Laser-Assisted Liposuction Leaves Skin Tighter

ORLANDO - Laser-assisted liposuction appears to be safer than power-assisted liposuction, leaving patients with significantly fewer complications and side effects by 3 months.

Patients undergoing the laser-assisted procedure also requested significantly fewer revisions, Dr. Jeffry B. Schafer said at the annual meeting of the American Academy of Cosmetic Surgery.

The laser exerts a dual effect - fat removal and skin tightening - in one procedure, Dr. Schafer said in an interview. "The laser gives you smoothing by melting the fat and tightens the skin by heating the collagen so you get tighter skin, eliminating both lumps and loose skin - the complaints after lipo," he said.

He reported a retrospective study of 214 patients treated with liposuction; half underwent the traditional, power- or suction-assisted liposuction (PAL), and half underwent laser-assisted liposuction (LAL).

During LAL, Dr. Schafer uses a 4-mm Mercedes cannula with a dual wavelength laser (924 nm and 975 nm). He uses both settings at the highest power and makes two lasing passes. "The first pass is to soften and remove the adipose tissue, and the second pass is right beneath the skin, to tighten the collagen," he said. He uses a handheld infrared thermometer to monitor the temperature; it should be at about 35ºC to liquify the fat, and 40ºC to affect the collagen.

The 107 PAL patients were a mean of 40 years old, with a mean body mass index of 27 kg/m2. The 107 LAL patients were not significantly different: their mean age was 38, and their mean BMI was 28 kg/m2.

The mean tumescent anesthesia volume used in the LAL group was 3,756 cc; the mean volume in the PAL group was 4,485 cc. Mean procedure time was slightly longer in the LAL group (57 vs. 46 minutes), because of the additional 27-minute lasing time. Actual suction time in the LAL group was 32 minutes.

Lasing time in the LAL group varied with the wattage system, Dr. Schafer pointed out. "That time is reduced by about 6 minutes if using the 40-watt system compared to the 24-watt system. So the lasing time could be about 21 minutes instead of 27 minutes if using 40 watts."

Side effects were described as an anticipated reaction that resolved without medical intervention, and included hardness, swelling, and abrasions. Overall, side effects were significantly less common in the LAL group at both 1 month (16% vs. 56%) and 3 months (12% vs. 54%). Hardness was the most commonly reported, occurring in 11% of the LAL group and 54% of the PAL group.

Complications were described as anticipated reactions that may not resolve with medical intervention, and included seroma, scar tissue, loose skin, and irregularity in skin surface. At 1 month, the complication rate was similar (4% LAL vs. 3% PAL). By 3 months, the rate was significantly less in the LAL group than in the PAL group (3% vs. 13%). Seroma was more common in the LAL group both at 1 month (3% vs. 1%) and 3 months (2% vs. 0%). At 3 months, scar tissue occurred in 1% of the LAL group and 3% of the PAL group. Also at 3 months, fewer LAL patients reported loose skin (0% vs. 8%).

Revisions were significantly less common in the LAL group (4 vs. 73). "Fewer revisions mean less patient hand-holding in the post treatment period," Dr. Schafer said.

Some samples of the aspirate were sent for stem cell extraction. Under gross observation, the fat extracted with LAL appeared smoother, Dr. Schafer said.

Histology showed intact membranes on the adipocytes; cell membranes in the PAL-extracted samples were ruptured. "Aspirate with LAL is more homogenous with higher fat content than PAL," Dr. Schafer said. "Melting from laser leaves much smoother skin, fewer contour issues, less lipo filling, and a high degree of skin tightening." Maintaining intact adipocytes is also critical if the fat is to be used in a transfer, he added.

Dr. Schafer is in private practice in Coronado, Calif. He disclosed that he helped develop the SlimLipo machine, which he used in the study. He is also a teacher and speaker for Palomar Medical Technologies Inc., the Burlington, Mass., company that developed the system.

ORLANDO - Laser-assisted liposuction appears to be safer than power-assisted liposuction, leaving patients with significantly fewer complications and side effects by 3 months.

Patients undergoing the laser-assisted procedure also requested significantly fewer revisions, Dr. Jeffry B. Schafer said at the annual meeting of the American Academy of Cosmetic Surgery.

The laser exerts a dual effect - fat removal and skin tightening - in one procedure, Dr. Schafer said in an interview. "The laser gives you smoothing by melting the fat and tightens the skin by heating the collagen so you get tighter skin, eliminating both lumps and loose skin - the complaints after lipo," he said.

He reported a retrospective study of 214 patients treated with liposuction; half underwent the traditional, power- or suction-assisted liposuction (PAL), and half underwent laser-assisted liposuction (LAL).

During LAL, Dr. Schafer uses a 4-mm Mercedes cannula with a dual wavelength laser (924 nm and 975 nm). He uses both settings at the highest power and makes two lasing passes. "The first pass is to soften and remove the adipose tissue, and the second pass is right beneath the skin, to tighten the collagen," he said. He uses a handheld infrared thermometer to monitor the temperature; it should be at about 35ºC to liquify the fat, and 40ºC to affect the collagen.

The 107 PAL patients were a mean of 40 years old, with a mean body mass index of 27 kg/m2. The 107 LAL patients were not significantly different: their mean age was 38, and their mean BMI was 28 kg/m2.

The mean tumescent anesthesia volume used in the LAL group was 3,756 cc; the mean volume in the PAL group was 4,485 cc. Mean procedure time was slightly longer in the LAL group (57 vs. 46 minutes), because of the additional 27-minute lasing time. Actual suction time in the LAL group was 32 minutes.

Lasing time in the LAL group varied with the wattage system, Dr. Schafer pointed out. "That time is reduced by about 6 minutes if using the 40-watt system compared to the 24-watt system. So the lasing time could be about 21 minutes instead of 27 minutes if using 40 watts."

