Possible long-term complications in ultrasound-assisted lipoplasty induced by sonoluminescence, sonochemistry, and thermal effect

Ultrasound-assisted lipoplasty has become a common procedure for the extraction of fat, together with conventional vacuum liposuction. There is a trend to equate ultrasound-assisted lipoplasty with vacuum liposuction, yet it is important to point out that each uses totally different physical modes and techniques to extract fat. Research comparing the efficacy of ultrasound-assisted lipoplasty with vacuum liposuction has been reported and continues to be evaluated. Since its early use by Zocchi1–3 and Maillard et al.,4 much experience and knowledge have been gained regarding side effects and complications. Although short-term side effects such as burns, infection, fibrosis, seroma, and the coagulation of blood vessels and nerves have already been noted and reported, long-term complications are possible. Recent studies have reported the use of ultrasound-assisted lipoplasty on the breast4 and the extraction of high volumes of fat. Emphasis should be placed on the long-term effects of ultrasound-assisted lipoplasty on young patients when sensitive areas such as the head, neck, and breast are treated and when high-intensity ultrasound energy is applied in close proximity to major blood vessels and nerves. The commonly accepted understanding of the physics of the ultrasound energy affecting the surrounding tissue involves the thermal, cavitational, and mechanical effects. A thorough review of the literature regarding the chemistry and physics of ultrasound energy, however, reveals a more detailed and comprehensive mechanism that can contribute to adverse effects of ultrasound energy in biologic systems. This mechanism comprises three major factors that may create long-term complications when associated with ultrasound-assisted lipoplasty: The …