Disclaimer: This blog post provides general information and is not a substitute for professional medical advice. Individual results may vary. It is crucial to consult with a qualified plastic surgeon to discuss your specific needs and determine the most appropriate treatment plan for you. The study discussed here is a retrospective review and while valuable, further large-scale randomized studies are always beneficial for broader validation.
As plastic surgeons, we constantly seek innovative ways to refine our techniques and optimize patient outcomes. My journey in this field has been a continuous pursuit of excellence, from embracing new technologies to advocating for holistic well-being – a journey that led me to experience the profound benefits of yoga for both personal and professional vitality. (A message to younger surgeons: prioritize self-care early on; your future self will thank you!
My dedication to advancing plastic surgery has seen me participate in the early adoption of groundbreaking technologies like Renuvion (helium plasma) and VASERlipo. For years, I’ve been intrigued by a fundamental question that has largely remained unaddressed in scientific literature: Can we safely and effectively perform abdominoplasty using two distinct energy modalities on the abdominal flap?
I recently had the privilege of presenting the largest series to date addressing this very question, a retrospective review of 77 consecutive cases over a seven-year period. Our study compared two cohorts: one undergoing VASERlipo abdominoplasty, and another receiving both VASERlipo and Renuvion on the same flaps. Our primary objective was to determine if combining these energies impacted the complication rates compared to traditional abdominoplasty or VASERlipo abdominoplasty alone.
Abdominoplasty Study Design: VASERlipo and Renuvion Cohorts
Our study meticulously stratified patients based on various demographics, including BMI, Fitzpatrick skin types, smoking status, and co-morbidities, ensuring comparable groups. We focused on Zone 1 (over the rectus abdominis) and Zone 2 (lateral to the rectus border) of the abdominal flap, areas well-understood from the tram flap era in terms of blood supply.
The energy application was carefully controlled:
- Zone 1: Consistent low UAL energy (two-groove, 40V suction). No suctioning with hollow cannulas in this zone.
- Zone 2: VASER energy applied between 70-100V.
- Renuvion: Applied at approximately 80% power throughout the flap.
A crucial aspect of our surgical protocol involved placing access ports for energy delivery below the domain of the resected abdominal plasty, further optimizing the procedure.
Key Findings: Safety and Efficacy of Combined Abdominoplasty
The data analysis revealed compelling results:
- No Increased Morbidity with VASERlipo Abdominoplasty: The VASERlipo abdominoplasty group demonstrated complication rates consistent with historical literature for traditional abdominoplasty. This strongly suggests that the addition of VASERlipo does not increase the risk of adverse events.
- No Increased Morbidity with Combined VASERlipo and Renuvion: The most significant finding was that the addition of both VASERlipo and Renuvion to the abdominoplasty procedure did not lead to an increase in co-morbidities or adverse events compared to VASERlipo abdominoplasty alone. We meticulously examined various potential complications, including fat cysts and seromas (clinically determined with close follow-up in the first six weeks).
- Consistent Abdominoplasty Outcomes: The average blood loss was remarkably low (40-75 ccs), and drain removal was not significantly impacted by the type of energy used.
One notable case from our study involved a high BMI patient in the UAL helium plasma group who experienced focal skin necrosis, which was successfully addressed with scar revision, showcasing excellent healing at one year post-op.
Implications for Modern Abdominoplasty Practice
Our findings strongly support the safety of incorporating both VASERlipo and Renuvion into abdominoplasty procedures. This combined approach, without adversely impacting overall complication rates, offers exciting possibilities for enhanced contouring and skin tightening.
While this was a single-surgeon retrospective review, the consistent protocol advanced throughout the study period lends significant power to these findings. Of course, larger-scale, randomized studies are always beneficial for further validation.
AON Device: Accessibility and Renuvion Training
The technology involved, particularly the separate VASER and Renuvion devices, has historically been a significant investment. However, the emergence of integrated devices like AON, which combine both technologies, promises to make this advanced approach more accessible.
My personal learning curve for Renuvion, with the invaluable guidance of colleagues like Dr. Paul Ruff, was surprisingly short – about four cases to feel comfortable. The procedural time added by Renuvion is typically 10-20 minutes per zone, depending on BMI, while VASERlipo often reduces overall suctioning time.
I am enthusiastic about the future of this combined approach and am committed to sharing my knowledge and experience. We will be offering training for the AON device, and I welcome any inquiries from fellow surgeons regarding patient cases or the technology.
