I think this is in earlier clinical trial

http://www.enhanced-you.com/bodycontour ... of-lipoma/

I at least would appreciate if my lipomas were removed with liposuction through a very small incision, even if it meant that occasionally I had to have the procedure repeated. Of course I'd like there to be a non-invasive treatment but if that is not possible, then somekind of repeated liposuction could be an option.



But the treatment should be affordable.

Liposuction is an option since it leaves practically no visible scars. The scar size is only some millimeters compared to many centimeters with the traditional incision.

I think this new laser liposuction somehow liquefies the fatty tumor and it's then easier to get the fat out. This can, however, leave tumor cells behind but so can the traditional method. And I would accept a tiny liposuction scar every now and then instead of multiple big scars.

If only this treatment became widely available and affordable priced or even covered by the health insurance...

Here's the link to the study: http://www.ncbi.nlm.nih.gov/pubmed/20064183

One of the best methods is using a light speculum. Here they removed dozens with only 3 scars.

http://derm.hsl.washington.edu/wp-conte ... ipmas2.pdf

Remote incisions and a light speculum - looks promising but if it's only available at plastic surgeon the insurance won't cover it.
How long did the procedure take and are there any video for this procedure (not necessary for Lipoma) available to view?
They took out a LOT in that session - wonder how much that costed.

I don't quite understand the light speculum procedure so if someone knows better, please explain.

The article states that excisional surgery of multiple lipomas may be cosmetically unacceptable in regard to the localisation, number and length of scars created. Which is obvious since the scarring can be extensive. It also says that small keyhole incisions and squeeze delivery are in situ approaches, applicable mainly for solitary tumours in certain regions.

Many times the current excision techniques are blind and may fragment the tumour. Endoscopic procedures are time-consuming and technically demanding. Liposuction is being advocated by some authors as a cosmetically superior method for removal of large or multiple lipomas. The article states, however, liposuction is a blind and fragmenting procedure which may lead to incomplete removal of the lipomas, and it is useless in cases of firm, encapsulated lipomas or angiolipomas.

I don't get the bolded part? As far as I have understood encaplsulated lipomas can be removed via liposuction, although lipoma fractions may be left behind. This means that one should have a periodic procedure to remove new lipomas.

Then the article then states that with the use of a light speculum all tumours can be visualised and be extirpated completely. By how, is unvclear to me. It seems there are quite a big incisions made but there are only few of them. And only those closer than 20 cm of the cut can be removed. I think the distance is greater in liposuction and the cut is minimal (2-3 mm).

The article finishes that the light speculum method is less technically demanding and more time-costeffective than endoscopic procedures which is probably true but liposuction is not an endoscopic procedure.

But like I said, I don't understand the the technique so I hope someone can explain it more detailed.

Matt,

I cannot be 100% sure but i believe they insert the speculum under the skin, drive it at the lipoma, open it up and then get the lipoma out with a clamp tool or something.

Concerning encapsulated or hard lipomas they cant be removed like soft lipomas because i think it is hard to pulverize them using just vaccum so that they can pass inside the liposuction pipe.

Has anyone ever heard of cool sculpting? Its advertised in the Boston area and created by some docs at Harvard. I think its mostly used in the the abdominal region for belly fat but they somehow freeze the fat to a point where the adipose cells die and the body disposes of it. I wonder if this same technology can be used with lipomas. The same doc advertises it that did lipodisolve on me a while back. I will ask him his opinion.

http://www.doctoroz.com/videos/cutting- ... rgery-pt-1

http://www.realself.com/CoolSculpting/cost

http://health.usnews.com/health-news/bl ... ut-surgery

http://www.coolsculptingcost.com/

I read some more about SmartLipo laser liposuction.



Apparently there is no fat sucked out but instead the lipolysis is conducted with a short laser beam which breaks up or burns the surface of the fat cells instantly. The used laser beam is selective and only targets the fat cells. The liquefied fat tissue is then removed via natural pathways. Excessive amounts of fat are often removed by normal liposuction. The treatment has many other names as laser lipolysis, laser liposuction, SmartLipo lipolysis or SmartLipo liposuction.



The treatment should already be globally accepted and used all around the world. The treatment last from 30 mins to 3 hours and can be done in local anesthesia.

Prices start from € 890 for a small area.

This is interesting, it might work in tender lipomas, but will it work in the case of encapsulated lipomas?

There are some newer liposuction procedures coming out that are without putting a laser on you. Although, right now it is interesting to see the differences in preference from one country. The UK is big on [url=htp://www.getliposuction.net/vaser-lipo.html]vaser lipo[/url] while the US is all the rave with smart lipo.

http://www.realself.com/review/mountain ... le-lipomas

Any in NJ that uses this?

I think its mostly used in the the abdominal region for belly fat but they somehow freeze the fat to a point where the adipose cells die and the body disposes of it. I wonder if this same technology can be used with lipomas. The same doc advertises it that did lipodisolve on me a while back. I will ask him his opinion.

