Clinical papers

Background: Male gynecomastia is a commonly occurring aesthetic concern. Traditional liposuction, laser and ultrasound-assisted liposuction have many limitations, and excisional gynecomastia procedures can leave undesirable scars in the treatment of the enlarged male breast.

Methods: In this study, the authors report the use of radiofrequency-assisted liposuction (RFAL) in the treatmentof male gynecomastia. A total of 59 males had their gynecomastia treated by RFAL technology, 47/59 by closed RFAL alone, and an additional 12 patients with RFAL combined with our personal technique of trans-mammillary glandular reduction. The RFAL device afforded strong RF current and thermal energy for glandular and adipose coagulation and liquefaction, together with strong soft tissue contraction forces.

Results: All patients were followed for more than 12 months, and all reported good to excellent breast contour results. There was one seroma and over 90 % of patients report being very happy with their contour, and no secondary surgical procedures were necessary. The authors report RFAL as new and potentially powerful option in the treatment of male gynecomastia, having the advantages of strong coagulation, liquefaction and aspiration of glandular tissue, simultaneous coagulation and aspiration with constant thermal monitoring, and very strong soft tissue contraction, eliminating the need for skin resection in the majority of cases. In minority of cases where there may be remnant glandular structures following RFAL, a simple, minimally intrusive trans-mammillary glandular extraction technique can be deployed that leaves minimal scarring.

Conclusions: The mixed technique presented in this study appears to be safe and effective. The RFAL mixed technique has proven to be superior to ultrasonic and power-assisted liposuction due to the skin contraction, having no limitation dependent on the quality of the patient’s skin.

Abstract:

42 patients with broad age and ethnic demographics where treated with a novel, non-excisional, minimally invasive device to coagulate a very thin layer of sub-dermal septo-fascial fat, denature the deep reticular dermis and tighten the skin and sub-dermal matrix of connective tissue. The detailed treatment protocol and results are presented. Patients were observed for up to 6 month following the procedure. No major side effects were observed. The aesthetic outcome of this non-excisional procedure includes improvement of the position and shape of the cheek, lower lid-cheek junction, jawline and neck. The overall aesthetic results deliver a noticeable and impressive tightening of the soft-tissue and may be compared with a conservative, small excisional procedure. The authors propose this versatile device and treatment as a non-excisional, moderate facial rejuvenation procedure on its own, or as an adjunct to open procedures performed simultaneously, or as a simplified treatment for secondary skin laxity in combination with a lift procedure.

Introduction:

The increased prevalence of obesity worldwide has grown the body contouring market, as patients demand more solutions. One of the most popular body contouring methods is liposuction. Pioneered in Europe in the early 1980’s as a simple fat aspirating technique, liposuction has quickly expanded its breadth to incorporate a variety of energy sources and modus operandi.

Many types of energies have been combined with standard liposuction techniques in an attempt to improve and optimize treatment outcomes. The current chapter is dedicated to the authors’ experience with the most recent addition to the liposuction family, Radio-Frequency Assisted Liposuction (RFAL). RFAL delivers RF energy for a thermal effect to the adipose tissue, skin and sub-dermal matrix in a minimally invasive manner. Enhancing the standard lipoplasty experience with a safe and consistent thermal influence provides the following key benefits:

• Blood vessel coagulation to reduce patient downtime through less bleeding and bruising.
• Tissue tightening to expand the range of patients to now include individuals who are obese and/or have compromised skin conditions (lax skin).
• Increased patient comfort and safety will increase consumer acceptance.
• Reduced procedure time and ease of treatment will increase physician acceptance.