Summary
Objective
Recently, water jet-assisted liposuction (WAL) was successfully applied by several
other authors to remove fat and induce skin contraction in nonfacial body areas. Extending
the range of indications for this new method, the authors of this article report on
their first experience with its use in facial contouring, fat harvesting, and hydrodissection
of the facial skin flap in rhytidectomy in a case series of 25 patients.
Methods
Twenty-five patients (median age: 56 years) had facelift surgery under sedation, and
the WAL technique was used for facial contouring, fat harvesting for facial lipotransfer,
and hydrodissection of the facial skin flap. Patients were monitored for discomfort
during the procedure. Complications such as bleeding, postoperative swelling, and
hematoma formation were observed during a 1-week follow-up period, and intensity was
rated by two independent surgeons using a special grading system. Furthermore, a patient
survey (FACE-Q) was performed to analyze the patients' satisfaction and perception
of the postsurgical esthetic results.
Results
The WAL technique can be applied under intravenous sedation without causing any discomfort
in all treated patients [mean 1.16, standard deviation (SD) 0.31]. Intraoperative
bleeding during WAL-assisted facial dissection was judged as not present at all times
(mean 1.3, SD 0.32). Postoperative swelling (day 1: mean 1.82, SD 0.28; day 7: mean
1.18, SD 0.28) and hematoma formation following surgery (day 1: mean 1.58, SD 0.34;
day 7: mean 1.18, SD 0.31) were judged as minor in all cases. Overall, no skin necrosis
was detected. There was no need for revision surgery. More than half of our treated
patients (n = 13) answered the FACE-Q questionnaire, verifying a high satisfaction
rate with beneficial treatment results without the occurrence of any major complications.
Conclusions
The WAL technique seems to offer a safe and efficient treatment approach for facial
contouring, facial fat harvesting, and simultaneous facial flap hydrodissection with
only minor postoperative swelling and hematoma formation. Therefore, the authors believe
that the WAL technique is a powerful and useful tool and should be used in modern
facial plastic surgery.
Keywords
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Article info
Publication history
Published online: November 02, 2017
Accepted:
October 13,
2017
Received:
July 29,
2017
Footnotes
Authored by a member of BAPRAS
☆Presentation: 1. 5th ISPRES Congress, October 2016, Marseille; 2. Congress of the German Society of Aesthetic, Plastic Surgeons, September 2016, Kassel (Germany).
Ethical statement
The research project with all its procedures was granted approval by the local Ethical Committee and is in accordance with national law and the World Medical Association Declaration of Helsinki (1964) with its ethical principles for medical research involving Human Subjects and subsequent amendments.
Identification
Copyright
© 2017 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.