I think this is in earlier clinical trial

http://www.enhanced-you.com/bodycontour ... of-lipoma/

On that page they link to an article regarding the efficacy of laser-assisted lipoma removal. This one I could finally access. Here are some quotes from that article if anyone's interested (I hope this is permitted...):

The pulsed 1064-nm Nd:YAG laser offers two modes of action that may be of relevance in the treatment of lipoma: thermal heating (thermal effect) and optomechanical effect, represented by the shock of the laser beam against the fat cell and membrane of the lipoma. Previous studies have shown lipolytic activity, coagulation of small vessels, coagulation of the reticular dermis, and neocollagen formation in the subcu- taneous layer and dermal tissue. The action of the laser on the capsular membrane of a lipoma probably involves disruption and fragmentation, in the same manner as in adipocyte membranes. In addition, the technique allows a minimally invasive approach as small cannulas are used for subdermal laser irradiation.

The procedure was initiated following a 20-min delay to allow the diffusion of the solution and appropriate vasoconstriction. After ensuring adequate eye protection for the patient and the entire team, a cannula with an optical fiber was inserted through a 1-mm incision; thus, the Nd:YAG laser acted inside the lesion. The cannula containing the fiber was moved slowly, allowing adequate time for effective laser–tissue interaction. The laser system used was a pulsed 1064-nm Nd:YAG laser (Smartlipo; Deka, Italy and Cynosure, USA). The laser energy was delivered to the subcutaneous tissue in direct contact with the lipoma through a 300-lm fiberoptic with a 1-mm-diameter stainless steel microcannula of variable length connected to the tip of the fiber(Fig. 1). In large lipomas (more than 5 cm in diameter), a 600-lm fiberoptic with a 1.2-mm-diameter cannula was used. The equipment worked at 4–10 W in most anatomic regions according to the size, consistency, and location of the lipoma.

Before, during, and immediately after treatment, a cold gel dressing, or even an air-cooling device, was applied so as to minimize postoperative edema or discomfort and to decrease the possibility of damage or skin burning. The product of laser action was an oily solution containing fragments of cells and membrane, oil, and tumescent solution. This product was removed from the region by aspiration using a 2-mm-diameter cannula and a negative pressure of ≤ 0.5 atm (50 kPa or 350–400 mmHg). In all patients, the aspirated material was sent for histologic analysis and the diagnosis was confirmed as lipoma (not liposarcoma).

Histologic evaluation of the removed oily tissue demonstrated and confirmed the clinical diagnosis of lipoma. The major outcome of the procedure was a reduction or complete disappearance of the lipoma in 83.3% of lesions treated with a single laser session (Figs 2 and 3). Of the 20 patients treated, four relapsed partially and required additional laser treatment to the same area 2 months after the initial procedure using the same technique. One required a third surgical procedure in order to eliminate the lipoma completely. The adverse effects were mild and temporary, mainly ecchymosis and edema. No burns or skin lesions were observed. The post-surgical period was well tolerated in all subjects.

In 10 patients with 11 lipomas who underwent liposuction, complete remission was achieved in six lesions and partial remission with a reduction in size of more than 50% in five. A single patient was treated in two sessions; all other patients were treated only once. The treatment time was comparable. The adverse effects were generally mild. No infection, severe bleeding, or any other serious adverse effect was noted.

Although liposuction is usually well accepted, the inherent fibrous anatomic characteristics of lipomas represent a limitation in many cases. Small lipomas are usually difficult to treat with liposuction because of their small dimensions. The rare CD34-positive spindle cell lipoma, which can be ‘‘fat-free,’’ is not suitable for liposuction therapy. The rate of incomplete removal of lipomas has been reported to be up to 10% of tumors. Without the removal of remnants, the rate may be higher.
Using a subdermal Nd:YAG laser technique, 83.3% of lesions were treated effectively with a single session. The adverse effects were mild and temporary. The small 1–2-mm scar was well accepted in all patients. Giant lipomas are therapeutically challenging. In our series, four giant lipomas, larger than 10 cm in diameter, were treated. In such situations, the relapse rate is higher, reaching about 18% in surgically removed tumors. The opportunity to re-treat lipoma relapse using the same minimally invasive device and technique, avoiding large scars, represents a positive aspect of the use of the pulsed 1064-nm Nd:YAG laser.

I don't know how this compares to the normal liposuction, but in any case I can see the pros of this method. It would be very interesting to know about the long-term relapse rates of removed lipomas though (and also the relapse rates of this laser treatment compared to the rates with regular liposuction). But still the minimal scarring is very impressive! Hopefully this will be available soon enough (even in Europe).

caribou wrote:

I think this is in earlier clinical trial

http://www.enhanced-you.com/bodycontour ... of-lipoma/

On that page they link to an article regarding the efficacy of laser-assisted lipoma removal. This one I could finally access. Here are some quotes from that article if anyone's interested (I hope this is permitted...):

This Doctor is pretty close to where I live , I would try to get the price for SmartLipo MPX procedure.