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The liquid facelift: First hands-on experience with facial water jet-assisted liposuction as an additive technique for rhytidectomy – a case series of 25 patients

  • Kai O. Kaye
    Affiliations
    Center for Plastic and Aesthetic Surgery, Ocean Clinic Marbella, Av. Ramon y Cajal 7, ES-29601 Marbella, Spain
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  • Sonja Kästner
    Affiliations
    Center for Plastic and Aesthetic Surgery, Ocean Clinic Marbella, Av. Ramon y Cajal 7, ES-29601 Marbella, Spain
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  • Felix J. Paprottka
    Affiliations
    Center for Plastic and Aesthetic Surgery, Ocean Clinic Marbella, Av. Ramon y Cajal 7, ES-29601 Marbella, Spain
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  • Phillipp Gonser
    Correspondence
    Corresponding author. Department for Otolaryngology, Head and Neck Surgery, Eberhard Karls University Tübingen, Elfriede Aulhorn Str 5, 72076 Tübingen, Germany.
    Affiliations
    Center for Plastic and Aesthetic Surgery, Ocean Clinic Marbella, Av. Ramon y Cajal 7, ES-29601 Marbella, Spain

    Department for Otolaryngology, Head and Neck Surgery, Eberhard Karls University Tübingen, Elfriede Aulhorn Str 5, DE-72076 Tübingen, Germany
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Published:November 02, 2017DOI:https://doi.org/10.1016/j.bjps.2017.10.024

      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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