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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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Basic to Advanced Liposuction Comprehensive Course Objectives: 

  1. Discuss history and evolution of liposuction in 35 years.
  2. Identify relevant surgical anatomy for areas of treatment
  3. Understand the unique demands of the cosmetic patient in 2009, in a highly competitive market, and how to separate your self from the competition
  4. Conduct efficient consultation
  5. Identify indications, contraindications, and proper preoperative preparation
  6. Learn the necessary staff requirement, supplies and equipment
  7. Become familiar with office tumescent liposuction by local anesthesia
  8. Discuss the basic concepts of laser lipolysis, and begin to apply this knowledge in practice
  9. Learn the concept of power assisted liposuction and available devices
  10. Identify the various available machines and various wave lengths used for laser lipolysis
  11. Describe the procedure with proper treatment protocols:
    • Liposuction of the Neck
    • Liposuction of the breast
    • Liposuction of the arms
    • Liposuction of the abdomen
    • Liposuction of the thighs
  12. Describe novel indications of laser lipolysis:
    • Laser lower blepharoplasty
    • Treatment of lipomas with liposuction
    • Scarless reduction mammaplasty
  13. Discuss the postoperative care
  14. Identify safety issues, potential complications of liposuction, management, and how to avoid them
  15. Describe the current data in medical research relevant to liposuction safety, and its impact on patient care
  16. Visualize the procedure performed:
    • Liposuction of the Neck
    • Liposuction of the breast
    • Liposuction of the arms
    • Liposuction of the abdomen
    • Liposuction of the thighs

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