | - Angelica Gracia Budhipramono
- ICTEC (Indonesian Clinical Training and Education Center), Cipto Mangunkusumo Hospital/ Faculty of Medicine, Universitas Indonesia, Jl. Diponegoro No. 71, Jakarta, 10430, Indonesia
| | - Illona Andromeda
- ICTEC (Indonesian Clinical Training and Education Center), Cipto Mangunkusumo Hospital/ Faculty of Medicine, Universitas Indonesia, Jl. Diponegoro No. 71, Jakarta, 10430, Indonesia
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[Current status and prospects of clinical application of liposuction]. ZHONGGUO XIU FU CHONG JIAN WAI KE ZA ZHI = ZHONGGUO XIUFU CHONGJIAN WAIKE ZAZHI = CHINESE JOURNAL OF REPARATIVE AND RECONSTRUCTIVE SURGERY 2022; 36:127-132. [PMID: 35038811 PMCID: PMC8844613 DOI: 10.7507/1002-1892.202108077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
OBJECTIVE 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. METHODS The literature related to liposuction in recent years was consulted, and the principle, indications as well as existing problems were reviewed. RESULTS 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. CONCLUSION 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.
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Raheem AA, Zaghloul AS, Sadek AMG, Rayes B, Abdel-Raheem TM. The Impact and Management of Gynaecomastia in Klinefelter Syndrome. FRONTIERS IN REPRODUCTIVE HEALTH 2021; 3:629673. [PMID: 36303983 PMCID: PMC9580767 DOI: 10.3389/frph.2021.629673] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2020] [Accepted: 01/15/2021] [Indexed: 11/21/2022] Open
Abstract
Gynecomastia is defined as a palpable enlargement of the male breast, secondary to an increase in the glandular and stromal breast tissue. Gynecomastia is encountered in up to 80% of Klinefelter syndrome cases. The pathophysiology involves testosterone/estrogen imbalance. This review article will further explore the pathophysiology of gynecomastia along with the different lines of management.
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Affiliation(s)
- Amr Abdel Raheem
- Andrology Department Cairo University Hospital, Beni Suef, Egypt
- Faculty of Population Health Sciences, Institute for Women's Health, University College London, London, United Kingdom
- *Correspondence: Amr Abdel Raheem
| | | | | | - Bilal Rayes
- King's College London, London, United Kingdom
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Aboelatta YA, Abdelaal MM. Comparison of laser-assisted liposuction and traditional liposuction combined with endoscopic surgical excision of grade II gynecomastia. EUROPEAN JOURNAL OF PLASTIC SURGERY 2017. [DOI: 10.1007/s00238-017-1305-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Sönmez Ergün S, Kayan RB, Güleş ME, Kuzu İM. Effects of laser-assisted lipolysis on nipple-areola complex. J COSMET LASER THER 2017; 19:215-218. [PMID: 28151025 DOI: 10.1080/14764172.2017.1288258] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
BACKGROUND Gynecomastia, as a most common benign condition, represents itself as the enlargement of the male breast and also nipple-areola complex as the severity of the condition increases. With this study, we aimed to clarify the effects of 980-nm diode laser on nipple-areola complex (NAC). OBJECTIVES Although numerous open techniques have been described to correct gynecomastia, nowadays trends have shifted to minimally invasive techniques such as laser-assisted lipolysis (LAL). METHODS A total of 25 patients with bilateral gynecomastia treated with LAL by using a 980-nm diode laser. RESULTS The resultant contour and reduced size of the complex were satisfactory. CONCLUSIONS LAL leads to significant reduction of the size of NAC.
