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Aesthetic Dermatology Liposuction
The Selective Laser-induced Melting Procedure –
Advanced Laser Body Sculpting
Robert A Weiss
President, American Society for Dermatologic Surgery (ASDS), and Associate Professor of Dermatology, Johns Hopkins University School of Medicine
Abstract
Background and objectives: The potential benefits of laser-assisted liposuction include enhanced body shaping and skin tightening with
reduced patient downtime. In this clinical study, we investigated whether additional safety and efficacy are achieved with a diode laser
system that includes a novel 924nm highly lipid-selective wavelength. Study design/materials and methods: Clinical subjects were treated
with a continuous-wave (CW) power 924/975nm diode laser system in the submental area, abdomen, thighs and flanks. Side effects were
documented. The efficacy evaluation included investigator-assessed improvements and subject self-assessments. Results: Study
investigators observed good to excellent improvement across all subjects by three months post-treatment in the four categories evaluated.
‘Good’ to ‘excellent’ skin textural improvement was observed in the vast majority. At two weeks post-treatment, 83% of subjects felt their
skin was smoother and 67% felt their skin was tighter; by three months post-treatment these numbers had increased to 100%. One of the
best indicators of a successful cosmetic procedure is whether patients would recommend the procedure to family and friends. When asked
this question at the six-week follow-up visit, 100% of patients indicated they would recommend this procedure and would choose it again
for themselves. Patients were extremely satisfied with the procedure and all of them reported that the appearance of unwanted fat was
significantly improved in the treatment area. Another positive outcome was that all treated patients felt their skin looked smoother at six
months post-treatment – an end-point that is more difficult to achieve with plain or traditional liposuction alone. Conclusion: These clinical
findings demonstrate that the 924/975nm diode laser system provides safe and efficacious body shaping, fat reduction and enhanced skin
tightening. Ease of movement through the tissue of both the laser system treatment tip and the aspiration cannula resulted in reduced
fatigue for the treating physician. Patient benefits included high patient satisfaction, significant reductions in fat and smoother and tighter
skin with minimal downtime.
Keywords
Diode lasers, laser-assisted liposuction, lipolysis, skin tightening, fat reduction, body sculpting, body contouring
Disclosure: The author receives a discount on equipment and a research grant from Palomar Medical.
Received: 6 January 2009 Accepted: 21 January 2009
rweiss@mdlsv.com
History of Liposuction regional anaesthesia and to vasoconstrict and compress capillaries to
Liposuction has come a long way since Charles Dujarrier’s failed attempt reduce intra-operative blood loss, reduce post-operative pain and
in 1921 to sculpt the lower legs of a well-known ballerina.
1
Modern-day reduce post-operative bleeding and bruising.
4,5
This breakthrough was
suction-assisted liposuction (SAL) was developed by two Italian immediately embraced by dermatological practitioners and many other
cosmetic surgeons, father and son Arpad and Giorgio Fischer, in 1975.
1
surgeons as it allowed them to safely perform liposuction in an office
They used a blunt-ended, hollow cannula to cut and suction adipose setting.
2
In direct contrast to the risks of a liposuction procedure
tissue through a series of criss-cross tunnelling movements.
1
In 1984, performed under general anaesthesia, there has never been a death
the French plastic surgeon Yves-Gerard Illouz modified the blunt with tumescent anaesthesia-guided liposuction.
cannula and introduced the so-called ‘wet technique’ to reduce
bleeding and facilitate suctioning. This technique involved the injection Alternatives to Conventional Liposuction
of hypotonic saline and hyaluronidase into adipose tissue to facilitate fat Ultrasound-assisted Liposuction
removal and reduce trauma.
2,3
Pierre Fournier, another French surgeon, Following the innovative modification introduced by Dr Klein,
demonstrated an early interest in liposuction, and developed the ‘dry practitioners of liposuction have tried to modify the technique to
technique’. While this method of liposuction was not universally alleviate drawbacks including the amount of operator effort required,
accepted, he is credited with refining the Fischers’ criss-cross technique blood loss, patient discomfort and patient downtime. In 1992, Michele
and travelled the world to teach liposuction to other surgeons of Zocchi introduced internal ultrasound (iUAL), a sequential procedure
different specialities.
2
In 1985, dermatologist Jeffrey Klein revolutionised consisting of an internal cannula to fragment adipose tissue followed
the field by introducing ‘tumescent anaesthesia’, a technique to avoid by suction.
6
In 1998, Barry Silberg launched external ultrasound (XUAL),
general anaesthesia. Tumescent anaesthesia consists of injecting large which externally delivers ultrasonic waves through a paddle or pads
volumes of very dilute amounts of lidocaine and epinephrine to provide and is also followed by suction.
7
Although fibrous areas such as the
54 © TOUCH BRIEFINGS 2009
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