Laser lipolysis of the arm, with and without suction aspiration: Clinical and histologic changes

Abstract Background and objective: Liposuction has become increasingly popular over the past several decades. However, liposuction is a relatively traumatic procedure with known risks, which include skin redundancy. Laser lipolysis has the potential of producing similar clinical results to those seen with liposuction while providing the additional benefit of tissue tightening. In this study, we evaluated the efficacy, safety, and histologic changes induced by 1064-nm Nd:YAG laser lipolysis. Furthermore, we investigated the benefit of suction aspiration after laser lipolysis. Methods: Twenty female subjects, aged 44–66 years, underwent a single laser lipolysis treatment of the extensor arm fat pads. Treatment was undertaken after infusion of tumescent anesthesia. Lipolysis was undertaken with a 10-Watt 1064-nm Nd:YAG laser (SmartLipo™ Cynosure Lasers, Chelmsford, MA, USA), delivered via a 300-μm fiber encased in 1-mm micro-cannula introduced through a 1-mm incision. The liquefied fat was removed via standard liposuction aspiration in 50% of patients. Subjects were evaluated at 6 months after laser lipolysis for reduction of unwanted fat and any associated complications. Post-procedure histologic changes were also evaluated. Results: Clinical improvement in both unwanted fat and associated skin tightening was noted in most subjects. Results at 6 months were greater than those seen at 1 month. The clinical observations were substantiated by measurements showing an average reduction in the arm circumference following treatment. No significant treatment-induced complications were noted. Treatment with and without post-laser lipolysis suction aspiration produced similar results. Histologic changes showed disruption of adipocytes and evidence of connective tissue thermal injury. Conclusion: Laser lipolysis using the 1064-nm Nd:YAG represents a safe and effective option for removal of unwanted fat of the upper arm. Results were identical whether or not post-laser suction aspiration was undertaken.