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Affiliation(s)
- Selma Sönmez Ergün
- a Department of Plastic , Reconstructive and Aesthetic Surgery, Bezmialem Medical School, Bezmialem Vakif University , Istanbul , Turkey
| | - Reşit Burak Kayan
- a Department of Plastic , Reconstructive and Aesthetic Surgery, Bezmialem Medical School, Bezmialem Vakif University , Istanbul , Turkey
| | - Mustafa Ekrem Güleş
- a Department of Plastic , Reconstructive and Aesthetic Surgery, Bezmialem Medical School, Bezmialem Vakif University , Istanbul , Turkey
| | - İsmail Melih Kuzu
- a Department of Plastic , Reconstructive and Aesthetic Surgery, Bezmialem Medical School, Bezmialem Vakif University , Istanbul , Turkey
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Comparison of Cellular Alterations in Fat Cells Harvested With Laser-Assisted Liposuction and Suction-Assisted Liposuction. J Craniofac Surg 2016; 27:631-5. [DOI: 10.1097/scs.0000000000002589] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
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Hwang J, Hau NT, Park SY, Rhee YH, Ahn JC, Kang HW. Ex vivo laser lipolysis assisted with radially diffusing optical applicator. JOURNAL OF BIOMEDICAL OPTICS 2016; 21:58001. [PMID: 27207114 DOI: 10.1117/1.jbo.21.5.058001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/19/2016] [Accepted: 04/25/2016] [Indexed: 06/05/2023]
Abstract
Laser-assisted lipolysis has been implemented to reduce body fat in light of thermal interactions with adipose tissue. However, using a flat fiber with high irradiance often needs rapid cannula movements and even undesirable thermal injury due to direct tissue contact. The aim of the current study was to explore the feasibility of a radially diffusing optical applicator to liquefy the adipose tissue for effective laser lipolysis. The proposed diffuser was evaluated with a flat fiber in terms of temperature elevation and tissue liquefaction after laser lipolysis with a 980-nm wavelength. Given the same power (20 W), the diffusing applicator generated a 30% slower temperature increase with a 25% lower maximum temperature (84±3.2°C in 1 min; p<0.001) in the tissue, compared with the flat fiber. Under the equivalent temperature development, the diffuser induced up to fivefold larger area of the adipose liquefaction due to radial light emission than the flat fiber. Ex vivo tissue tests for 5-min irradiation demonstrated that the diffuser (1.24±0.15 g) liquefied 66% more adipose tissue than the flat fiber (0.75±0.05 g). The proposed diffusing applicator can be a feasible therapeutic device for laser lipolysis due to low temperature development and wide coverage of thermal treatment.
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Affiliation(s)
- Jieun Hwang
- Pukyong National University, Department of Biomedical Engineering, Busan 48513, Republic of Korea
| | - Nguyen Trung Hau
- Pukyong National University, Interdisciplinary Program of Marine-Bio, Electrical & Mechanical Engineering, Busan 48513, Republic of Korea
| | - Sung Yeon Park
- University of California, Molecular Environmental Biology, Berkeley, California 95124, United States
| | - Yun-Hee Rhee
- Dankook University, Beckman Laser Institute Korea, Cheonan 31116, Republic of Korea
| | - Jin-Chul Ahn
- Dankook University, Department of Biomedical Science, College of Medicine and Medical Laser Research Center, Cheonan 31116, Republic of Korea
| | - Hyun Wook Kang
- Pukyong National University, Department of Biomedical Engineering, Busan 48513, Republic of KoreabPukyong National University, Interdisciplinary Program of Marine-Bio, Electrical & Mechanical Engineering, Busan 48513, Republic of KoreafPukyong National Un
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Leclère FM, Alcolea JM, Vogt PM, Moreno-Moraga J, Casoli V, Mordon S, Trelles MA. Laser-assisted lipolysis for arm contouring in Teimourian grades III and IV: A prospective study involving 22 patients. Plast Surg (Oakv) 2016. [DOI: 10.1177/229255031602400105] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Background Upper arm deformities secondary to weight loss or senile elastosis have led to an increased demand for aesthetic contouring procedures. Objective To objectively assess whether, in Teimourian high-grade upper arm remodelling, laser-assisted lypolysis (LAL) alone could result in patient satisfaction. Methods Between 2012 and 2013, 22 patients were treated for excessive upper arm fat (Teimourian grade III and IV) solely with LAL. The laser used in the present study was a 1470 nm diode laser (Alma Lasers, Israel) with the following parameters: continuous mode, 15 W power and transmission through a 600 μm optical fibre. Previous mathematical modelling suggested that 0.1 kJ was required to destroy 1 mL of fat. Patients were asked to complete a satisfaction questionnaire. The arm circumference was measured pre- and postoperatively. Treatment parameters, adverse effects and outcomes were recorded. Results Pain during the anesthesia and discomfort after the procedure were minimal. Complications included ecchymoses and prolonged edema. The mean (± SD) arm circumference decreased 5.5±1.0 cm in the right arm (P<0.01) and 5.2±1.1 cm in the left arm (P<0.01) in grade III patients and 4.9±1.1 cm in the right arm (P<0.01) and 4.9±1.1 cm in the left arm (P<0.01) in grade IV patients. Although the circumference of both arms significantly decreased in grade III and grade IV patients, the skin tightening remained incomplete. Overall, the average opinion of treatment was poor for both patients and investigators. Of the 22 patients, only nine (41%) would recommend this treatment. Conclusion LAL for upper arm remodelling is not sufficient to ensure full skin tightening for patients with Teimourian grades III and IV upper arm deformities. A complementary surgery is mandatory for grades III and IV.
