9808-534 Ablaza
Ablaza VJ, Gingrass MK, Perry LC, Fisher J, Maxwell GP.
Tissue temperatures during ultrasound-assisted lipoplasty.
Plast Reconstr Surg. 1998 Aug;102(2):534-42. PMID: 9703095
Institute for Aesthetic and Reconstructive Surgery, Baptist Hospital, Nashville,
Tenn, USA.
Removing excess subcutaneous fat with the assistance of ultrasonic energy has
recently become a technique of interest in the United States after nearly a
decade of use in Europe. There are a number of reported advantages of
ultrasound-assisted lipoplasty over traditional liposuction, and there are also
some theoretical concerns. Ultrasound-assisted lipoplasty involves the
conversion of electrical energy to mechanical energy and transfer to the tissues
through acoustic pressure waves, with the formation of heat as a by-product.
Heat generated in this process dissipates through the body's own cooling
mechanisms and conduction to the surrounding tissues, and it does not contribute
to the clinical treatment of the adipose tissue. Reports of "burns" and ischemic
skin injuries in the literature, and concerns for potential heat-related
problems, prompted us to investigate whether significant temperature elevations
occur in the clinical setting. Subcutaneous tissue temperature determinations
during ultrasound-assisted lipoplasty were begun in February of 1996, and data
were collected from 55 patients who had the procedure performed during a 6-month
period. Intraoperatively, temperature measurements were made with a data-logging
instrument and a needle microprobe inserted into the subcutaneous tissues.
Temperatures were taken in the area of liposuction before the infusion of
tumescent fluid, after tumescent fluid infusion, and at 5-minute intervals until
the end of the procedure. The patient's core body temperature remained stable
during the procedure within a narrow range (35.7 degrees C to 36.3 degrees C).
There was a gradual increase in the temperature of the subcutaneous tissues over
time during the application of ultrasonic energy; however, average subcutaneous
temperatures remained below the core temperature (p < 0.05) at all time
intervals. Room-temperature tumescent fluid further enhanced the thermal safety
zone without lowering core body temperature. There were no temperature related
complications in our study population and no untoward effects of performing
temperature measurements. We conclude that there is no clinically significant
elevation of subcutaneous temperatures during ultrasound-assisted lipoplasty.
Reported ischemic skin complications are more likely the result of injury to the
subdermal plexus rather than a temperature-induced thermal injury. Although heat
is a natural by-product of the energy transfer involved in ultrasound-assisted
lipoplasty, the risk of thermal injury is negligible when the procedure is
performed by experienced operators. Complete understanding of the technique
along with strict adherence to basic principles of flap vascularity will ensure
safe and effective performance of ultrasound-assisted lipoplasty.
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