VASER-assisted high-definition liposculpture

BACKGROUND: The introduction of VASER (vibration amplification of sound energy at resonance) technology has enabled the application of lipoplasty techniques to the superficial fat layers. Differential lipoplasty has been used to detail abdominal musculature by "abdominal etching," but was applicable only to limited areas in male patients with low body fat. OBJECTIVE: The authors report on the use of VASER-assisted high-definition liposculpture to not only improve body contour but also to highlight the 3-dimensional muscular anatomy in a wide variety of patients. METHODS: After deep and superficial infiltration, emulsification was performed using VASER technology in continuous mode for high debulking and in pulsed mode at lower power for more delicate areas and the immediate subdermal plane. Debulking was performed using ventilated cannulas, beginning in the deep layers and continuing to the mid-lamellar layer and between muscle groups. Superficial emulsification was performed to define the relevant anatomy for the muscle groups in each treatment area. Transitioning was then performed to define the superficial anatomy landmarks by debulking some of the remaining fat over the muscles and smoothing the surfaces over the mid-lamellar area. RESULTS: A total of 306 patients were treated in two separate series; 281 by the senior author (AEH) and 25 by the co-author (JAM) Satisfactory results were obtained in 257 patients (84%). No cases of skin necrosis occurred. Minor complications included 20 cases of seroma, 9 cases of port site burns, and 5 cases of prolonged swelling. CONCLUSIONS: VASER-assisted high-definition liposculpture is an aggressive approach to body contouring that enables the surgeon to perform body sculpting of the superficial tissues to define the 3-dimensional surface musculature in a wide range of patients. However, it is a difficult and time-consuming procedure with a high learning curve that is appropriate only for highly experienced surgeons.