title: Laser-assisted lipolysis for arm contouring in Teimourian grades III and IV: A prospective study involving 22 patients.
abstract: BACKGROUND
  Upper arm deformities secondary to weight loss or senile elastosis have led to an increased demand for aesthetic contouring procedures.
  
  
  OBJECTIVE
  To objectively assess whether, in Teimourian high-grade upper arm remodelling, laser-assisted lypolysis (LAL) alone could result in patient satisfaction.
  
  
  METHODS
  Between 2012 and 2013, 22 patients were treated for excessive upper arm fat (Teimourian grade III and IV) solely with LAL. The laser used in the present study was a 1470 nm diode laser (Alma Lasers, Israel) with the following parameters: continuous mode, 15 W power and transmission through a 600 μm optical fibre. Previous mathematical modelling suggested that 0.1 kJ was required to destroy 1 mL of fat. Patients were asked to complete a satisfaction questionnaire. The arm circumference was measured pre- and postoperatively. Treatment parameters, adverse effects and outcomes were recorded.
  
  
  RESULTS
  Pain during the anesthesia and discomfort after the procedure were minimal. Complications included ecchymoses and prolonged edema. The mean (± SD) arm circumference decreased 5.5±1.0 cm in the right arm (P<0.01) and 5.2±1.1 cm in the left arm (P<0.01) in grade III patients and 4.9±1.1 cm in the right arm (P<0.01) and 4.9±1.1 cm in the left arm (P<0.01) in grade IV patients. Although the circumference of both arms significantly decreased in grade III and grade IV patients, the skin tightening remained incomplete. Overall, the average opinion of treatment was poor for both patients and investigators. Of the 22 patients, only nine (41%) would recommend this treatment.
  
  
  CONCLUSIONS
  LAL for upper arm remodelling is not sufficient to ensure full skin tightening for patients with Teimourian grades III and IV upper arm deformities. A complementary surgery is mandatory for grades III and IV.
authors.affiliation: Department of Plastic & Transsexual Surgery, Burn Surgery, Hand Surgery, CHU University of Bordeaux, Centre François-Xavier-Michelet, Groupe hospitalier Pellegrin, Bordeaux;; INSERM U1189, University of Lille, France;; Department of Plastic Surgery, Hannover Medical School, University of Hannover, Germany;
authors.forename: Franck Marie
authors.initials: FM
authors.lastname: Leclère
authors.affiliation: Instituto Médico Vilafortuny, Cambrils (Tarragona);
authors.forename: Justo M
authors.initials: JM
authors.lastname: Alcolea
authors.affiliation: Department of Plastic Surgery, Hannover Medical School, University of Hannover, Germany;
authors.forename: Peter M
authors.initials: PM
authors.lastname: Vogt
authors.affiliation: Instituto Médico Láser, Madrid, Spain.
authors.forename: Javier
authors.initials: J
authors.lastname: Moreno-Moraga
authors.affiliation: Department of Plastic & Transsexual Surgery, Burn Surgery, Hand Surgery, CHU University of Bordeaux, Centre François-Xavier-Michelet, Groupe hospitalier Pellegrin, Bordeaux;
authors.forename: Vincent
authors.initials: V
authors.lastname: Casoli
authors.affiliation: INSERM U1189, University of Lille, France;
authors.forename: Serge
authors.initials: S
authors.lastname: Mordon
authors.affiliation: Instituto Médico Vilafortuny, Cambrils (Tarragona);
authors.forename: Mario A
authors.initials: MA
authors.lastname: Trelles
keywords: Arm; Arm remodelling; Brachioplasty; LAL; Laser; Laser lipolysis