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Surgical - Body - Laser Liposuction - Information
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Laser liposuction (Laser-Assisted Liposuction) is a minimally invasive treatment in which laser technology is used to melt the fat under the skin. Ultrasound guidance of a fiber optic laser during the laser liposuction can be used on many parts of the body and results in excellent sculpting with tight skin. Laser liposuction is based on thermal effect. The laser can vaporize, melt tissues and coagulate blood vessels. More importantly, the laser stimulates the formation of collagen in the region, enhancing skin elasticity and promoting skin contraction in the treated areas.

 

Different Types of Fat

 

To understand the indications and limitations of liposuction and laser liposuction, different types of fat should be explained briefly:

The structural organization of fat in the trunk and extremities has both a superficial and deep fatty layer. The superficial layer is composed of small dense pockets of fat separated by vertical, well-organized fibrous septa. The deeper fat layers is organized more loosely, with looser fatty tissue interspersed with less regular fascia septae intervening between the pockets.

The deep fat reserve is very difficult to lose through dieting and appears to be of genetic origin. The areas are perfectly delimited anatomically (love handles, saddle bags, internal parts of the knees). They resist weight loss by sports activity. It is easy and safe to remove this deep fat by aspiration.

The superficial fat is very rich in blood vessels and is responsible for the phenomenon of cellulite. This metabolic fat, easy to lose or gain, is not limited anatomically; it is diffuse and thus difficult to aspirate.

The quality of the results also depends on the capacity of the skin to retract and espouse the newly created shape. Skin is too thick (back rolls and epi-gastric skin), too thin (inner thighs and arms) and stretch-marked skin will have some difficulties in retracting.

 

Liposuction vs Laser Liposuction

Parameter

Liposuction

Laser Lipolysis

Initial Objective 

Removal of fat deposit

Removal of fat deposit

Additional Effect

Depending on the spontaneous ability of the skin to retract: prior satisfactory skin elasticity is mandatory, quality of skin underneath is the decisive factor for the end result Laser thermal action over tissue enhances skin retraction

Principle

Fat cells are sucked out

Destruction of adipocytes leading to a delayed melting fat

Mechanism

Mechanical action by aspiration

Thermal action through laser fiber

Indications

Moderate-to-large fat deposits. Aspirated fat volume can represent 5-10% of the total bodyweight

Moderate fat deposits. Theoretically limited to daily metabolization ability of the body, namely 1800 kcla/day or 300 g of fat

Preferencial treated areas

Deep localized or large amount of fat overload

Superficial or deep localized fat deposits or liposuction failure

Indications limits

Superficial fat deposits: cellulite

Deep fat deposit

Counterindications

Thick skin, too thin skin; primarily lack of elasticity because risk of insufficient secondary skin retraction or secondary skin depressions

Substantially overweight, large areas

Anesthesia method

Depending on the size of the area to be treated: general or local anesthesia

Depending on the size of the area to be treated: general or local anesthesia

Hospitalization

1 Night

Outpatient basis / Sometimes 1 Night stay requires

Procedure

Short incision: 3-4 mm. Tunneling and fat aspiration using a cannula to avoid damage to vessels and nerves

Short incision: 2 mm. Tunneling with a 1 mm cannula containing a thick fiber

Duration of the procedure

Proportional to the amount of aspirated fat and number of area to be treated. From 30 mins to 3 hours

For a similary sized area, laser liposuction takes longer as work on several planes needs to be performed to achieve an homogeneous thermal effect

Post-operative pain

Moderate to severe, mainly depending on the number of treated areas and amount of fat removed

Moderate or no pain

Side effects

Large edemas and ecchymosis. Fading of edema and ecchymosis within 15 days to 1 month. Postoperative tiredness

Moderate edemas and moderate or no ecchymosis. Fading of the edemas within 3-7 days

Return to work

Return to work after 1 week (depending on the amount of fat removed)

Immediate return to work (moderate-sized treated areas)

Post-operative compression

3 weeks to 1 month

15 days

Assessment of results

As soon as the edemas disappeared, between 15 days and 1 month. Improvements seen until the 6th month

Delayed, usually after 3 months. Improvements seen until the 6th month

Complications

The larger the areas treated, the more frequent the complications. Thromboembolism, anemia and metabolic disorders if excessive lipoaspiration and complications due to anesthesia.

