Abstract
The physical and technical principles of ultrasonically assisted liposculpturing (UAL) are described, and clinical experience through 4 years (1992–1996) of use of this procedure is presented.
The technique relies on the surgical use of ultrasonic energy, which allows the selective destruction or emulsification of adipose tissue, producing a “cream,” which is then aspirated. The procedure produces less edema and bruising than does traditional liposuction and allows a great degree of skin retraction due to “stimulation” of the dermis of the treated areas.
Clinical application of ultrasonically assisted liposculpturing is for lipodystrophy, secondary cases, and difficult areas such as the inner thigh, circumferential thigh, calf, and abdomen. There is little blood loss, and a greater volume of fat tissue can be removed in one session. UAL can be used to treat obesity.
This method has been applied to surgery of the breast for volume reduction of the adipose components in the fatty breast (mostly in juvenile breast) and for skin retraction after dermis stimulation for correction of minor-degree ptosis. This technique chiefly relies on the selective destruction of mainly the fluid fraction of the adipose tissue, which represents nearly 90% of all the adipose tissue's volume. Contrary to traditional liposuction, which mechanically attacks and destroys all the structures of the dermis that may have undesired side effects, UAL selectively destroys only the target adipocytes and spares the supporting structures of the skin and dermis, such as vessels, nerves, collagenic matrix, and elastic fibers, thus conserving the elasticity of the treated areas.
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