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A Comparative Multimodal Approach to Post-Inflammatory Hyperpigmentation After Energy-Assisted Liposuction: Laser

Roberta Albanese1, Federica Tomaselli1, Katarina Andjelkov2

  • 1Plastic Surgery Unit, San Carlo di Nancy Hospital, GVM Group, Rome, Italy.

Aesthetic Surgery Journal
|May 15, 2026
PubMed
Summary

Adding hyperbaric oxygen therapy (HBOT) to Q-switched Nd:YAG laser treatment significantly improves outcomes for post-liposuction hyperpigmentation. This combined approach offers enhanced efficacy for managing this common complication without increased adverse events.

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Area of Science:

  • Dermatology
  • Aesthetic Medicine
  • Regenerative Medicine

Background:

  • Post-inflammatory hyperpigmentation (PIH) is a common complication after energy-assisted liposuction, potentially impacting aesthetic results.
  • Current treatments like Q-switched Nd:YAG laser therapy often yield incomplete resolution or recurrence.
  • There is a need for adjunctive therapies to address the inflammatory microenvironment in PIH.

Purpose of the Study:

  • To investigate if hyperbaric oxygen therapy (HBOT) can enhance the effectiveness of Q-switched Nd:YAG laser therapy for treating PIH.
  • To evaluate the safety and efficacy of combining HBOT with laser therapy for post-liposuction PIH.

Main Methods:

  • A retrospective study of 186 patients with PIH after VASER-assisted liposuction was conducted.
  • Patients were divided into two groups: laser therapy alone (n=93) and HBOT followed by laser therapy (n=93).
  • PIH severity was assessed using the Post-Aspiration Hyperpigmentation Index (PAHPI) before and after treatment, with a minimum 6-month follow-up.

Main Results:

  • Both treatment groups showed significant reduction in PAHPI scores (p<0.0001).
  • The group receiving combined HBOT and laser therapy demonstrated significantly greater PIH improvement than the laser-only group (p<0.001).
  • Greater improvement was noted on the abdomen and back, while lower limbs had more residual pigmentation; increased lipoaspirated volume correlated with greater PAHPI reduction in the combined group (p<0.001).

Conclusions:

  • Adjunctive hyperbaric oxygen therapy (HBOT) significantly boosts the efficacy of Q-switched Nd:YAG laser therapy for post-liposuction PIH.
  • The combination therapy is effective and does not appear to increase adverse events.
  • This suggests HBOT is a valuable addition to standard laser treatment for managing PIH after liposuction.