"Cook Weekend Alternative to the Facelift". Liposculpture of the face, neck, and jowls with laser dermal resurfacing and platysmal plication.

The "Cook Weekend Alternative to the Facelift" is a combined liposculpture and laser surgical procedure which produces excellent cosmetic results, in many cases comparable to the results of traditional surgical rhytidectomy, without the extensive surgical intervention and prolonged recovery time needed for rhytidectomy. The procedure consists of liposculpture of the face, neck, and jowls; laser resurfacing of the platysma and underside of the dermis; vaporization of subcutaneous fat; resection of a small ellipse of excess submental skin; separation of the neck septa; and plication of the platysma, with or without chin augmentation. Cosmetic results can be dramatic, and most patients return to normal activities approximately three days postoperatively.

"Three-dimensional tumescent liposculpture" of the abdomen, waist, and flanks.

Treating the entire area as a cosmetic unit is the best approach to tumescent liposculpture of the abdomen, waist, and flanks. This "Three-Dimensional Tumescent Liposculpture" procedure is performed under tumescent local anesthesia with optional intraoperative external ultrasound. Areas treated are the abdomen, waist, flanks, and infrascapular fat pad if indicated. Postoperatively, patients show a flatter abdomen, a smaller and better-defined waist (the "Cook waist"), reduction of unsightly bulges, and a smoother, better proportioned and more attractive overall contour. Patient recovery is rapid with minimal complications.

Laser neck and jowl liposculpture including platysma laser resurfacing, dermal laser resurfacing, and vaporization of subcutaneous fat.

BACKGROUND: Submental tumescent liposculpture alone is not able to achieve the results of rhytidectomy. OBJECTIVE: To improve the results of submental tumescent liposculpture new laser techniques were developed to provide maximum cosmetic results with minimal disability and rapid recovery. METHODS: Extensive tumescent liposculpture of the lower face, jowls, neck, and subplatysma was performed on 100 patients. Platysma fascia and undersurface of the dermis of the neck were laser resurfaced. Septae and platysma insertions were separated. Subcutaneous fat was laser vaporized. Platysma muscle was plicated. Where indicated, a chin implant was inserted. RESULTS: Clinical results far superior to tumescent liposculpture alone included improved cervico-mental angle and marked reduction in laxity of the neck skin, platysma banding, and horizontal neck creases. Patients recovered rapidly with minimal to no bruising, scarring, or pain. CONCLUSION: Laser neck and jowl liposculpture produces superior results to standard submental tumescent liposculpture with no increase in recovery time and no complications to date.

Utilizing external ultrasonic energy to improve the results of tumescent liposculpture.

BACKGROUND: External ultrasound has been used safely for many years for therapy and diagnosis by multiple medical specialists. It has also been utilized safely to treat postoperative swelling after liposculpture. Recently, internal tumescent ultrasonic liposculpture has been introduced. Since internal and external ultrasonic devices utilize injected fluid to create an environment in the fat that efficiently transmits sound waves, it seemed logical that external ultrasound incorporated with tumescent liposculpture would be successful. This study was designed to compare tumescent liposculpture combined with external ultrasound with tumescent liposculpture alone. OBJECTIVE: A side-by-side comparison of the results of tumescent liposculpture combined with external ultrasound versus tumescent liposculpture alone was performed. METHODS: Thirty patients were infused with therapeutic amounts of tumescent solution to achieve anesthesia and vasoconstriction in the areas to be treated. External ultrasound was then applied to one-half of the areas to be treated in a randomized fashion. Either the left side or the right side of the body was treated with ultrasound. Liposculpture was then performed using a variety of cannulas. Evaluations were made of the temperature of the tissues, the ease of cannula movement by the surgeon, and the time of performing the technique in each area. Postoperatively, the amount of bruising and swelling were evaluated, as was the discomfort of the patient. RESULTS: Clinical assessment results revealed that external ultrasound combined with tumescent liposculpture was easier for the surgeon, requiring less physical effort with less operating time, and less bruising, swelling, and discomfort for the patient postoperatively. CONCLUSIONS: External ultrasound combined with tumescent liposculpture produced significant doctor and patient benefit both operatively and postoperatively. Ongoing studies are currently being performed to evaluate higher wattage ultrasonic units.