Literature Review and Evidence-Based Comparative Analysis of Traditional Suction-Assisted Lipectomy (SAL) vs. Ultrasound-Assisted Liposuction (UAL) Reported Outcomes

Abstract

Background: Over the past two decades, liposuction techniques have significantly evolved. Methods aimed at improving safety, efficiency, and cosmetic outcomes have been developed. Energy-based devices (EBD) that generate heat capable of fragmenting fat and inducing skin retraction are the most advertised and marketed as a possible alternative to invasive surgical skin excision. Third-generation ultrasound-assisted liposuction (UAL), vibration amplification of sound energy at resonance (VASER) is at present employed in approximately 20% of liposuction cases. Whether it has truly advanced the field or offers only a marketing advantage with negligible benefits, or whether any benefits, if present, outweigh the costs, remains a subject of debate. In an evidence-based perspective, the current review is intended to critically analyze reported outcomes of UAL compared to suction-assisted lipectomy SAL.

Methods and materials: A PICO literature search was conducted across the MEDLINE, PubMed, and EMBASE databases RESULTS: Only 5 studies that specifically compared ultrasound-assisted liposuction with traditional liposuction techniques were identified and included in this review.

Conclusion: In spite of well-documented clinical efficiency, relative safety, decreased incidence of postoperative anemia, and less physician effort, there are at present little convincing long-term data to confirm UAL superior aesthetic outcomes and skin tightening. Offering this technology to patients with excessive fat or skin flaccidity or redundancy for whom more invasive surgery is indicated, on the promise that it will meet their expectations of optimal body contouring and skin tightening without visible scarring, may be somewhat misleading. 1. UAL is known for its clinical effectiveness, safety, lower rates of postoperative anemia, and reduced physician fatigue. 2. Currently, there are insufficient convincing long-term data to validate that UAL delivers better aesthetic results and skin tightening compared to SAL. 3. UAL should be offered to specific patients to ensure satisfactory results.

Level of evidence iii: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Keywords: Complications; Outcomes; SAL; Suction-assisted liposuction; UAL; Ultrasound-assisted liposuction.