Laser Assisted Liposuction - E

Kongres Założycielski
Polskiego Towarzystwa Ginekologii Estetycznej i Rekonstrukcyjnej
Warszawa, Hotel Hilton 26/27.06.2015r
Współczesne metody
usuwania tkanki tłuszczowej
Paweł Surowiak
PTMEiAA Warszawa
DermaMed Wrocław
Uniwersytet Medyczny we Wrocławiu
Metody klasyczne
Metody współczesne
1. Nieinwazyjne zabiegi z użyciem różnych
źródeł energii
2. Lipoliza iniekcyjna
3. Liposukcja
- Klasyczna i odmiany
- Laserowa
- Ultradźwiękowa
1. Nieinwazyjne zabiegi z użyciem różnych źródeł
energii
- Kriolipoliza
1. Nieinwazyjne zabiegi z użyciem różnych źródeł
energii
- Kriolipoliza
1. Nieinwazyjne zabiegi z użyciem różnych źródeł
energii
- Ultradźwięki – efekt kawitacji
- Ultradźwięki - HiFu
1. Nieinwazyjne zabiegi z użyciem różnych źródeł
energii
- Radiofrekwencja (Fale radiowe)
2. Lipoliza iniekcyja
• Fosfatydylocholina + deoksycholat (PC + DC))
• Opisano setki tysięcy pacjentów
• Bardzo wysoki profil bezpieczeństwa
Dzień 0
4 tygodnie
8 tygodni
10 tygodni
Wskazania
Usuwanie zlokalizowanych otłuszczeń
+s
+ Sculptra
+ kwas
hialuronowy
+ VelaShape
03.09.2010
2 dni !!!
3. Liposukcja
- Klasyczna
•Tumescent Technique
•Dry Technique
•Wet Technique - The wet
technique required the injection of
approximately 100 milliliters of local anesthesia containing epinephrine.
•Super Wet Technique - The super wet technique requires
the injection of a volume of dilute local anesthesia that is less than half the volume used
for the tumescent technique.
3. Liposukcja
- Wspomagana – laserowa,
ultradźwiękowa etc
•Ultrasonic (UAL)
- Ultrasonic Assisted Liposuction (UAL) requires
the use of a large volume of tumescent fluid and uses either a metal probe or metal
paddle to deliver ultrasonic energy and heat into subcutaneous fat.
•Vaser Liposuction
- Vaser liposuction, also called LipoSelection,
is another alternate technology to traditional liposuction. Vaser ultrasonic liposuction is
still a process by which fatty deposits are removed from beneath the skin to improve the
aesthetics of a particular body part.
•Power Assisted Techniques (PAL)
- PAL
devices use power supplied by an electric motor or compressed air to produce either a
rapid in-and-out movement or a spinning rotation of an attached liposuction cannula.
•Laser Liposuction,
Liposuction (LAL), -
Laser
Assisted
Laser Liposuction requires the use of
tumescent fluid and uses a microcannula inserted through a small incision to deliver
laser energy and heat into subcutanteous fat.
•Water Assisted Liposuction
- Water jet assisted
liposuction is another method of liposuction being used by cosmetic surgeons today.
Water jet assisted liposuction actually uses a slightly pressurized stream of saline to
dislodge fat and simultaneously remove the cells. Instead of destroying fat cells, this
type of liposuction loosens the fat cells to facilitate more gentle removal.
The most commonly utilized lasers:
• 1,064 nm, 1,320 nm, 1,440 nm,
2,010 nm, 980 nm, 924 nm,
and the 975 nm
• the three major lasers evaluated for LAL
are the 1,064 nm Nd:YAG, the 980 nm
diode, and the 1,064/1,320 nm Nd:YAG
lasers
Lipo Laser
Lasery a tkanka tłuszczowa
Krzywa absorpcji tk. tłuszczowej
The American Society for Aesthetic Plastic Surgery (ASAPS) Survey:
Current Trends in Liposuction
Jamil Ahmad , Felmont F. Eaves III, Rod J. Rohrich , Jeffrey M.