Localized burns

Quality of the result

Depending on the ability of the skin to retract spontaneously

Depending on the homogeneity of laser delivery by the operator (localized overheating must be avoided)

 

Topography

Liposuction

Laser Liposuction

Saddlebags (usually elastic skin) 

+++

+ most of the time, large fat deposits

 Hips (love handles) usually elastic skin 

+++

+ most of the time, large fat deposits

Internal side of knees (usually elastic skin) 

+++

+++ most of the time, localized fat deposits

Inner-thighs (usually thin skin, spontaneously fladdy) 

+

+ to +++ if moderate amounts of fat deposit. Combining laser liposuction with liposuction required if there is large amounts of fat deposits with lax skin.

Inner-side thights 

Counterindicated: risk of undulated sheet metal effect

+ to +++ if moderate amounts of fat deposit. Combining laser liposuction with liposuction required if there is large amounts of fat deposits with lax skin.

Lower abdomen: below the navel 

+++ if tonic and young skin. Contraindicated if the skin is not elastic

+ rarely advisable on the its own because of the size of the area. Laser liposuction associated with liposuction in order to improve skin thightening should be considered

Upper abdomen: above the navel 

+ thick skin insufficient secondary skin contraction

+++ if moderate amount of fats. Associate with liposuction if there is large amount of fat deposits with lax skin

Back (rolls of fat) 

+ thick skin insufficient secondary skin contraction

+++ if moderate amount of fats. Associate with liposuction if there is large amount of fat deposits with lax skin

Neck  

+ to +++ dependin g on skin elasticity, result generally unpredictable

++ to +++ improve skin significantly skin contraction

+: Partially effective

++: Effective

+++: Very Effective

 

Patients still can gain weight after undergoing liposuction, but their shape remains more balanced than before the procedure. Its simplicity, quality of results and relatively rare complication rates explain its success and its use of as a tool in combination with other surgical techniques (e.g. abdominoplasty and body lift). Its main limitation is the limited amount of skin retraction after the procedure.

 

Liposuction does not improve skin elasticity, which may explain why new laser lipolysis techniques, whose thermal effect assists in skin retraction, are increasingly looked upon as an attractive alternative.

 

All procedures involved in laser liposuction are performed in an outpatient hospital setting. Sometimes, 1 night hospital can be required. Patients are given pain medication and an anxiolytic pretreatment. Local anesthesia is performed using the wet infiltration technique. After infiltration of tumescent fluid, a small incision of 1-2 mm is made. A 1 mm microcannula is then inserted through the incision into the subcutaneous fat. To achieve optimal lipolysis, enough energy must be cumulatively delivered throughout the different fat layers (superficial, medium and deep) and into the subdermal plane so as to reach the collagenous layer. Further, a homogenous distribution of light energy is required in order to achieve an optimal temperature tissue elevation in the fat layer.

 

After lipolysis, liquefied fat can either be aspirated with a small diameter cannula or massaged out. Aspiration is usually performed in large treated volumes and in locations that are easily accessible.  Massage is performed in small volumes and in areas that are not easily accessible (e.g. knees or arms). After the operation the tape/bandage remains in place for a 1 week and the compression garment should be used for 1 month.

 

Patients are required not to resume physical activities (especially those involving mechanical shocks) for a minimum of 7 days.

 

Laser lipolysis has proven to be less traumatic than conventional liposuction methods. Primary reasons for this are the small diameter (1mm) cannula and the effects of laser tissue interaction. Laser lipoplasty is associated with less pain, the absence of bruising and edema and faster recovery.

 

In sum, laser lipolysis is more suitable for treating small and compact areas. Furthermore, it can also be used to improve localized irregularities following conventional liposuction.

 

The aim of this article is to give you a general information about the surgical intervention in question. You need to make more research about possible complications and risks of this selected procedure in order to make an informed decision. Please note that complications occur more frequently with patients who are obese, smoke, and have a history or lung or other chronic underlying medical conditions.

 

Smokers are recognized to have a significantly higher risk of post operative wound healing problems with a subsequently higher potential of infection as well as operative and post operative bleeding. Patients should discontinue smoking for two weeks before and two weeks after surgery. Although it helps to stop smoking before and after surgery, this does not completely eliminate the increased risks resulting from long­ term smoking. Smoking also has a long term adverse effect on the skin and ageing process.

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