Procedure could surpass liposuction in popularity
Training set for ultrasound-assisted lipoplasty
A procedure on the horizon will be at least as popular as traditional liposuction, which is the most common aesthetic procedure performed by plastic surgeons today, same-day surgery experts say.
Ultrasound-assisted lipoplasty (UAL) won't replace, but will augment, traditional liposuction, says Mary Gingrass, MD, staff plastic surgeon at The Institute for Aesthetic and Reconstructive Surgery at Baptist Hospital in Nashville, TN. Gingrass and her partner, Patrick G. Maxwell, MD, have performed more than 200 UALs.
"It's another tool to help get excellent results in body contouring," Gingrass says.
UAL differs significantly from traditional liposuction in that with UAL, mechanical sound waves are transmitted by a generator to the tip of a suction cannula. When the cannula tip has contact with the fat cells, those cells are emulsified. In comparison, liposuction tears out the fat with pure suction.
"The traditional procedure uses a mechanical force that's like a jackhammer action," says Franklin DiSpaltro, MD, chairman of the Department of Plastic Surgery at St. Barnabas Medical Center in West Orange, NJ. "With ultrasound, what you're accomplishing is like playing a violin."
DiSpaltro serves as chairman of the Ultrasound-Assisted Lipoplasty Task Force of the Arlington Heights, IL-based American Society of Plastic and Reconstructive Surgery. The task force was set up by the major plastic surgery organizations to evaluate the procedure. The task force has not reached a definite conclusion about the safety and efficacy of the technique but says additional research and clinical trials are needed first.
UAL may play its most significant role in treating obesity of the central third of the body, from the hips to the thighs, including the "saddlebags" and abdominal area, according to the task force. Gingrass says UAL also appears to be effective in treating male breast enlargement (gynecomastia).
Traditional procedure still may be needed
"Even when these areas are treated with UAL, however, traditional liposuction may be required to complete and refine the surgical result," according to a position statement from the task force.1
Gingrass and others who have been offering the procedure tout its benefits. For example, UAL offers more precise and artistic body sculpturing than traditional liposuction, Gingrass says.
This benefit means that one of the problems with traditional liposuction -- contour irregularity -- is less of a problem, she says.
"[UAL] is almost like doing liposuction with an airbrush instead of a suction cannula," says Gingrass.
In addition, UAL can be used to treat overweight patients who may not be good candidates for traditional liposuction, according to the task force. Because UAL is associated with less bleeding, greater volumes of fat can be removed without the bruising, swelling, and discomfort associated with traditional liposuction, says DiSpaltro. (UAL may not be appropriate for all patients. See story, above.)
The risks are comparable to traditional liposuction, Gingrass says. The risk of bleeding is less than 1%. If bleeding does occur, it causes prolonged bruising, she says. The risk of infection is significantly less than 1%, Gingrass says.
A risk of burns exists at the cannula entry site, DiSpaltro says. However, a skin protector has been developed by Medical Device Alliance in Las Vegas that lessens the risk of burns, he says. The shield is inserted into the patient's skin, and the cannula passes through the shield. (See source box, above.)
The procedure has a learning curve, Gingrass says. To assist surgeons, a training program is scheduled to begin in January that will offer a full day of training to cover surgical instructions, physiology, effectiveness, tips on avoiding complications and risks, as well as a demonstration of the technology, DiSpaltro says. (For more information, see sources, above.)
Same-day surgery programs will need a generator and probes to offer UAL, DiSpaltro says. Medical Device Alliance in Las Vegas has received 510K approval to distribute a device in the U.S. for soft-tissue aspiration. The U.S. Food and Drug Administration (FDA) gives 510K approval when a device is substantially equivalent to one that is already on the market. (The FDA does not recognize lipoplasty.) Lysonix 2000 includes a generator and hand probes and sells for about $39,000. (See source box, above.) Other companies including Mentor in Santa Barbara, CA, and Wells Johnson in Tuscon, AZ, will offer comparably priced 510K evaluated instruments this year, DiSpaltro says.
Reference
1. The Aesthetic Surgery Education and Research Foundation, The American Society for Aesthetic Plastic Surgery, American Society of Plastic and Reconstructive Surgeons, Lipoplasty Society and Plastic Surgery Educational Foundation. Ultrasound-Assisted Lipoplasty Task Force Position Statement. May 1996. *
For more information on ultrasound-assisted lipoplasty, contact:
* Franklin DiSpaltro, MD, 101 Old Shorthills Road, West Orange, NJ 07052-59097. Telephone: (201) 736-5907. Fax: (201) 736-4987. E-mail: 104772.1424&compuserve.com.
* Mary Gingrass, MD, Staff Plastic Surgeon, The Institute for Aesthetic and Reconstructive Surgery, 2021 Church St., Suite 806, Nashville, TN 37203. Telephone: (615) 340-4500. Fax: (615) 340-4598. E-mail: [email protected].
* John Panik, Medical Device Alliance, 871 Grier Drive, Suite B2, Las Vegas 89119. Beeper: (800) 800-7759. Telephone: (619) 436-8408. Fax: (619) 633-388.
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