Kenkel
Burns and contour irregularities on the arms after laser-assisted
liposuction treatment.
Liposukcja VASER
Druga generacja UAL
Plast Reconstr Surg. 2012 Apr;129(4):681e-9e. doi:
10.1097/PRS.0b013e3182442274.
A multicenter, prospective, randomized, single-blind, controlled clinical trial
comparing VASER-assisted Lipoplasty and suction-assisted Lipoplasty.
Nagy MW1, Vanek PF Jr.
Abstract
BACKGROUND:
No scientific comparative study has demonstrated any statistically significant clinical improvement attributable to a new lipoplasty technology relative to traditional suction-assisted lipoplasty.
This prospective study used a contralateral study design to evaluate postoperative differences between vibration amplification of sound energy at resonance (VASER)-assisted lipoplasty and
suction-assisted lipoplasty.
METHODS:
Twenty female patients between the ages of 20 and 48 years received contralateral
treatment with suction-assisted lipoplasty andVASER-assisted lipoplasty in one or
more anatomical regions for a total of 33 regions. Patients received suction-assisted
lipoplasty on one side of the body and VASER-assisted lipoplasty on the
contralateral side. Patients were blinded to technology application. Aspirate was
analyzed for blood content, and skin retraction was analyzed by measuring changes
in ultraviolet light tattoos.
RESULTS:
Regarding skin retraction, the VASER-assisted lipoplasty-treated side resulted in a statistically significant improvement in skin retraction of 53 percent relative to suction-assisted lipoplasty
(17 percent per liter versus 11 percent per liter, p = 0.003) with 33 paired sites using a two-tailed t test. Regarding blood loss, VASER-assisted lipoplasty treatment resulted in a statistically
significant reduction in blood loss of 26 percent (11.2 versus 14.0 cc blood/100 cc) relative to the suction-assisted lipoplasty side (p = 0.019 with n = 20 using a two-tailed t test). Subjective
measures (i.e., pain, swelling, appearance, and patient and physician preference) showed no statistical difference between the two methods at the 6-month evaluation.
CONCLUSIONS:
The VASER-assisted lipoplasty method demonstrated improved skin retraction and
reduction in blood loss compared with suction-assisted lipoplasty. This is the first
study to demonstrate statistically significant and clinically relevant improvements in a
new lipoplasty technology relative to suction-assisted lipoplasty.
RF-assisted
liposuction
As surgeons and scientists continued to explore combining surgical suction of subcutaneous
adipose with technology to tighten skin/provide soft tissue contraction, increased interest has
grown in utilizing RF as an adjunct to SAL. RF energy is high frequency oscillating electrical
current (one million cycles per second) applied to the tissue to create a thermal effect. RFassisted liposuction (RFAL) is responsible for dissolving fat cells, which leads to the creation of
small channels in the fatty tissue. Furthermore, RFAL causes dermal physiologic responses
including immediate contraction of the collagen fibers, subdermal remodeling, and neocollagen
formation.59–61
Nonexcisional Tissue TighteningCreating Skin Surface Area Reduction During Abdominal Liposuction by Adding Radiofrequency Heating
Diane Irvine Duncan
DOI: http://dx.doi.org/10.1177/1090820X13505862 1154-1166 First published online: 1 November 2013
The American Society for Aesthetic Plastic Surgery (ASAPS) Survey:
Current Trends in Liposuction
Jamil Ahmad , Felmont F. Eaves III, Rod J. Rohrich , Jeffrey M.
Kenkel
Percentage of respondents who currently or have previously performed the various methods of fat
removal. SAL, suction-assisted liposuction; UAL, ultrasound-assisted liposuction; PAL, power-assisted
liposuction; LAL, laser-assisted liposuction.
The American Society for Aesthetic Plastic Surgery (ASAPS) Survey:
Current Trends in Liposuction
Jamil Ahmad , Felmont F. Eaves III, Rod J. Rohrich , Jeffrey M.
Kenkel
Specialty of physicians/practitioners associated with a fat removal
procedure resulting in complications.
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