Side effects were described as an anticipated reaction that resolved without medical intervention, and included hardness, swelling, and abrasions. Overall, side effects were significantly less common in the LAL group at both 1 month (16% vs. 56%) and 3 months (12% vs. 54%). Hardness was the most commonly reported, occurring in 11% of the LAL group and 54% of the PAL group.

Complications were described as anticipated reactions that may not resolve with medical intervention, and included seroma, scar tissue, loose skin, and irregularity in skin surface. At 1 month, the complication rate was similar (4% LAL vs. 3% PAL). By 3 months, the rate was significantly less in the LAL group than in the PAL group (3% vs. 13%). Seroma was more common in the LAL group both at 1 month (3% vs. 1%) and 3 months (2% vs. 0%). At 3 months, scar tissue occurred in 1% of the LAL group and 3% of the PAL group. Also at 3 months, fewer LAL patients reported loose skin (0% vs. 8%).

Revisions were significantly less common in the LAL group (4 vs. 73). "Fewer revisions mean less patient hand-holding in the post treatment period," Dr. Schafer said.

Some samples of the aspirate were sent for stem cell extraction. Under gross observation, the fat extracted with LAL appeared smoother, Dr. Schafer said.

Histology showed intact membranes on the adipocytes; cell membranes in the PAL-extracted samples were ruptured. "Aspirate with LAL is more homogenous with higher fat content than PAL," Dr. Schafer said. "Melting from laser leaves much smoother skin, fewer contour issues, less lipo filling, and a high degree of skin tightening." Maintaining intact adipocytes is also critical if the fat is to be used in a transfer, he added.

Dr. Schafer is in private practice in Coronado, Calif. He disclosed that he helped develop the SlimLipo machine, which he used in the study. He is also a teacher and speaker for Palomar Medical Technologies Inc., the Burlington, Mass., company that developed the system.

ORLANDO - Laser-assisted liposuction appears to be safer than power-assisted liposuction, leaving patients with significantly fewer complications and side effects by 3 months.

Patients undergoing the laser-assisted procedure also requested significantly fewer revisions, Dr. Jeffry B. Schafer said at the annual meeting of the American Academy of Cosmetic Surgery.

The laser exerts a dual effect - fat removal and skin tightening - in one procedure, Dr. Schafer said in an interview. "The laser gives you smoothing by melting the fat and tightens the skin by heating the collagen so you get tighter skin, eliminating both lumps and loose skin - the complaints after lipo," he said.

He reported a retrospective study of 214 patients treated with liposuction; half underwent the traditional, power- or suction-assisted liposuction (PAL), and half underwent laser-assisted liposuction (LAL).

During LAL, Dr. Schafer uses a 4-mm Mercedes cannula with a dual wavelength laser (924 nm and 975 nm). He uses both settings at the highest power and makes two lasing passes. "The first pass is to soften and remove the adipose tissue, and the second pass is right beneath the skin, to tighten the collagen," he said. He uses a handheld infrared thermometer to monitor the temperature; it should be at about 35ºC to liquify the fat, and 40ºC to affect the collagen.

The 107 PAL patients were a mean of 40 years old, with a mean body mass index of 27 kg/m2. The 107 LAL patients were not significantly different: their mean age was 38, and their mean BMI was 28 kg/m2.

The mean tumescent anesthesia volume used in the LAL group was 3,756 cc; the mean volume in the PAL group was 4,485 cc. Mean procedure time was slightly longer in the LAL group (57 vs. 46 minutes), because of the additional 27-minute lasing time. Actual suction time in the LAL group was 32 minutes.

Lasing time in the LAL group varied with the wattage system, Dr. Schafer pointed out. "That time is reduced by about 6 minutes if using the 40-watt system compared to the 24-watt system. So the lasing time could be about 21 minutes instead of 27 minutes if using 40 watts."

Side effects were described as an anticipated reaction that resolved without medical intervention, and included hardness, swelling, and abrasions. Overall, side effects were significantly less common in the LAL group at both 1 month (16% vs. 56%) and 3 months (12% vs. 54%). Hardness was the most commonly reported, occurring in 11% of the LAL group and 54% of the PAL group.

Complications were described as anticipated reactions that may not resolve with medical intervention, and included seroma, scar tissue, loose skin, and irregularity in skin surface. At 1 month, the complication rate was similar (4% LAL vs. 3% PAL). By 3 months, the rate was significantly less in the LAL group than in the PAL group (3% vs. 13%). Seroma was more common in the LAL group both at 1 month (3% vs. 1%) and 3 months (2% vs. 0%). At 3 months, scar tissue occurred in 1% of the LAL group and 3% of the PAL group. Also at 3 months, fewer LAL patients reported loose skin (0% vs. 8%).

Revisions were significantly less common in the LAL group (4 vs. 73). "Fewer revisions mean less patient hand-holding in the post treatment period," Dr. Schafer said.

Some samples of the aspirate were sent for stem cell extraction. Under gross observation, the fat extracted with LAL appeared smoother, Dr. Schafer said.

Histology showed intact membranes on the adipocytes; cell membranes in the PAL-extracted samples were ruptured. "Aspirate with LAL is more homogenous with higher fat content than PAL," Dr. Schafer said. "Melting from laser leaves much smoother skin, fewer contour issues, less lipo filling, and a high degree of skin tightening." Maintaining intact adipocytes is also critical if the fat is to be used in a transfer, he added.

Dr. Schafer is in private practice in Coronado, Calif. He disclosed that he helped develop the SlimLipo machine, which he used in the study. He is also a teacher and speaker for Palomar Medical Technologies Inc., the Burlington, Mass., company that developed the system.