Related Experiment Video
Updated: May 17, 2026
Using a 1064-nm Picosecond Neodymium-Doped Yttrium Aluminum Garnet Laser for Periorbital Hyperpigmentation
Published on: May 23, 2025
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.
Background:
Post-inflammatory hyperpigmentation (PIH) is a frequent but underrecognized complication following energy-assisted liposuction and may compromise aesthetic outcomes, particularly in procedures marketed as minimally invasive and scarless. Although Q-switched Nd:YAG laser therapy is considered a standard treatment, incomplete resolution and recurrence remain common, suggesting the need for adjunctive therapies targeting the inflammatory tissue microenvironment.
Objectives:
To evaluate whether hyperbaric oxygen therapy (HBOT) enhances the efficacy of Q-switched Nd:YAG laser therapy in the treatment of post-liposuction PIH.
Methods:
A retrospective observational study was conducted on 186 patients who developed clinically relevant PIH (Post-Aspiration Hyperpigmentation Index [PAHPI] >10) after ultrasound-assisted liposuction (VASER®) between 2019 and 2024. Patients were divided into two groups: Group A (laser therapy alone, n=93) and Group B (HBOT followed by laser therapy, n=93). HBOT consisted of 20 sessions at 2 ATA for 45 minutes. PIH severity was assessed using PAHPI scores at baseline and after treatment, with a minimum follow-up of 6 months. Multivariable analyses evaluated the influence of procedural variables.
Results:
Both groups demonstrated significant PAHPI reduction after treatment (p<0.0001). However, the combined HBOT and laser group showed significantly greater improvement compared with laser alone (p<0.001). The greatest improvements were observed in the abdomen and back, while lower limbs showed higher residual pigmentation. In the combined group, a significant inverse correlation was observed between lipoaspirated volume and PAHPI reduction (p<0.001). VASER application time was not independently associated with baseline PIH severity.
Conclusions:
Adjunctive HBOT significantly enhances the efficacy of Q-switched Nd:YAG laser therapy in post-liposuction PIH treatment without increasing adverse events.
