Water-assisted liposuction device yields viable lipo-aspirate for fat grafting

The preservation of septal fibers and connective tissue during a liposuction procedure is instrumental in maximizing cosmetic outcomes. Body-Jet (Human Med, Schwerin, Germany) is a water-assisted liposuction (WAL) device that proves to be not only gentle on the target tissues but highly effective in yielding a viable and ready to re-inject lipo-aspirate for subsequent fat grafting procedures, offering clear advantages over other leading liposuction devices.

"The Body-Jet device is a potent yet one of the more forgiving liposuction devices currently available on the market today. The spray from the cannula is gentle on the tissues, preserving the septal fibers and vasculature, which is not only important for the viability of the tissues, but also key in minimizing adverse events often seen with traditional or laser-assisted liposuction devices," says Barry E. DiBernardo M.D., F.A.C.S., medical director of New Jersey Plastic Surgery in Montclair, N.J., and associate clinical professor in Plastic and Reconstructive Surgery at the University of Medicine and Dentistry of New Jersey.

TRADITIONAL PITFALLS Traditional liposuction devices rely on the vacuum itself to pull the cells apart and into the cannula, often yielding groups and clumps of adipocytes. Clearly, this is less than optimal for fat grafting procedures. The Body-Jet device uses a unique irrigation and aspiration technique in which the fluid injected through the cannula is actually the tumescent fluid. This high-pressure fluid separates the fat tissue from the connective tissue much more gently, simultaneously removing the fat tissue by suction.

Body-Jet's novel irrigation technique results in increased pain control, which is extremely useful when opting to perform the procedure under local anesthesia. Epinephrine added to the tumescent solution increases hemostasis and reduces bruising.

"Instead of just adding the epinephrine at the beginning of the procedure, the local anesthetic is being constantly infused and sprayed throughout the targeted tissue," Dr. DiBernardo says.

HARVEST VIABILITY According to Dr. DiBernardo, the harvest of the adipocytes is one of the major advantages of the device. The viability of the harvested adipocytes including the stem cells is high because the fat cells are not physically forced apart as with other liposuction techniques, but, instead, they are sprayed with a fluid to separate. This gentler separation decreases the torsion and trauma of the cells and the subcutaneous tissues as a whole, which results in decreased adverse events such as bruising, shortening downtime.

"Downtime is significantly less using Body-Jet. Just a few days post-procedure, patients look like they are much further ahead, in terms of less swelling and bruising, than those who undergo traditional liposuction. This is almost expected in patients who undergo a Body-Jet procedure, as there is less physical trauma to the tissues resulting from the procedure, which translates into a faster recovery time," Dr. DiBernardo explains.

LEARNING CURVES There is a learning curve with the device, and, at first, the Body-Jet technique may appear to be slower than traditional or power-assisted liposuction techniques. Dr. DiBernardo says this learning curve has very much to do with the volumes of fluid that are injected — only about 25 percent of what is normally used initially, followed by more than usual in other liposuction techniques — and it is this sheer contrast in technique which is different. Once surgeons get used to the fluid volumes and calculations, the technique is ultimately quicker.

According to Dr. DiBernardo, the Body-Jet technique can save the surgeon many steps during a liposuction procedure and, therefore, much valuable time. Even large-volume liposuction procedures are much faster because the adipocytes are directed into a sterile container and are ready to immediately re-inject for fat grafting.

"Those aesthetic surgeons interested in fat grafting procedures should try the device several times before making their final judgment, simply because the technique is so different. After pushing through the learning curve issue and the different volumes used, the final aesthetic results as well as the quality of the harvest will be self-evident. When surgeons see those two things, I think that is where their opinion is formed," Dr. DiBernardo says. Body-Jet is distributed in the United States by Eclipsemed Ltd.

DISCLOSURES:
Dr. DiBernardo is a training and research consultant for Eclipsemed Ltd.