*3.3.8 Advantages*


#### **Figure 8.**

*Pre (A) and post operative (B) photographs (6 weeks later) of a 40 yr old patient who underwent liposuction of the abdomen and flanks along with fat transfer to the face. Fat was collected in a sterile manner using water jet technology. Fat was collected in a closed system as shown in the photograph (C).*

*Use of Technologies to Improve the Liposuction Outcome Including Skin Texture and Form DOI: http://dx.doi.org/10.5772/intechopen.99947*

• As compared to normal tumescent technique, there is substantially less painrelated impairment before and after the operation. Patients heal well and return to their regular routines faster.

#### **3.4 Radiofrequency assisted liposuction**

In the early 2000s, radiofrequency-assisted liposuction (RFAL) was undertaken through two main platforms: a monopolar point source with grounding pad and a novel asymmetric bipolar configuration that did not need a grounding pad. The energy is delivered between two electrodes in the latter device: an external one that maintains contact with the skin and an internal probe that is inserted into the subcutaneous fat layer. Separate temperature targets can be reached with different energy distribution (more internally than externally) (**Figure 9**). The dermis and external temperature can reach about 40°C and higher, while internal temperatures can reach up to 70°C. In addition to subtractive body contouring, these energy modalities are often combined with SAL to maximize soft tissue contraction [33, 34].

The second-generation asymmetric bipolar system (**Figures 10** and **11**) has many added safety features. When done with and without SAL, many RFAL users record substantial soft tissue contraction as a result of the applied energy [33–35].

The second generation bipolar RFAL system can be used safely and efficiently in a number of anatomical regions under local anesthesia, with a low complication rate and a quicker return to daily activities than conventional SAL and anesthesia techniques.

#### *3.4.1 Techniques*

The treated area was injected with tumescent solution (1000 mg lidocaine per 1000 mL Ringer's Lactate, 10 mL NaHCO3, and 1.5 mL 1:1,000 concentration epinephrine) into the subcutaneous adipose layer of the treated area through an

**Figure 9.** *The power distribution between the internal and external electrode of the radio frequency probe.*

#### **Figure 10.**

*Radiofrequency assisted liposuction device platform.*

access incision made after careful marking of the topography of the areas to be treated. To achieve sufficient touch, the internal probe of the bipolar radiofrequency handpiece (BodyTite, InMode Company, Lake Forest, Calif.) (**Figure 11**) was inserted into the intermediate subcutaneous adipose layer, and the corresponding external probe was placed onto the skin covered in a water-based, sterile ultrasonic gel.

The device's maximum external and internal temperature parameters were then set in accordance with the operating surgeon's clinical indications. The RF system was then turned on, releasing asymmetric electromagnetic radiation to gently heat all the soft tissues between the external and internal probes until the desired temperatures were reached on both the skin and the collagen/fat layer. Once the optimum temperatures for both layers were reached, the heating was retained for several seconds according to the clinical presentation, and the energy deposition process was repeated until all treatment zones received the desired amount of energy.

Any areas requiring contouring were treated with regular manual suctionassisted lipectomy (SAL) or power-assisted liposuction (PAL) to remove excess fat *Use of Technologies to Improve the Liposuction Outcome Including Skin Texture and Form DOI: http://dx.doi.org/10.5772/intechopen.99947*

and fluid after this was accomplished. All access incisions were closed with 5–0 nylon sutures, and compression garments were worn on the treated areas for 3–4 weeks after surgery.