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Affiliation(s)
- Franck Marie Leclère
- Department of Plastic & Transsexual Surgery, Burn Surgery, Hand Surgery, CHU University of Bordeaux, Centre François-Xavier-Michelet, Groupe hospitalier Pellegrin, Bordeaux
- INSERM U1189, University of Lille, France
- Department of Plastic Surgery, Hannover Medical School, University of Hannover, Germany
| | | | - Peter M Vogt
- Department of Plastic Surgery, Hannover Medical School, University of Hannover, Germany
| | | | - Vincent Casoli
- Department of Plastic & Transsexual Surgery, Burn Surgery, Hand Surgery, CHU University of Bordeaux, Centre François-Xavier-Michelet, Groupe hospitalier Pellegrin, Bordeaux
| | | | - Mario A Trelles
- Department of Plastic & Transsexual Surgery, Burn Surgery, Hand Surgery, CHU University of Bordeaux, Centre François-Xavier-Michelet, Groupe hospitalier Pellegrin, Bordeaux
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Yoo KH, Bae JM, Won CY, Chung YS, Goo B, Rho YK, Kim GM, Lee J, Ahn BH, Kim BJ. Laser-Assisted Liposuction Using the Novel 1,444-nm Nd:YAG Laser for the Treatment of Gynecomastia: A Pilot Study. Dermatology 2015; 231:224-30. [DOI: 10.1159/000430494] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2014] [Accepted: 04/14/2015] [Indexed: 11/19/2022] Open
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Laser-assisted lipolysis for arm contouring in Teimourian grades I and II: a prospective study of 45 patients. Lasers Med Sci 2015; 30:1053-9. [PMID: 25596934 DOI: 10.1007/s10103-014-1705-2] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2014] [Accepted: 12/18/2014] [Indexed: 10/24/2022]
Abstract
Upper arm deformities secondary to weight loss or senile elastosis have led to an increased demand for aesthetic contouring procedures. We conducted this study to objectively assess if, in Teimourian low-grade upper arm remodelling, one session of laser-assisted lypolisis (LAL) could result in full patient satisfaction. Between 2011 and 2013, 45 patients were treated for unsightly fat arm Teimourian grade I (15 patients), grade IIa (15 patients) and grade IIb (15 patients) with one session of LAL. The laser used in this study was a 1470-nm diode laser (Alma Lasers, Cesarea, Israel) with the following parameters: continuous mode, 15 W power and transmission through a 600-μm optical fibre. Previous mathematical modelling suggested that 0.1 kJ was required in order to destroy 1 ml of fat. Treatment parameters and adverse effects were recorded.The arm circumference and skin pinch measurements were assessed pre and postoperatively. Patients were asked to file a satisfaction questionnaire. Pain during the anaesthesia and discomfort after the procedure were minimal. Complications included prolonged oedema in 11 patients. The average arm circumference decreased by 4.9 ± 0.4 cm in the right arm (p < 0.01) and 4.7 ± 0.5 cm in the left arm (p < 0.01) in grade I patients, 5.5 ± 0.6 cm in the right arm (p < 0.01) and 5.2 ± 0.5 cm in the left arm (p < 0.01) in grade IIa patients and 5.4 ± 0.5 cm in the right arm (p < 0.01) and 5.3 ± 0.5 cm in the left arm (p < 0.01) in grade IIB patients. The skin tightening effect was confirmed by the reduction of the skin calliper measurements in all three groups. Overall mean opinion of treatment was high for both patients and investigators. Of the 45 patients, all but one would recommend this treatment. A single session of LAL in upper arm remodelling for Teimourian grades I to IIb is a safe and reproducible technique. The procedure allows reduction in the amount of adipose deposits while providing full skin tightening.
