9804-1090 Rohrich
Rohrich RJ, Beran SJ, Kenkel JM, Adams WP Jr, DiSpaltro F.
Extending the role of liposuction in body contouring with ultrasound-assisted
liposuction.
Plast Reconstr Surg. 1998 Apr;101(4):1090-102; discussion 1117-9. PMID: 9514347
Department of Plastic and Reconstructive Surgery at the University of Texas
Southwestern Medical Center, Dallas 75235-9132, USA.
The initial experience with ultrasound-assisted liposuction in treating
difficult fibrous areas, such as gynecomastia, hitherto not uniformly responsive
to traditional suction-assisted lipoplasty, has led to the evolution and
improvement of ultrasound-assisted liposuction techniques. This prospective
study examined 114 consecutive patients treated with ultrasound-assisted
liposuction over a 13-month period, from September of 1996 to September of 1997.
The means by which this procedure helps achieve fat contouring differs from that
of suction-assisted lipoplasty. Ultrasound-assisted liposuction removes fat
through a fat emulsification process termed "cavitation," whereas
suction-assisted lipoplasty achieves contouring through the mechanical avulsion
of fat. The technique for the use of ultrasound-assisted liposuction has changed
significantly from our initial series of patients to our current technique. To
optimize the benefits of both ultrasound-assisted and traditional
suction-assisted lipoplasty, we use a three-stage technique consisting of
infiltration, ultrasound-assisted sculpturing, and suction-assisted lipoplasty
for evacuation and final contouring. This has decreased our operative time,
minimized complications, and optimized our body contouring results. Data were
collected intraoperatively, including treatment times, treatment volumes, and
treatment areas for both suction-assisted and ultrasound-assisted lipoplasty. A
total of 114 patients were treated with ultrasound-assisted liposuction between
September of 1996 and September of 1997. There were 23 male patients and 91
female patients. In general, the average total volume removed with this
procedure decreased by about 50 percent throughout the series, whereas the
suction-assisted lipoplasty volume increased correspondingly by 50 percent.
Overall, suction-assisted lipoplasty volume was approximately two times
ultrasound-assisted liposuction volume in the same area. Exceptions to this
include the dense fibrous areas such as the back and male breast, where
aspiration volumes were approximately equal. The total ultrasound-assisted
liposuction treatment times were reduced after our initial 30 patients, and
suction-assisted lipoplasty times increased. Total aspiration rates in our later
patients averaged 36.2 cc/per minute for ultrasound-assisted and 58.4 cc/per
minute for suction-assisted lipoplasty, whose rates were approximately 1.5 to 2
times faster than for ultrasound-assisted liposuction in most areas. After using
this technology in our initial series of 30 patients, it became apparent that
ultrasound was not a substitute for suction-assisted lipoplasty but rather a
natural complement. We have found that the marriage of the techniques enhances
results and minimizes complications, such as seromas, which have been reported
to be 11.4 percent with ultrasound-assisted liposuction alone and are 2.6
percent in our series.
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