Współczesne metody usuwania tkanki tłuszczowej

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1 Kongres Założycielski Polskiego Towarzystwa Ginekologii Estetycznej i Rekonstrukcyjnej Warszawa, Hotel Hilton 26/ r Współczesne metody usuwania tkanki tłuszczowej Paweł Surowiak PTMEiAA Warszawa DermaMed Wrocław Uniwersytet Medyczny we Wrocławiu

2 Metody klasyczne

3 Metody współczesne

4 1. Nieinwazyjne zabiegi z użyciem różnych źródeł energii 2. Lipoliza iniekcyjna 3. Liposukcja - Klasyczna i odmiany - Laserowa - Ultradźwiękowa

5 1. Nieinwazyjne zabiegi z użyciem różnych źródeł energii - Kriolipoliza

6 1. Nieinwazyjne zabiegi z użyciem różnych źródeł energii - Kriolipoliza

7 1. Nieinwazyjne zabiegi z użyciem różnych źródeł energii - Ultradźwięki efekt kawitacji - Ultradźwięki - HiFu

8 1. Nieinwazyjne zabiegi z użyciem różnych źródeł energii - Radiofrekwencja (Fale radiowe)

9 2. Lipoliza iniekcyja Fosfatydylocholina + deoksycholat (PC + DC)) Opisano setki tysięcy pacjentów Bardzo wysoki profil bezpieczeństwa

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13 Dzień 0 4 tygodnie 8 tygodni 10 tygodni

14 Wskazania Usuwanie zlokalizowanych otłuszczeń

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16 + s + Sculptra + kwas hialuronowy

17 + VelaShape

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21 2 dni!!!

22 3. Liposukcja - Klasyczna Tumescent Technique Dry Technique Wet Technique - The wet technique required the injection of approximately 100 milliliters of local anesthesia containing epinephrine. Super Wet Technique - The super wet technique requires the injection of a volume of dilute local anesthesia that is less than half the volume used for the tumescent technique.

23 3. Liposukcja - Wspomagana laserowa, ultradźwiękowa etc Ultrasonic (UAL) - Ultrasonic Assisted Liposuction (UAL) requires the use of a large volume of tumescent fluid and uses either a metal probe or metal paddle to deliver ultrasonic energy and heat into subcutaneous fat. Vaser Liposuction - Vaser liposuction, also called LipoSelection, is another alternate technology to traditional liposuction. Vaser ultrasonic liposuction is still a process by which fatty deposits are removed from beneath the skin to improve the aesthetics of a particular body part. Power Assisted Techniques (PAL) - PAL devices use power supplied by an electric motor or compressed air to produce either a rapid in-and-out movement or a spinning rotation of an attached liposuction cannula. Laser Liposuction, Laser Assisted Liposuction (LAL), - Laser Liposuction requires the use of tumescent fluid and uses a microcannula inserted through a small incision to deliver laser energy and heat into subcutanteous fat. Water Assisted Liposuction - Water jet assisted liposuction is another method of liposuction being used by cosmetic surgeons today. Water jet assisted liposuction actually uses a slightly pressurized stream of saline to dislodge fat and simultaneously remove the cells. Instead of destroying fat cells, this type of liposuction loosens the fat cells to facilitate more gentle removal.

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26 The most commonly utilized lasers: 1,064 nm, 1,320 nm, 1,440 nm, 2,010 nm, 980 nm, 924 nm, and the 975 nm the three major lasers evaluated for LAL are the 1,064 nm Nd:YAG, the 980 nm diode, and the 1,064/1,320 nm Nd:YAG lasers

27 Lipo Laser

28 Lasery a tkanka tłuszczowa

29 Krzywa absorpcji tk. tłuszczowej

30 The American Society for Aesthetic Plastic Surgery (ASAPS) Survey: Current Trends in Liposuction Jamil Ahmad, Felmont F. Eaves III, Rod J. Rohrich, Jeffrey M. Kenkel Burns and contour irregularities on the arms after laser-assisted liposuction treatment.

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34 Liposukcja VASER Druga generacja UAL

35 Plast Reconstr Surg Apr;129(4):681e-9e. doi: /PRS.0b013e A multicenter, prospective, randomized, single-blind, controlled clinical trial comparing VASER-assisted Lipoplasty and suction-assisted Lipoplasty. Nagy MW 1, Vanek PF Jr. Abstract BACKGROUND: No scientific comparative study has demonstrated any statistically significant clinical improvement attributable to a new lipoplasty technology relative to traditional suction-assisted lipoplasty. This prospective study used a contralateral study design to evaluate postoperative differences between vibration amplification of sound energy at resonance (VASER)-assisted lipoplasty and suction-assisted lipoplasty. METHODS: Twenty female patients between the ages of 20 and 48 years received contralateral treatment with suction-assisted lipoplasty andvaser-assisted lipoplasty in one or more anatomical regions for a total of 33 regions. Patients received suction-assisted lipoplasty on one side of the body and VASER-assisted lipoplasty on the contralateral side. Patients were blinded to technology application. Aspirate was analyzed for blood content, and skin retraction was analyzed by measuring changes in ultraviolet light tattoos. RESULTS: Regarding skin retraction, the VASER-assisted lipoplasty-treated side resulted in a statistically significant improvement in skin retraction of 53 percent relative to suction-assisted lipoplasty (17 percent per liter versus 11 percent per liter, p = 0.003) with 33 paired sites using a two-tailed t test. Regarding blood loss, VASER-assisted lipoplasty treatment resulted in a statistically significant reduction in blood loss of 26 percent (11.2 versus 14.0 cc blood/100 cc) relative to the suction-assisted lipoplasty side (p = with n = 20 using a two-tailed t test). Subjective measures (i.e., pain, swelling, appearance, and patient and physician preference) showed no statistical difference between the two methods at the 6-month evaluation. CONCLUSIONS: The VASER-assisted lipoplasty method demonstrated improved skin retraction and reduction in blood loss compared with suction-assisted lipoplasty. This is the first study to demonstrate statistically significant and clinically relevant improvements in a new lipoplasty technology relative to suction-assisted lipoplasty.

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38 RF-assisted liposuction As surgeons and scientists continued to explore combining surgical suction of subcutaneous adipose with technology to tighten skin/provide soft tissue contraction, increased interest has grown in utilizing RF as an adjunct to SAL. RF energy is high frequency oscillating electrical current (one million cycles per second) applied to the tissue to create a thermal effect. RFassisted liposuction (RFAL) is responsible for dissolving fat cells, which leads to the creation of small channels in the fatty tissue. Furthermore, RFAL causes dermal physiologic responses including immediate contraction of the collagen fibers, subdermal remodeling, and neocollagen formation.59 61

39 Nonexcisional Tissue TighteningCreating Skin Surface Area Reduction During Abdominal Liposuction by Adding Radiofrequency Heating Diane Irvine Duncan DOI: First published online: 1 November 2013

40 The American Society for Aesthetic Plastic Surgery (ASAPS) Survey: Current Trends in Liposuction Jamil Ahmad, Felmont F. Eaves III, Rod J. Rohrich, Jeffrey M. Kenkel Percentage of respondents who currently or have previously performed the various methods of fat removal. SAL, suction-assisted liposuction; UAL, ultrasound-assisted liposuction; PAL, power-assisted liposuction; LAL, laser-assisted liposuction.

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42 The American Society for Aesthetic Plastic Surgery (ASAPS) Survey: Current Trends in Liposuction Jamil Ahmad, Felmont F. Eaves III, Rod J. Rohrich, Jeffrey M. Kenkel Specialty of physicians/practitioners associated with a fat removal procedure resulting in complications.

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