Kaye Kai O, Kästner Sonja, Paprottka Felix J, Gonser Phillipp
Center for Plastic and Aesthetic Surgery, Ocean Clinic Marbella, Av. Ramon y Cajal 7, ES-29601 Marbella, Spain.
Center for Plastic and Aesthetic Surgery, Ocean Clinic Marbella, Av. Ramon y Cajal 7, ES-29601 Marbella, Spain; Department for Otolaryngology, Head and Neck Surgery, Eberhard Karls University Tübingen, Elfriede Aulhorn Str 5, DE-72076 Tübingen, Germany.
J Plast Reconstr Aesthet Surg. 2018 Feb;71(2):171-177. doi: 10.1016/j.bjps.2017.10.024. Epub 2017 Nov 2.
Recently, water jet-assisted liposuction (WAL) was successfully applied by several other authors to remove fat and induce skin contraction in nonfacial body areas. Extending the range of indications for this new method, the authors of this article report on their first experience with its use in facial contouring, fat harvesting, and hydrodissection of the facial skin flap in rhytidectomy in a case series of 25 patients.
Twenty-five patients (median age: 56 years) had facelift surgery under sedation, and the WAL technique was used for facial contouring, fat harvesting for facial lipotransfer, and hydrodissection of the facial skin flap. Patients were monitored for discomfort during the procedure. Complications such as bleeding, postoperative swelling, and hematoma formation were observed during a 1-week follow-up period, and intensity was rated by two independent surgeons using a special grading system. Furthermore, a patient survey (FACE-Q) was performed to analyze the patients' satisfaction and perception of the postsurgical esthetic results.
The WAL technique can be applied under intravenous sedation without causing any discomfort in all treated patients [mean 1.16, standard deviation (SD) 0.31]. Intraoperative bleeding during WAL-assisted facial dissection was judged as not present at all times (mean 1.3, SD 0.32). Postoperative swelling (day 1: mean 1.82, SD 0.28; day 7: mean 1.18, SD 0.28) and hematoma formation following surgery (day 1: mean 1.58, SD 0.34; day 7: mean 1.18, SD 0.31) were judged as minor in all cases. Overall, no skin necrosis was detected. There was no need for revision surgery. More than half of our treated patients (n = 13) answered the FACE-Q questionnaire, verifying a high satisfaction rate with beneficial treatment results without the occurrence of any major complications.
The WAL technique seems to offer a safe and efficient treatment approach for facial contouring, facial fat harvesting, and simultaneous facial flap hydrodissection with only minor postoperative swelling and hematoma formation. Therefore, the authors believe that the WAL technique is a powerful and useful tool and should be used in modern facial plastic surgery.
最近，其他几位作者成功地应用水刀辅助吸脂术（WAL）在非面部身体部位去除脂肪并促使皮肤收缩。为了扩大这种新方法的适应证范围，本文作者报告了他们在25例患者的病例系列中首次将其用于面部轮廓塑形、脂肪采集以及除皱术中面部皮瓣的水分离的经验。
25例患者（中位年龄：56岁）在镇静状态下接受面部提升手术，WAL技术用于面部轮廓塑形、采集面部脂肪用于面部脂肪移植以及面部皮瓣的水分离。在手术过程中监测患者的不适情况。在1周的随访期内观察出血、术后肿胀和血肿形成等并发症，并由两名独立的外科医生使用特殊的分级系统对其严重程度进行评分。此外，进行了一项患者调查（面部整形效果问卷，FACE-Q）以分析患者对术后美学效果的满意度和认知。
WAL技术可在静脉镇静下应用，所有接受治疗的患者均未感到任何不适[平均值1.16，标准差（SD）0.31]。WAL辅助面部解剖过程中的术中出血在所有时间均被判定为完全不存在（平均值1.3，SD 0.32）。术后肿胀（第1天：平均值1.82，SD 0.28；第7天：平均值1.18，SD 0.28）以及术后血肿形成（第1天：平均值1.58，SD 0.34；第7天：平均值1.18，SD 0.31）在所有病例中均被判定为轻微。总体而言，未检测到皮肤坏死。无需进行修复手术。超过一半接受治疗的患者（n = 13）回答了FACE-Q问卷，证实了对有益治疗效果的高满意度，且未发生任何重大并发症。
WAL技术似乎为面部轮廓塑形、面部脂肪采集以及同时进行面部皮瓣水分离提供了一种安全有效的治疗方法，术后仅伴有轻微的肿胀和血肿形成。因此，作者认为WAL技术是一种强大且有用的工具，应在现代面部整形手术中使用。
