Radiofrequency-assisted Liposuction for Arm Contouring: Technique under Local Anesthesia

BACKGROUND: Contouring of the arms that does not involve skin excision remains a difficult challenge due to the dependent nature and quality of the skin. Although brachioplasty remains effective, it requires a lengthy incision. Radiofrequency-assisted liposuction (RFAL) may improve skin retraction with a satisfactory aesthetic result without skin resection and the resultant scar. The purpose of this study is to present our experience of RFAL arm contouring under local anesthesia, detailing safety guidelines, the marking technique, operative technique, complications, third-party surgeon appraisal, and patient satisfaction survey. METHODS: Forty patients underwent RFAL under local tumescent anesthesia for aesthetic arm contouring. Postoperative patient satisfaction surveys were conducted and independent third-party surgeons were surveyed to assess improvements in contour and skin quality with preoperative and postoperative photographs. RESULTS: Complications included 1 burn near the elbow treated successfully with local wound care and 1 seroma that resolved with aspiration. The patient survey indicated that most patients had minimal or no discomfort with the injection of local anesthesia, application of radiofrequency energy, or aspiration of fat. The majority of patients were satisfied with their contouring result and degree of skin tightening. Third-party plastic surgeons found the improvement in contouring and degree of skin tightening good to excellent. CONCLUSIONS: In appropriately selected patients, RFAL arm contouring under local anesthesia represents an alternative procedure with acceptably low morbidity and high patient satisfaction. To achieve consistent results while minimizing complications, consideration to anatomic details, infiltration of the local anesthetic, and application of the radiofrequency energy must be given.