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 considerable attention in the United States, and some controversy has arisen surrounding its introduction into this country. Ultrasound-assisted lipoplasty is performed using the tumescent technique. Ultrasonic energy is applied to adipose tissue in the subcutaneous plane via a solid or hollow titanium probe, which effectively "liquefies" the fat by cellular fragmentation. The liquefied fat, along with the infused tumescent fluid, forms a stable fatty emulsion that can be either simultaneously or subsequently extracted from the subcutaneous space by means of low-vacuum suction and small suction cannulas. We have used this technique for over 2 years and have accumulated data on over 250 consecutive 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 approximately 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 was 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 considerable experience with this technique, we have found extremely high patient and surgeon satisfaction. We confirm that large volumes of fat can be effectively removed with minimal blood loss, little or no bruising, and exceptional control of contour. Difficult fibrous areas such 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 effective, and although a learning curve exists, we feel that ultrasound-assisted lipoplasty will establish itself as the preferred method of suction-assisted lipoplasty in many clinical situations.