ULTRASOUND-ASSISTED LIPOPLASTY - A CLINICAL-STUDY OF 250 CONSECUTIVE PATIENTS

Ultrasound-assisted lipoplasty has been practiced in Europe and South America for almost a decade. This technique has recently attracted con siderable attention in the United States, and some controversy has ari sen surrounding its introduction into this country. Ultrasound-assiste d lipoplasty is performed using the tumescent technique. Ultrasonic en ergy is applied to adipose tissue in the subcutaneous plane via a soli d or hollow titanium probe, which effectively ''liquefies'' the fat by cellular fragmentation. The liquefied fat, along with the infused tum escent fluid, forms a stable fatty emulsion that can be either simulta neously or subsequently extracted from the subcutaneous space by means of low-vacuum suction and small suction cannulas. We have used this t echnique for over 2 years and have accumulated data on over 250 consec utive patients. Patient age ranged from 10 to 75 years. Total volume ( fluid and fat) removed ranged from 100 to 16,835 cc. The average ratio of tumescent fluid infused to total fluid volume removed was approxim ately 1:1 and the average amount of fat within the total fluid volume was 63 percent. The most common areas treated were the posterior hips, abdomen, and lateral thighs. Intraoperative subcutaneous temperatures were recorded in 55 patients and have shown no dangerous elevation of temperature in the subcutaneous space. The most common complication w as skin blistering from Reston foam applied to the skin as part of the postoperative dressing (unrelated to the use of ultrasound). Only one patient has required minor revision for contour irregularity. After c onsiderable experience with this technique, we have found extremely hi gh patient and surgeon satisfaction. We confirm that large volumes of fat can be effectively removed with minimal blood loss, little or no b ruising, and exceptional control of contour. Difficult fibrous areas s uch as the male breast and the back are especially well treated. This outcome can all be accomplished with considerably less physical effort by the surgeon, allowing more energy for performance of precise body contouring. We have documented this procedure to be both safe and effe ctive, and although a learning curve exists, we feel that ultrasound-a ssisted lipoplasty will establish itself as the preferred method of su ction-assisted lipoplasty in many clinical situations.