The use of external ultrasound combined with superficial subdermal liposuction.

Superficial subdermal liposuction (SSL) was presented by the authors as an evolution in traditional liposuction in 1989. It allows one to treat the superficial fat to obtain better skin retraction during every liposuction procedure. The use of ultrasound (US) in liposuction began 10 years ago as the direct application of this energy to the adipose tissue using a probe to obtain the selective destruction of fat, followed by its aspiration. This technique gave rise to many complications and thus many concerns. The external delivery of US has been proposed to overcome some of the drawbacks associated with this procedure. The authors investigate the role of external ultrasound (EU) used in conjunction with SSL. When comparing EU and SSL with SSL alone, pretreatment with EU results in less bleeding during liposuction, aspirated fat that is clearer and more oily, and less bruising and swelling during the early postoperative period. EU is an ideal complementary procedure to SSL because the crumbling of the fat induced by US permits a more uniform aspiration of the subdermal fat layer, making skin retraction more even and effective.