Power-assisted liposuction proves the best method in cosmetic surgeon's study
Liposuction is a popular procedure, and with the increasing demand, medical device companies have responded with several techniques. However, not all liposuction techniques are equal in terms of positive aesthetic outcomes and low adverse events.
     Dr Afschin Fatemi, a cosmetic surgeon at the S-thetic clinics in Düsseldorf, Hamburg and Munich, performed a study using four liposuction devices. He compared suction-assisted liposuction (SAL), power-assisted liposuction (PAL), waterjet-assisted liposuction (WAL) and ultrasound-assisted liposuction (UAL). In the study, Dr Fatemi collected data from 20 patients who were then randomised and divided into four groups of five patients each. Each group received either SAL, PAL, WAL or UAL. The study was completed at three months.
     Dr Fatemi’s study concluded PAL worked best. Dr Fatemi said it best spared the subcutaneous septal fibres and vasculature, crucial in maintaining the integrity of the subcutaneous tissues, maximising aesthetic results and minimising adverse events. This was verified by endoscopy. “This study shows that optimal results can be achieved by not only removing the undesired fat but also by preserving the septal fibres and vital vasculature in the subcutaneous tissue,” Dr Fatemi said.
     Dr Fatemi compared the four liposuction techniques using 3mm and 4mm cannulas. Several weeks following the liposuction procedure, he performed an endoscopy in each liposuction patient and compared the clinical outcome with the subcutaneous tissue damage seen under the skin following each procedure. He also compared effects on the subcutaneous tissue after using different cannulae in the same patient, followed by open abdominoplasty.

Short-scar facelift sees resurgence as all ages benefit from new technology
Facelifts may be a corner-stone of cosmetic surgery, but there are many variations in technique. One expert in the field says the short-scar facelift, with an incision around half the size of a trad-itional facelift, is experiencing a revival in popularity.
     Alan Matarasso FACS, Manhattan Eye, Ear and Throat Hospital in New York, said: “This is a hot topic and is talked about at all major plastic surgery meetings. The short-scar facelift is a variant of the traditional facelift that has been around for years and is experiencing its renaissance in plastic surgery. Up until a few years ago, the procedure was performed only in certain circumstances.”
     Dr Matarasso said it was automatically thought, about 30 years ago, that the short-scar facelift could be done on certain individuals such as younger (less tissue to be lifted) facelift patients. Plastic surgeons simply did not realise it had an application to a greater percentage of patients.
     “Intuitively, we thought that patients who had more tissues to lift needed a larger incision. In the older patients, who had more tissue to be lifted, larger, more traditional facelifts were done. Now we realize that the short scar can be done in all patients,” Dr. Matarasso said.
   
Emphasis on value for money
With scepticism rising over cosmetic procedures that promise notable results with minimal downtime, and a more demanding clientele emerging, Dr Jeffery Spiegel, chief of facial plastic and reconstructive surgery at Boston University School of Medicine and Boston Medical Centre, predicts changes are on the horizon in 2008.
     Dr Spiegel believes patients seeking facial rejuvenation have become frustrated and disappointed with expensive, minimally effective procedures that are hyped as “a quick fix”.
     “People are going to expect better and more predictable results. With the economy slowing, the desire to look your best will remain, but people will expect to get what they pay for, and be a lot less tolerant of only minor improvements at a big cost.”

Thumbs-up from US youth
A study commissioned by the American Society for Aesthetic Plastic Surgery (ASAPS) reveals that, in the US, cosmetic surgery is most approved by men and women aged 18–24.
     One thousand people aged 18+ took part, with 69% of 18-24s in favour of cosmetic surgery, a 7% increase from 2007. Men and women aged 65+ had the lowest approval rating, with only 41% sharing the younger respondents’ favourable view.
     ASAPS president Foad Nahai said: “It makes sense that young people are the most approving of plastic surgery. Twenty years ago people thought only movie stars and rich women had plastic surgery. Now, people grow up knowing friends and family who talk openly about the procedures they have had or plan to have.”

Higher incidence of "botched" procedures abroad, says BAAPS
With the popularity of travelling abroad for low-cost cosmetic surgery rising, so, too, is the incidence of patients returning needing further care following complications from “botched” treatments.
     A recent British Association of Aesthetic Plastic Surgeons (BAAPS) survey highlighted this trend, saying a third of its members had seen “much more” repair work needed for patients as a result of medical tourism over the past five years. More worryingly, perhaps, 14 per cent of surgeons had seen nine or more patients in the last year alone suffering problems resulting from cheap cosmetic surgery packages abroad, with 44 per cent having seen at least three to five cases. Of the surgeons polled, the overriding concern for holiday surgery is the lack of aftercare provided, with 92 per cent in agreement.
     Douglas McGeorge, BAAPS president, feels that savings made on surgery abroad could end up costing patients their health. “The counselling is inadequate. The individuals have no idea of the standards of care in the country they are visiting or knowledge of the experience of the surgeon. Follow-up is difficult. Complications do occur and are usually left to the British system to treat.”
     BAAPS members were asked which countries their patients had cited as providing unsatisfactory treatment and care: more than half said Poland.
     Of course, not all patients encounter problems when embarking on cosmetic procedures abroad. Lindsay Hopkins chose to have a face-lift and blephroplasty in Poland and said she had entirely favourable results. She selected a package from Euromedica and had surgery after a consultation with the surgeon on the third day of her visit, allowing nine days of recovery time after the operation. During this time, the aftercare was round the clock for the first 24 hours, followed by daily checkups from a nurse and a post-operative visit from the surgeon to ensure there were no complications before she flew home. She felt entirely confident in the surgeon’s competence, despite the language barrier, as the clinic manager was able to translate.