Tumescent in-office Power Assisted Laser Lipolysis (TOPAL):
A Prospective Clinical Study of 500 Consecutive Procedures
Author Block Ayman El-Attar, MD.
Derma Laser Centers, Mercerville, NJ, USA.
Abstract:
Objective:
To evaluate the indications, contra-indications, safety, efficacy, patient satisfaction, and cost-effectiveness of Tumescent in-Office Power Assisted Laser Lipolysis. (TOPAL)
To open new horizons and new applications of this technique that may trigger more interests and further studies. Methods:
One hundred consecutive patients underwent (TOPAL). Patients underwent a total of 500 procedures.All patients had preoperative history and physical examination to exclude any medical or surgical contraindications. Of the initial 112 patients screened for the procedure, twelve were excluded for concurrent severe medical conditions or abdominal hernias. The study included 80 females and 20 males. Age range 18 to 67. Weight range 52 to 127 Kg. Seventy six patients were not taking any concurrent medications, 22 patients were receiving medications interfering with Cytochrome P450 hepatic enzyme, for whom dose modification was addressed.
MicroAire System was used for power suctioning. Laser lipolysis devices included 10 watt 1064 nm Nd:YAG Cynosure Smartlipo™
Results:
Results appeared immediately after the procedure with progressive improvement over 45-120 days after the procedure. All patients showed significant reduction in circumference (6.3±2.3 cm) and significant improvement in skin tightening with significant improvement of striae. There was two mild skin burns, one mild hematoma that resolved without aspiration, and one mild skin infection, and 3% of the patients required another session for touch up. No other complications.
Conclusions:
TOPAL results seem superior to laser or traditional liposuction alone. It can be used for heavier patients who do not benefit from laser lipolysis by itself. TOPAL is safe, with less complications than that reported for traditional liposuction. The touch up rate for this technique is much less than that reported for traditional liposuction
The recovery time for TOPAL is uniformly low regardless of the preoperative weight of the patient, as compared to traditional liposuction. TOPAL has novel new indications including:
Treatment of multiple lipomas (Dercum’s disease)
Treatment of axillary hyperhidrosis
Skin tightening after massive weight loss as a non surgical alternative to massive skin excisions.
Treatment of Striae distensae
Biography:
Dr. El-Attar is a board certified physician and surgeon. He graduated from Alexandria Medical School with honors in 1987. He completed residencies in both General Surgery and Family Medicine, and obtained a Masters of Surgery in 1992. He was an assistant lecturer of Surgery at Alexandria University, and a visiting instructor of Surgery at the Medical College of Ohio.
Memberships:
Fellow American Society of Laser Medicine & Surgery
Associate American Academy of Cosmetic Surgery
Member of International Society of Dermatology
Member American Medical Association
Member American Society of Aesthetic medicine
Member Canadian Academy Aesthetic Medicine
Member American College of Phlebology
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