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    SAFElipo maximizes smooth, even fat removal


    Dr. Wall
    SAFELipo provides a nonthermal liposuction, fat-grafting and body-shaping method that minimizes bleeding, tissue trauma and contour deformities while maximizing smooth and even fat removal, and it can be utilized with excisional procedures safely and effectively, says Simeon Wall Jr., M.D., a plastic surgeon at The Wall Center for Plastic Surgery, Shreveport, La. Conventional wisdom dictates that the more aggressive, or more superficial, a surgeon performs liposuction, the higher the chances of creating a contour deformity. This is why most surgeons use more conservative liposuction techniques, Dr. Wall explains.

    Newer thermal-based technologies such as laser-assisted liposuction (LAL), ultrasound-assisted liposuction (UAL) and radiofrequency modalities have promised various procedural improvements, but in general they have resulted in increased complications and long-term problems, Dr. Wall says, adding that SAFElipo provides a better solution in the effort to achieve greater effectiveness with fewer irregularities.

    "With SAFElipo, we do not really have this give-and-take problem anymore," Dr. Wall says. "We can be extremely thorough and achieve very dramatic results and yet we do not increase the risk of creating contour deformities or other problems associated with traditional or thermal-based liposuction technologies.

    "In fact, you can be about as dramatic as you want and the risks of irregularities and unevenness do not go up," Dr. Wall adds. "It's also nice not to have to worry about burning the skin and other tissues. The equalized fat we leave behind with SAFELipo is viable, in a receptive, healthy tissue bed, as opposed to a tissue bed that has been burned, coagulated and inflamed by an internal thermal device."

    TALKING TECHNIQUE SAFElipo is based on a three-step process: Separation, fat Aspiration, and Fat Equalization, Dr. Wall says.

    The fat globules are first separated from one another and from their attachments such as blood vessels, nerves and the stromal architecture. The fat separation is performed using specialized probes, with or without a power-assisted vibrational device, leaving separated and viable fat behind. This is in stark contrast to laser and radiofrequency modalities, which destroy the targeted fat and coagulate the surrounding structures, Dr. Wall says.

    Next, aspiration of the separated fat is performed. This is less aggressive than standard techniques, as the already separated and largely intact fat cells can be easily harvested, Dr. Wall explains. This is followed up with the final step of fat equalization, where the remaining bed of fatty tissues is smoothened out and aesthetically contoured.

    "Regardless of the liposuction technique used, we plastic surgeons always think that the area we just finished suctioning is smooth, but in actuality, it usually isn't," Dr. Wall says. "There are almost always irregularities present with thicker and thinner areas of fat left behind. With fat equalization, we can precisely further separate the remaining irregular fat deposits and reposition them and smooth them out. These serve as what I call 'local' fat grafts that help to achieve much smoother contouring results that are lasting."

    PROTECTION IS PARAMOUNT SAFElipo can be performed using both power-assisted liposuction (PAL) and non-power techniques and with some other up-and-coming modalities, but not with internal thermally based modalities (ultrasound, laser, radiofrequency), as they are generally incompatible with the concepts of fat preservation and equalization, Dr. Wall says.


    A 52-year-old male patient before (top two images) and six months after SAFELipo of the circumferential trunk, chest and axillary sculpting. (Photos credit: Simeon Wall Jr., M.D.)
    "On one hand, we have the liposuction technologies racing to see which one can kill the fat and surrounding structures the most effectively. On the other hand, we have all the modern pioneers of fat grafting coming to a consensus that regardless of the technique, we need to protect and preserve the grafted fat and recipient bed to maximize results," Dr. Wall says.

    According to Dr. Wall, whether fat is being removed (liposuction) or added (grafting), surgeons should aim to protect and preserve all the remaining fat and surrounding structures for optimal results. With SAFElipo, unwanted fatty tissue is removed without causing bleeding, through significantly less traumatic liposuction, and the remaining preserved fat cells are used locally in the minimally traumatized fertile bed left behind to smoothen out contour, he says. The treated areas can also be treated with fat shifting and/or fat grafting concurrently.

    "Yes, we need to remove excess fat, but preserving what we leave behind has far more benefits," Dr. Wall says. "The exciting part is that we're just beginning to understand why many of these SAFELipo results turn out so well, why many times even the skin improves, and what role the interplay of the remaining fat, adipose-derived stromal cells and the body's regenerative signals play in the remodeling that happens after surgery."

    Disclosures:
    Dr. Wall reports no relevant financial interests.

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