Post-liposuction Persistent Reticular Erythema and Response to Intradermal Insufflation With Carbon Dioxide

Background: Persistent reticular erythema (RE) is a well-known complication of liposuction following mechanical and/or thermal trauma. It results from injury to the superficial vascular plexus. Carbon dioxide therapy is considered a safe, minimally invasive therapy for rejuvenation, restoration, and reconditioning of the skin. Objective: To evaluate the efficacy of carbon dioxide (carboxytherapy) for the treatment of RE. Methods: Six patients with RE on the flanks and 1 patient with RE on both the flanks and abdomen underwent intradermal insufflation of medical-grade carbon dioxide 6 times with triweekly intervals. The efficacy of carboxytherapy was evaluated by the patients at the end of the treatment, and improvement was expressed as a percentage. Results: All patients reported subjective improvement ranging from 50% to 90%, with an average improvement of 75.7% following carboxytherapy. None of the patients reported adverse effects. Conclusion: These findings suggest that intradermal insufflation of sterile carbon dioxide may be a beneficial adjunctive treatment for post-liposuction RE, although further studies are required to establish its efficacy.