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Leclère FM, Vogt PM, Moreno-Moraga J, Alcolea JM, Casoli V, Mordon SR, Trelles MA. Laser-assisted lipolysis for neck and submental remodeling in Rohrich type IV patients: fact or fiction? J COSMET LASER THER 2014; 17:31-6. [PMID: 25286033 DOI: 10.3109/14764172.2014.968581] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Since the first studies by Apfelberg in 1994 and the mathematical model of Mordon introduced in 2004, laser-assisted lipolysis (LAL) has been on the rise. In a previous study, we presented our results in patients treated with LAL for Rohrich type I to III aging neck. The average cervicomental angle decreased from 152.6 ± 5.9 to 123.6 ± 8.8 degrees after LAL. This demonstrated a systematic decrease in fat thickness, and improved skin tightening. OBJECTIVE This new protocol focuses solely on LAL in the Rohrich type IV aging neck. METHODS Between June 2012 and February 2013, a prospective study was performed on 10 patients treated with LAL for Rohrich type IV aging neck. The laser used in this study was a 1470 nm diode laser (Alma Lasers, Caesarea, Israel). Laser energy was transmitted through a 600 μm optical fiber and delivered in a continuous mode, at 15 W power. Previous mathematical modeling suggested that 0.1 kJ was required in order to destroy 1 ml of fat. Patients were asked to fill out a satisfaction questionnaire. The cervicomental angle was measured 6 months postoperatively, and compared with the preoperative values. RESULTS No seromas were observed, but prolonged edema was observed in two patients. Pain during anesthesia and discomfort after the procedure were minimal. The average cervicomental angle decreased from 191.5 ± 5.7 to 164.9 ± 14.2 degrees (p < 0.01). This demonstrated a systematic decrease in fat thickness and improved skin tightening. Even though the cervicomental angle was higher than 140° in each case, the investigators, in agreement with the patients, decided to perform a complementary surgery with platysma muscle advancement and plication six months after LAL, in only two of the ten patients. This complementary surgery led to a mean cervicomental angle of 140.2 ± 11.4, and fair satisfaction of both patients and investigators. CONCLUSION LAL alone appears insufficient for complete remodeling in Rohrich type IV aging neck. While LAL alone is sufficient for Grade I to III, a complementary surgery must be added for Grade IV.
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Affiliation(s)
- Franck Marie Leclère
- Department Plastic-, Hand-, Burn-, and Transsexual Surgery, CHU - University of Bordeaux , Bordeaux , France
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Leclère FM, Moreno-Moraga J, Alcolea JM, Casoli V, Mordon SR, Vogt PM, Trelles MA. Laser assisted lipolysis for neck and submental remodeling in Rohrich type I to III aging neck: a prospective study in 30 patients. J COSMET LASER THER 2014; 16:284-9. [PMID: 25065416 DOI: 10.3109/14764172.2014.946053] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Since the first studies by Apfelberg in 1994 and the mathematical model by Mordon in 2004, laser lipolysis (LAL) has been on the rise. Laser lipolysis has the advantages of reduced operator fatigue, excellent patient tolerance, quick recovery time, as well as the additional benefit of dermal tightening. This article reports our experience with laser-assisted lipolysis (LAL) in submental and neck remodelling. METHODS Between June 2010 and January 2013, a prospective study was performed on 30 patients treated for Rohrich type I to III aging neck, with LAL. The laser used in this study was a 980 nm diode laser (Quanta system, spa model D-plus, Solbate Olona (VA), Italy). Laser energy was transmitted through a 600 μm optical fiber and delivered in a continuous mode 15 W power. Previous mathematical modelling suggested that 0.1 kJ was required in order to destroy 1 ml of fat. Patients were asked to fill out a satisfaction questionnaire. The cervicomental angle was measured 6 months post-operatively and compared with the preoperative values. RESULTS Other than three patients who developed mild hyperpigmentation that disappeared after 4 months, there were no complications in the series. Pain during the anaesthesia and discomfort after the procedure were minimal. The time taken to return to normal activities was 3.2 ± 1 days. All patients would strongly recommend this treatment. Overall satisfaction was high with both patients and investigators and was validated by decrease in cervicomental angle demonstrating a systematic decrease in fat thickness and improved skin tightening. CONCLUSION LAL is a safe and reproducible technique for remodeling in Rohrich type I to III aging neck. The procedure allows for a reduction in the amount of adipose deposits while providing concurrent skin contraction.
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Affiliation(s)
- Franck Marie Leclère
- Department Plastic and Reconstructive Surgery, Gustave Roussy Cancer Campus Grand Paris , France
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Regula CG, Lawrence N. Update on Liposuction: Laser-Assisted Liposuction Versus Tumescent Liposuction. CURRENT DERMATOLOGY REPORTS 2014. [DOI: 10.1007/s13671-014-0074-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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