Abdominal Etching with Renuvion Helium Plasma

Dieter Brummund, Tarik Husain
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Abstract

Abstract Goals/Purpose Differential liposuction with abdominal etching is a powerful technique in high definition liposculpture to achieve an athletic aesthetic. Etching is performed in a superficial plane to create indentures mirroring the dermal-fascial inscriptions of the underlying desired musculature. Renuvion radiofrequency-helium plasma energy (Apyx Medical, Clearwater, FL) is an emerging technology that is used for subdermal coagulation and contraction of the subcutaneous tissue. This case series describes combination of differential liposuction with abdominal etching and Renuvion helium plasma subdermal coagulation in 68 patients and evaluates the outcomes. Methods/Technique A retrospective chart review of 68 patients undergoing differential liposuction with abdominal etching and Renuvion helium plasma subdermal coagulation between 2021 to 2023 by the senior author. The preoperative evaluation, markings, surgical technique and postoperative care are discussed. Clinical parameters assessed include age, gender, body mass index, combination of procedures, volume of lipoaspirate, degree of etching (light, moderate, deep), postoperative changes in weight, and complications such as contour irregularity, wound dehiscence, seroma, surgical site infection, patient dissatisfaction and operative revision. Results/Complications 68 consecutive patients who underwent abdominal etching with Renuvion by the senior author between July 2021 and August 2023 were included in this case series. There were 29 males (43%) and 39 females (57%). The average age of the patients was 39.11 (range, 22 to 64 years), with a non obese, average body mass index of 27.65 kg/m2 (range, 20.8 to 33.9 kg/m2). The average estimated intraoperative blood loss of patients was 104.68 ml (range, 75 to 150 ml); with an average tumescence of 4600 ml (range, 1400 to 8000 ml). The average lipoaspirate was 3920 ml (range, 500 to 9000 ml). In addition to the abdominal region, other areas liposuctioned at the time of etching included flanks (68, 100%), back (66, 97.05%), thighs (14, 20.58%), arms (9, 13.23%), neck (9, 13.23%), chest (8, 11.76%), axilla (3, 4.41%), calves (1, 1.47%). Use of ultrasound was used in 6 cases (8.82%), which were revisionary liposuction. Of our 68 abdominal etching with Renuvion cases the most common combined procedure was autologous fat transfer (20, 29.41%), platysmaplasty (4, 5.88%), mastopexy (5, 8%), breast augmentation (4, 5.88%), buccal fat pad excision (3, 4.41%), umbilical hernia repair (1, 1.47%) and rhytidectomy (1, 1.47%). There were 5 cases of seroma (7.35%) and 4 cases of contour irregularity (5.88%). There were 3 cases of surgical site infection (4.41%), but all in the area of fat grafting and not in the area of liposculpture. No cases of hyperpigmentation were identified. No major complications occurred including skin burns, skin necrosis, visceral injury, deep vein thrombosis, or pulmonary embolism. Overall 66 patients (97.05%) were satisfied following their procedure. Operative revision occurred in two patients (2.94%), who had residual skin laxity following Renuvion and desired skin excision. Conclusion Differential liposuction with abdominal etching and Renuvion helium plasma are safe and effective in combination to synergistically achieve an athletic physique and enhance abdominal aesthetics. Complication rates are low with appropriate surgical technique. Almost all patients reviewed were satisfied with the procedure and maintained long-term results.
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用 Renuvion 氦等离子体进行腹部蚀刻
摘要 目标/目的 差异吸脂和腹部蚀刻是高清晰度脂肪塑形术中的一项强大技术,可达到运动美学效果。蚀刻是在浅表平面上进行的,以创建与所需肌肉组织的真皮筋膜刻痕相匹配的凹痕。Renuvion 射频-氦等离子能量(Apyx Medical,佛罗里达州清水市)是一种新兴技术,可用于皮下凝固和收缩皮下组织。本病例系列描述了在 68 例患者中结合使用差分吸脂术、腹部蚀刻术和 Renuvion 氦等离子皮下凝固术的情况,并对结果进行了评估。方法/技术 由资深作者对 2021 年至 2023 年间接受差分吸脂术、腹部蚀刻术和 Renuvion 氦等离子皮下凝固术的 68 例患者进行回顾性病历审查。文中讨论了术前评估、标记、手术技巧和术后护理。评估的临床参数包括年龄、性别、体重指数、手术组合、吸脂量、蚀刻程度(轻度、中度、深度)、术后体重变化以及并发症,如轮廓不规则、伤口裂开、血清肿、手术部位感染、患者不满意和手术翻修。结果/并发症 本病例系列共收录了 68 例在 2021 年 7 月至 2023 年 8 月期间由资深作者使用 Renuvion 进行腹部蚀刻的连续患者。其中男性 29 人(43%),女性 39 人(57%)。患者平均年龄为 39.11 岁(22 至 64 岁不等),非肥胖,平均体重指数为 27.65 公斤/平方米(20.8 至 33.9 公斤/平方米不等)。估计患者术中平均失血量为 104.68 毫升(范围在 75 至 150 毫升之间);平均抽取量为 4600 毫升(范围在 1400 至 8000 毫升之间)。平均吸脂量为 3920 毫升(范围在 500 至 9000 毫升之间)。除腹部外,其他部位的抽脂包括:侧腹(68 例,100%)、背部(66 例,97.05%)、大腿(14 例,20.58%)、手臂(9 例,13.23%)、颈部(9 例,13.23%)、胸部(8 例,11.76%)、腋窝(3 例,4.41%)、小腿(1 例,1.47%)。使用超声波的有 6 例(8.82%),均为修正吸脂术。在 68 例使用 Renuvion 进行腹部蚀刻的病例中,最常见的联合手术是自体脂肪移植(20 例,占 29.41%)、板前成形术(4 例,占 5.88%)、乳房整形术(5 例,占 8%)、隆胸术(4 例,占 5.88%)、颊脂垫切除术(3 例,占 4.41%)、脐疝修补术(1 例,占 1.47%)和皱襞切除术(1 例,占 1.47%)。血清肿 5 例(7.35%),轮廓不规则 4 例(5.88%)。有 3 例手术部位感染(4.41%),但均发生在脂肪移植部位,而非脂肪塑形部位。没有发现色素沉着病例。没有发生皮肤烧伤、皮肤坏死、内脏损伤、深静脉血栓或肺栓塞等重大并发症。共有 66 名患者(97.05%)对手术表示满意。有两名患者(2.94%)进行了手术翻修,他们在接受雷诺维翁手术后出现了皮肤松弛残留,需要进行皮肤切除。结论 差异化腹部吸脂术与腹部蚀刻术和 Renuvion 氦等离子结合使用,既安全又有效,可协同实现运动体型,增强腹部美感。只要手术技巧得当,并发症发生率很低。几乎所有接受审查的患者都对手术感到满意,并能保持长期效果。
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