Laser-Assisted Liposuction in Face and Body Contouring

*Zoran Žgaljardić and Ivonne Žgaljardić*

### **Abstract**

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.

**Keywords:** laser, liposuction, endolight lifting, skin tightening

### **1. Introduction**

Body contouring surgeries have been one of the most common procedures among all the procedures in cosmetic surgery. According to the report of the American society of plastic surgeons, in the 2019, liposuction has been the second most common procedure with 3% rise compared with the previous year [1]. During the last 30 years many new technologies have emerged and have been implemented in the liposuction procedure in order to improve the results and facilitate recovery. First report on the laser use for liposuction was made by Dressel in 1990 but the report was unable to prove clinical advantages so the technique did not get the FDA (Food and Drug Administration) clearance [2]. Significant breakthrough was made by Apfelberg in 1994. He conducted an FDA-approved study (subsequently he expanded the study in 1996) that proved the benefits of the laser use in the liposuction technique in terms of reduced bleeding, discomfort and tissue swelling. All of the latter resulted in faster recovery [3, 4]. Due to those reports, Apfelberg is considered to be the father of the laser assisted liposuction. Many reports followed that proved the superiority of laser assisted liposuction over the standard technique. The articles mainly emphasized diminished blood loss, oedema and recovery time. Besides that, maybe one of the most important features of the laser implementation was the neocollagenesis and

consequently, the skin tightening effect after the procedure. Badin et.al were first to report that benefit [5]. The first laser to be approved by the FDA was 1064 nm Nd: YAG laser (smartLipo, Cynosure) on the 31st October of 2006.
