External Ultrasound-assisted Lipoplasty

Abstract Background: The role of internal ultrasound in liposuction has been debated for approximately 15 years since the preliminary work by Zocchi and colleagues. Objections to the use of internal ultrasound include the added cost, the risk of injury to dermal or nerve elements, the increased incidence of seromas, the increase in operating room time and personnel required by the new technology, and uncertainty regarding ultrasound-assisted lipoplasty (UAL) application times. Anecdotal reports of skin slough, especially when UAL was used in conjunction with abdominoplasty, have caused the introduction of external UAL (XUAL) to be greeted with caution and concern. Objective: At the request of the Innovative Procedures Committee of the American Society for Aesthetic Plastic Surgery, I undertook a study of the effectiveness of XUAL on the extremities and face, as well as in conjunction with abdominoplasty. Methods: Fifty-nine consecutive patients presenting for liposuction or liposuction with abdominoplasty during a 4-month time frame (September 1997 to January 1998) were treated with XUAL, external ultrasound, or XUAL on one side and standard liposuction on the opposite side. Results: Recovery from XUAL was uniformly rapid, with resolution of edema at an average of 3 to 4 weeks compared with 3 to 6 months in comparable non-XUAL patients. Skin shrinkage was most noticeably advantageous in the face, abdomen, and inner thighs, as well as the arms in both small and large upper arm fat deposits. There was no permanent discoloration or dysesthesia noted. Seromas and postoperative hemorrhages observed during the series were directly related to postoperative trauma in three patients. Conclusions: It was apparent in this study that external ultrasound is a valuable adjunct in body and facial sculpture.