Background: Laser-assisted lipolysis has been suggested to augment traditional liposculpture by improving skin laxity and providing hemostasis. Previous studies have reported improved hemostasis and smoother post-operative appearance with the 1,064 Nd:YAG laser-assisted lipolysis system. Methods: Three separate pilot studies were performed. In the first study, both arms were treated with tumescent liposculpture. One arm was randomized to treatment with a subcutaneous 1,064 nm Nd:YAG laser. The second study treated multiple sites with half of the area randomized to receive the 1,064 nm versus the 1,320 nm system followed by aspiration at equal power. The third study treated patients using a combined 1,064/1,320 nm multiplex laser system at multiple sites. The endpoint of laser treatment was determined by an external skin surface temperature of 408C. In all three studies, photographs were compared at 1 week, 1 month, and 3 months post-operatively.
Results: In the first study, no significant improvement over tumescent liposculpture alone was noted using the 10 W, 1,064 nm laser. The second study showed no difference using the 10 W, 1,320 nm versus the 10 W, 1,064 nm laser-assisted lipolysis system. Finally, the multiplex 1,064/1,320 nm system appeared to show improvement in skin laxity and fat reduction. Complications included intraoperative thermal burns in 2 of 20 patients using the multiplex system. No complications were noted using the 1,064 or 1,320 nm 10 W systems. Conclusions: Laser-assisted lipolysis provides an innovative way to address the problem of skin laxity and fat reduction. Clinical results increased dramatically with the combined 1,064/1,320 nm multiplex system. However, caution should be used when exceeding external skin temperatures of 408C to avoid unwanted thermal burns. Future studies comparing the end temperature and wavelengths independently may help to conclusively delineate the optimal system.