Guo Xiaoshuang, Yan Mengle, Zhao Minghao, Yu Panxi, Lu Jianjian
Craniofacial Department, Plastic Surgery Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, #33 Badachu Road, Shijingshan District, Beijing, 100144, China.
Aesthetic Plast Surg. 2025 May 27. doi: 10.1007/s00266-025-04901-0.
Radio-frequency assisted liposuction (RFAL) is a minimally invasive procedure that harnesses the subcutaneous fat and fascia for thermal skin tightening and subcutaneous tissue remodeling. It has gradually become an ancillary procedure to excisional facial surgeries, such as facelift, liposuction, and blepharoplasty. This study aims to report and summarize the complications of RFAL combination therapy.
We reported two unusual cases of temporary orbicular oculi muscle palsy, asymmetry of blinking, and opthalmospasm after transconjunctival lower blepharoplasty combined with RFAL. In addition, we performed a systematic review of the English literature on complications of RFAL combination therapy.
The bibliographic search retrieved 16 studies involving 1181 cases conducting ancillary RFAL in the face and neck and retrieved 27 studies involving 2522 cases conducting RFAL in body contouring. The overall complication rate for the RFAL procedure is 5% (range 2-10%) in the face and neck and 9% (range 5-15%) in body contouring. Periocular nerve injury has not been reported before; however, marginal mandibular neuropraxia is around 0.9% (range from 0 to 4.6%), and deep burn has been reported independently as case series. No complication of RFAL/transconjunctival lower blepharoplasty combination therapy has been reported due to a lack of relevant studies.
RFAL is an ancillary procedure for mild to moderate skin laxity with an acceptable complication rate. However, the protection of motor nerves during RFAL and transconjunctival lower blepharoplasty should always be considered. The suitable energy delivered and rational access incision ports are all necessary for a safe outcome.
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射频辅助吸脂术（RFAL）是一种微创手术，利用皮下脂肪和筋膜进行皮肤紧致和皮下组织重塑。它已逐渐成为诸如面部提升术、吸脂术和眼睑成形术等面部切除手术的辅助手术。本研究旨在报告并总结射频辅助吸脂联合治疗的并发症。
我们报告了两例经结膜下睑成形术联合射频辅助吸脂术后出现暂时性眼轮匝肌麻痹、眨眼不对称和眼球痉挛的不寻常病例。此外，我们对关于射频辅助吸脂联合治疗并发症的英文文献进行了系统综述。
文献检索发现16项研究涉及1181例在面部和颈部进行辅助射频辅助吸脂的病例，以及27项研究涉及2522例在身体塑形中进行射频辅助吸脂的病例。射频辅助吸脂术在面部和颈部的总体并发症发生率为5%（范围2 - 10%），在身体塑形中为9%（范围5 - 15%）。此前未报告过眼周神经损伤；然而，下颌缘神经失用症发生率约为0.9%（范围0至4.6%），深部烧伤已作为病例系列单独报告。由于缺乏相关研究，尚未报告射频辅助吸脂/经结膜下睑成形术联合治疗的并发症。
射频辅助吸脂术是治疗轻至中度皮肤松弛的辅助手术，并发症发生率可接受。然而，在射频辅助吸脂术和经结膜下睑成形术期间始终应考虑对运动神经的保护。合适的能量输送和合理的进针切口对于安全的手术效果都是必要的。
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