Laser Resurfacing for Latin Skins: The Experience with 665 Cases.

BACKGROUND: CO2 resurfacing and CO2 microfractionated laser systems are reliable tools to improve different facial pathologic skin conditions but are associated with a high rate of complications specially in Fitzpatrick III, IV, and V skin phototypes, predominant in the Latin population, which has pushed many surgeons to change technologies and abandon its use. OBJECTIVE: To compare patient results with the CO2 resurfacing laser and microfractionated CO2 laser resurfacing in all skin types and show similar results to those obtained worldwide in patients with phototypes III, IV, and V. METHODS: Standardized review of medical records from a database of private practice patients treated since January 1998 to July 2012 with SlimE30 MiXto SX(®) CO2 laser. Evaluation of outcomes, complications, and satisfaction of three different modalities of treatment (CO2 ablative laser, CO2 microfractionated and a combination of both) was made. RESULTS: A total of 665 treated patients were included. Ablative CO2 was applied to 80.3 %, CO2 microfractionated to 15.1 %, and mixed treatment to 4.5 % of cases. Globally, hyperpigmentation rates were 30.4 % in the CO2 resurfacing group, 16.3 % when a combination of modalities was applied and 11 % in microfractionated CO2 cases. A steady increase of these rates is shown as the phototype becomes higher. Satisfaction rates were high for all groups: 86.7 % in the mixed group, 82.2 % in the microfractionated CO2, and 79.6 % in the CO2 ablative. CONCLUSIONS: Good results and an acceptable rate of complications in latin skins are obtainable after treating patients with CO2 ablative and microfractionated CO2 systems alone or in combination. Staged treatments and adequate post-procedure care reduce these complications.

Liposuction: 25 years of experience in 26,259 patients using different devices.

BACKGROUND: The development of liposuction provided plastic surgeons with a safe and effective way to sculpt the human figure. The techniques and instrumentation used in the performance of liposuction have evolved significantly since its introduction. OBJECTIVE: The authors review their experience with different liposuction techniques over the past 25 years. METHODS: Data from patients who had undergone liposuction were collected from the personal databases of four different surgeons and from the database at the Corpus and Rostrum Plastic Surgery Clinic in Cali, Colombia. A retrospective review was conducted and the results from different liposuction techniques were compared. RESULTS: A total of 26,259 patient charts were reviewed. The results showed that 5% of patients experienced a postsurgical seroma. Postsurgical fibrosis developed to some degree in 2.3% of patients. Anemia was present in 18% of all patients and in 60% of those patients who underwent dry liposuction. Ninety percent of patients reported postoperative pain. The incidence of deep vein thrombosis was 0.03%, as was the incidence of pulmonary embolism. Mortality was 0.01% and was mainly caused by pulmonary embolism. Patient satisfaction was similar for all of the described techniques. CONCLUSIONS: The incidence of anemia was reduced significantly in patients undergoing tumescent liposuction versus dry liposuction. However, the occurrence of seroma increased with the introduction of tumescent liposuction. The incidence of postoperative pain and fibrosis was similar for all liposuction techniques reviewed. The aesthetic results obtained using ultrasound- or laser-assisted liposuction were similar to those obtaining using other techniques.

Augmentation mammoplasty using the retrofascia approach.

In augmentation mammoplasty, the selection of placement for implants is based on the characteristics of each patient and the tissue conditions to ensure an optimal covering of these. The location must not be arbitrarily based on the preferences of the surgeon and the patient, but must ensure adequate tissue covering, thus minimizing shorts and long-term risks. Retromammary, retropectoral, and total and mixed retromuscular implants have been used. The retrofascia location of the mammary prosthesis reported in this article was described for the first time in the year 2000. This retrofascia technique refers to the collocation of the implant behind the fascia and in front of the pectoralis major muscle with the goal of achieving proper covering and good support of the implant. This is a nonrandomized prospective study investigated 110 cases of mammary hypoplasia and ptosis levels 1 and 2 from October 2001 to October 2002 with an average follow-up period of 1 year. Periareolar incisions were used in the retrofascia collocation of the mammary implant. The types of implants used included texturized silicone gel (85%) and smooth silicone gel (15%). As demonstrated by the findings, this surgical technique can achieve a good support to keep the prosthesis in an adequate position, maintaining the superior pole with a very natural projection. The incidence of complications was 7.6%, the most frequent of which was capsular contracture (3.53%).