Chapters authored
Laser-Assisted Liposuction in Body Contouring
Laser liposuction was initially developed as a technique for laser lipolysis. In 1992, Apfelberg was the first to describe the direct action of laser in the adipose tissue. Initially, the technique was developed only for lipolysis of unwanted fat in a small region without suction of dissolved fat. Later, it evolved as laser-assisted liposuction, which is a technique that combines adipocyte disruption with laser beam and suction of the dissolved fat from the treated area with different types of cannulas. The neodymium-doped yttrium aluminum garnet (Nd:YAG) 1064 nm has been introduced as first laser for lipolysis. Blugerman, Schavelzon, and Goldman introduced the concept of the pulsed 1064-nm Nd:YAG system for laser lipolysis. They proved the effect of the laser energy on fatty tissue as well as the on surrounding tissues (dermis, vasculature, apocrine, and eccrine gland). After tissue damage with photo-optical thermal energy, the following histological changes have been noted: (1) adipocyte cells have been disrupted, (2) blood vessels have been coagulated, (3) new collagen has been induced. All those histological changes induce better clinical outcome such as less ecchymosis, less bleeding, smoother, and firmer skin as result of new collagen formation followed by skin retraction. Laser liposuction was developed as a minimally invasive liposuction technique, where energy breaks adipocytes (comparing with traditional liposuction, in which disruption is manual). Wave length of 1064 nm has hemoglobin as a target for its photo-optical energy, and new wave length of 1470 nm has water molecules (H2O) as a target. Infiltration of the Klein’s solution helps laser to dissolving of fatty tissue faster and more energy to accumulate, followed by new collagen formation. Laser-assisted liposuction in all types of lipodystrophies and cellulite can be successfully applied. High definition of the body is a result of the energy as well as the technique of liposuction. Laser liposuction can be applied on the face for fat removal and as a part of face lifting or better to say endolight lifting. Today, we have lot of companies that have developed different liposuction lasers (Nd:YAG; diode) with different wave lengths.
Part of the book: Body Contouring and Sculpting
Laser-Assisted Liposuction in Face and Body Contouring
Laser liposuction was developed as minimally invasive liposuction technique where energy breaks adipocytes (comparing with traditional liposuction where disruption is manual). After its implementation in the early 1990s, various academic reports were published that showed superiority of the laser assisted liposuction over standard tumescent technique. After tissue damage with photo-optical thermal energy, histological changes result in adipocyte disruption, blood vessel coagulation and neocollagenesis. The clinical manifestation of the latter is significant skin tightening and faster and more comfortable recovery. The diameter of the laser fiber is very small. Therefore, it is possible to reach adipose tissue entrapped in fibrotic areas and also superficially under the skin. The lysis of the given adipose tissue enables the subsequent suction with microcannulas. That explains the widespread use of the laser-assisted liposuction in the face and neck. Due to the significant skin tightening, the procedure can be done solely for rejuvenation purposes and is called endolight lifting. The possibility to reach fat in the fibrotic areas makes laser-assisted lipolysis/liposuction ideal procedure for contouring irregularities from previous body contouring procedures.
Part of the book: Enhanced Liposuction