A report medical fibers lipolysis

Keywords:lipolysis, medical, fibers, laser, surgical,  Time:12-01-2016

Medical fibers Liposuction is the most common cosmetic surgical procedure performed in North America, with over 400 000 operations performed in 2006 (1). When traditional liposuction is performed under general anesthesia, major systemic complications have been reported, including death. This has generated significant concern in the medical and lay community about the safety of this popular procedure. Liposuction, when performed under local tumescent anesthesia, has been associated with few systemic side effects and no deaths. Laser-assisted lipolysis (LAL) is an emerging minimally invasive technology whereby a laser fiber is inserted under the skin to melt fat and has been reported to tighten skin as well. Since January 2006, this center has performed over 500 LAL cases with a pulsed Nd:YAG 1064nm laser system (Smartlipo; manufactured by Deka,The purpose of this study was to determine whether LAL is associated with an increase in the rate of adverse events as well as necessary touch-up procedures.

Methods

In this study, 537 consecutive LAL cases performed with tumescent local anesthesia between January 2006 and November 2007 by a dermasurgeon and a plastic surgeon were analyzed retrospectively using chart review. A total of 466 female and 71 male patients comprised the study group. The age ranged from 17 to 77 years. Charts were reviewed for complications associated with tumescent local anesthesia that had been previously reported in the literature and were divided into local and systemic complications.

Local complications that were reviewed included skin or subcutaneous infection, permanent skin irregularity (dimpling, retraction), seroma, allergic contact dermatitis to tape, skin ulceration or necrosis, permanent sensory nerve damage, unacceptable scars, and persistent postoperative edema. The systemic complications that were reviewed included allergic reaction to oral or intramuscular medication, fevers, systemic infection, arrhythmias, anemia, fluid or blood loss requiring a transfusion, pulmonary emboli, fat emboli, shock, bowel or thoracic perforation, seizures, thrombophlebitis and death. Preoperatively, patients received intramuscular meperidine, hydroxyzine and midazolam as well as oral clonidine. These are administered to enhance patient comfort. All cases were performed using the tumescent technique. The tumescent anesthesia consisted of 1 l of normal saline, 1 ml of 1:1000 epinephrine, 50–75 cc of 1% lidocaine and 12.5 cc of 8.4% sodium bicarbonate. In no cases did the amount of tumescent anesthesia administered exceed 55 mg/kg. The laser used was a pulsed 1064-nm Nd:YAG system with a pulse width of 150 ms and a repetition rate of 40 Hz. The power output ranged from 6 W to 10 W. The medical fibers laser was directed subcutaneously in a criss-cross pattern until the endpoint of subcutaneous tissue softening and reduction by palpation was reached. The laser treatment was followed by suction aspiration to remove liquefied adipose tissue.

Results

A total of 537 patients underwent LAL. There were five complications including one skin infection and four skin burns, yielding a complication rate of 0.93%. All of the burns were successfully treated with topical emollients or antibacterial ointments and the infection resolved without sequela. No systemic complications occurred. Touch-ups were required 19 times out of the total 537 patients: a rate of 3.5%.