Ultrasound-assisted lipoplasty learning curve

Ultrasound-assisted lipoplasty is currently one of the newest techniques available to aesthetic surgeons. Plastic surgery organizations have undertaken the challenge of teaching proper ultrasound techniques and protocols via a series of ultrasound task force credentialing courses. The purpose of this article is to share our learning curve experiences with this technique. Our intent is to aid others with their learning curve so that more predictable early results are obtained. Between April 25, 1997, and July 15, 1997, a total of 84 patients comprising 150 anatomic sites underwent ultrasound-assisted lipoplasty at Naval Medical Center, Portsmouth, VA. These procedures were performed by four different plastic surgeons, with most cases (n=59) and procedures (n=114) performed by the senior author (M.L.Z.). The morbidity involved with these cases was early and consisted of three seromas and one focal area of iatrogenic epidermal abrasion. Follow-up has ranged from 7 to 10 months; there are no dissatisfied patients nor any patients currently scheduled for secondary corrective procedures. Our conclusions are (1) ultrasound-assisted lipoplasty is a safe and efficacious procedure; (2) there is a steep learning curve to the procedure, which we believe involves a minimum of 30 patients and requires great attention to detail in terms of volume of infused tumescent solution, and ultrasonic aspiration times; and (3) volume for volume, morbidity associated with this procedure should be no greater than with traditional tumescent lipoplasty.