COSMETIC A Prospective, Randomized, Double-Blind, Controlled Clinical Trial Comparing Laser-Assisted Lipoplasty with Suction-Assisted Lipoplasty Arturo Prado, M.D. Patricio Andrades, M.D. Stefan Danilla, M.D. Patricio Leniz, M.D., Ph.D. Paulo Castillo, M.D. Fancy Gaete, M.D. Santiago, Chile Background: The authors randomized and prospectively analyzed their clinical experience with the use of internal neodymium:yttrium-aluminum-garnet low- level laser-assisted lipoplasty compared with suction-assisted lipoplasty. Methods: Suction-assisted lipoplasty was generated through a SmartLipo ma- chine and delivered into the subcutaneous tissues through 2-mm solid optical probes. Ipsilateral suction-assisted lipoplasty and contralateral laser-assisted li- poplasty were performed on one or more comparable topographic areas of the body in the same patient. Laser-assisted lipoplasty and suction-assisted lipoplasty sides of 25 patients were compared with preoperative and postoperative pho- tographs at 3 to 5 days, 12 to 15 days, and 6 to 11 months. Statistical analysis considered surgeon and patient satisfaction, time used in the procedures, learn- ing curves, lipocrits, operative technique, postoperative pain, edema, ecchymo- sis, time of recovery, body mass index, DNA proteins, free fatty acids, and cytologic patterns of post–laser-assisted lipoplasty and suction-assisted lipoplasty adipocyte architecture. Photographs were sent to the patients (blinded to the operated sides) and two plastic surgeons unfamiliar with the cases for evaluation of results. Results: All patients completed the preestablished follow-ups. No complications were observed. Less pain, lower lipocrits, higher triglycerides, and DNA cellular membrane traces were detected in the laser-assisted lipoplasty sides. All other considerations studied showed no differences with either technique in the three periods of the follow-up controls. Cytologic studies showed more damage of the adipocytes in the laser-assisted lipoplasty sides. Conclusions: No major clinical differences for suction-assisted lipoplasty versus laser-assisted lipoplasty were found. Higher concentrations of free-fatty acids after laser-assisted lipoplasty must alert us to possible hepatic and renal toxicity. (Plast. Reconstr. Surg. 118: 1032, 2006.) S ince 1980 and after its presentation in the medical literature, 1,2 traditional suction- assisted lipoplasty has today become the most commonly performed aesthetic surgical procedure 3 and is executed with preference in accredited outpatient plastic surgery facilities. 4 When suction-assisted lipoplasty is performed af- ter competent training, it has low rates of com- plications, predictable recovery periods, and high patient satisfaction. 5–8 Body contouring procedures that use low-energy neodymium: yttrium-aluminum-garnet laser–assisted lipo- plasty devices have recently gained considerable attention in Europe and South America, 9,10 claiming many benefits over the traditional method. 11 Laser has been used extensively in many fields of plastic surgery, 12 but only a few reports have addressed its role in liposuction. Credit for the development of neodymium:yttrium-aluminum- From the Division of Plastic Surgery, School of Medicine, University of Chile. Received for publication June 22, 2005; accepted August 19, 2005. Presented in “Hot Topics in Plastic Surgery” and discussed by Dr. Nolan Karp at the combined American Society of Plastic Surgeons/Plastic Surgery Education Foundation/ American Society of Maxillofacial Surgeons 73rd Annual Scientific Meeting, Plastic Surgery 2004, in Philadelphia, Pennsylvania, October 10 through 13, 2004. Copyright ©2006 by the American Society of Plastic Surgeons DOI: 10.1097/01.prs.0000232428.37926.48 www.PRSJournal.com 1032