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easier to remove via liposuction, and helps to tighten the
skin. There is no scientific evidence demonstrating the
advantage of this technique over the ultrasound assisted
liposuction or the traditional liposuction.
Blugerman et al. described a novel technique using
[10]
radiofrequency assisted liposuction. Radio frequency is
a form electro‑magnetic energy similar to microwave.
The process involves passing radio frequency energy
through tissue to heat up fat cell and making it easier to
remove via liposuction and helps to tighten the skin. This
procedure was well‑tolerated, safe, and efficient in the
[11]
removal of a moderate volume of fat. Paul et al. reported
three‑dimensional skin tightening with this procedure and
proposed a mechanism of tissue tightening.
a b
The Water‑Jet assisted liposuction is a new technique that Figure 1: Simon syndrome. (a) Preoperative and (b) one‑year
uses fan‑shaped jet of tumescent solution to anaesthetize postliposuction treatment
the area for liposuction. Sasaki used this technique in
[12]
2011 on 41 patients. The amount of instilled tumescent
fluid, lidocaine dosage, and aspiration volumes appeared
to be safe, with minimal blood loss in small and moderate
volume liposuction cases, and have emphasized on
efficacy and safety of the technique.

ADIPOSE TISSUE DISEASES

[13]
El‑Khatib has used the wet technique to treat the lower
part of the body with unusual fat distribution that is
clinically characterized by massive symmetric and diffuse
fat deposition in the trochanters, groins, buttocks, hips,
and lower extremities; it contrasts sharply with the normal
fat distribution in the upper part of the body. The massive
lipomatoses of the lower body can be classified into a b
3 types: type 1, the familial symmetric lipomatosis (Simon’s Figure 2: Peritrochantric lipomatosis. (a) Preoperative and (b) 18 months
syndrome) that affects the groins, trochanters, hips, postliposuction
buttocks, and thighs [Figure 1]; type 2, the bilateral
peritrochanteric familial lipomatoses [Figure 2]; and type 3,
the unilateral peritrochanteric lipomatosis. The adipose
tissue diseases are often accompanied by psychological
depression due to their disturbed body image. The
traditional liposuction is the treatment of choice for these
esthetic deformities. The surgical removal of the localized
fatty deposit results in unacceptable cosmetic outcome.

MULTIPLE SYSTEMIC LIPOMATOSIS

Multiple Symmetrical Lipomatosis, also known as benign
symmetric lipomatosis or Madelung’s disease and
Lanois‑Bensaude syndrome are metabolic conditions
characterized by the growth of fatty masses around the a b
face, back of the head, neck, upper arms, abdomen, back
and upper leg in a very specific distribution [Figure 3]. Figure 3: Madelung’s disease. (a) Preoperative anterior and (b) posterior
photos
Unlike the usual lipoma, these benign fatty masses are
not enclosed in a membranous. Due to this characteristic is preferable due to a reduction of blood loss and
and symmetrical appearance, these conditions are often reduction of effort produced by surgeon.
dismissed as simple obesity.
Bassetto et al. used the ultrasound‑assisted liposuction DERCUM’S DISEASE
[14]
to treat multiple systemic lipomatosis. He compared
the traditional lipectomy and the ultrasound‑assisted Decrum’s disease is characterized by the presence of the
liposuction and concluded that the ultrasound liposuction painful condition, sleep disturbance, memory impairment,

2 Plast Aesthet Res || Vol 2 || Issue 1 || Jan 15, 2015