Laser-Assisted Liposuction in Body Contouring

Abstract

Laser liposuction was initially developed as a technique for laser lipolysis. In 1992, Apfelberg was the first to describe the direct action of laser in the adipose tissue. Initially, the technique was developed only for lipolysis of unwanted fat in a small region without suction of dissolved fat. Later, it evolved as laser-assisted liposuction, which is a technique that combines adipocyte disruption with laser beam and suction of the dissolved fat from the treated area with different types of cannulas. The neodymiumdoped yttrium aluminum garnet (Nd:YAG) 1064 nm has been introduced as first laser for lipolysis. Blugerman, Schavelzon, and Goldman introduced the concept of the pulsed 1064-nm Nd:YAG system for laser lipolysis. They proved the effect of the laser energy on fatty tissue as well as the on surrounding tissues (dermis, vasculature, apocrine, and eccrine gland). After tissue damage with photo-optical thermal energy, the following histological changes have been noted: (1) adipocyte cells have been disrupted, (2) blood vessels have been coagulated, (3) new collagen has been induced. All those histological changes induce better clinical outcome such as less ecchymosis, less bleeding, smoother, and firmer skin as result of new collagen formation followed by skin retraction. Laser liposuction was developed as a minimally invasive liposuction technique, where energy breaks adipocytes (comparing with traditional liposuction, in which disruption is manual). Wave length of 1064 nm has hemoglobin as a target for its photo-optical energy, and new wave length of 1470 nm has water molecules (H 2 O) as a target. Infiltration of the Klein's solution helps laser to dissolving of fatty tissue faster and more energy to accumulate, followed by new collagen formation. Laser-assisted liposuction in all types of lipodystrophies and cellulite can be successfully applied. High definition of the body is a result of the energy as well as the technique of liposuction. Laser liposuction can be applied on the face for fat removal and as a part of face lifting or better to say endolight lifting. Today, we have lot of companies that have developed different liposuction lasers (Nd:YAG; diode) with different wave lengths.

Multifrequency Laser-Assisted Lipolysis in a Patient with Excessive Redundant Skin Post Roux-en-Y Gastric Bypass: A Clinical Case and Literature Review

“…Since its Food and Drug Administration (FDA) approval in 2006, there has been an explosive development of medical lasers with different wavelengths (924, 968, 980, 1 064, 1 319, 1 320, 1 344, and 1 440 nm) that have eventually been employed for lipolysis and skin tightening (35)(36)(37)(38)(39) and mostly studies have supported the initial clinical observations in adiposity reduction, shorter recovery times, and improved skin retraction (40)(41)(42)(43). In this regard, the Lipolaser LPL9002™ device employed in this clinical case has the advantage of three lowpower cold lasers at wavelengths of 532, 650, and 980 nanometers, with no need for external cooling during the surgery, thus reducing the burn Panel 2.…”

Centralizing the Umbilicus in an Abdominoplasty: Eccentric Versus Concentric Fascial Plication in Addition to Medializing at the Skin

“…Knowledge of abdominal wall anatomy is key in any abdominoplasty and positioning of the umbilicus. 6 The umbilicus is a cicatricial scar on the abdomen composed of skin overlying a fibrous layer demarcating the conjoining of the ligamentum teres, median umbilical ligament, and two medial umbilical ligaments; transversalis fascia; umbilical fascia about the urachal remnant; and the peritoneum. It is located just below the midpoint of the linea alba and anchored into position by the aforementioned deeper structures.…”

“…To address the umbilicus properly, the practitioner must understand that it is both a superficial skin structure and tethered to fascia. 5,6 Multiple authors have described midline placement of the umbilicus, but they only addressed the skin component of the umbilicus, which increases likelihood of umbilical displacement and reversion as the skin begins to stretch with time. 7…”

Enhanced Abdominal Contouring

“…The three main lasers utilized for LAL are the 1064 nm Nd:YAG, the 980 nm diode, and the 1064/1320 nm Nd:YAG lasers [27]. The most studied wavelength is 1064 nm Nd:YAG which has hemoglobin as its target [28]. Both SmartLipo™ (Cynosure Inc., Westford, MA, USA) and ProLipo PLUS™ (Sciton, Inc., Palo Alto, CA, USA) utilize 1064 nm wavelengths.…”