SOFT-TISSUE SHAVING COULD REVOLUTIONIZE COSMETIC SURGERY
More tests needed to determine if liposhaving puts vital nerves at risk


     CHICAGO, Oct. 19 -- A new technique called soft-tissue shaving appears 
to be more precise and less traumatic than traditional liposuction in 
removing fat during cosmetic surgery, according to an article in the October 
issue of the AMAUs Archives of Otolaryngology-Head & Neck Surgery.
     Charles W. Gross, M.D., from the University of Virginia Health Sciences 
Center, Charlottesville, and colleagues compared soft-tissue shaving and 
liposuction on fresh cadavers.  Soft-tissue shaving was later tried on 
selected patients undergoing cosmetic facial liposuction.
     They found that with soft-tissue shaving:  "The fat was cleanly shaved 
and the contour result was even, without dimpling or asymmetry."
     In soft-tissue shaving, there is an oscillating cutting blade that lies 
within a blunt cannula or tube.  The blade of the liposhaver precisely cuts 
and extracts the tissue layer by layer.  The tissue is then sucked through 
the side of the cannula.  Soft-tissue shaving can be done in an open fashion 
under direct visualization.
     In liposuction, there is a blunt cannula tip without sharp edges.  Fat 
is torn away by a back-and-forth movement.  It is then drawn out by a vacuum.  
Neurovascular structures are pushed aside by the blunt tip.  Conventional 
liposuction is done in a closed fashion which does not allow for direct 
visualization and requires more suction.
     With traditional liposuction, aesthetic complications can include 
rippling and dimpling, contour excesses and depressions, skin discoloration 
and scar tissue, asymmetry and distortion.  In addition, liposuction can 
cause swelling, pain and bruising.
     The authors write:  RThe advantages of the liposhaver include the 
precise removal of fat in a minimally traumatic manner and the ability to 
remove fat in an open fashion without high suction pressures or the need for 
a closed system.  Disadvantages include the potential susceptibility of vital 
nerves and vessels to injury by the unique characteristics; specifically, 
the oscillating cutting blade of the inner cannula...It remains to be 
determined if vital nerves or vessels in the head and neck are susceptible to 
injury by the unique characteristics of this instrumentation.
     They also write that the liposhaver instrument is currently being used 
with great success in orthopedic arthroscopic surgery for delicate 
soft-tissue joint work.  It is also increasing in popularity in sinus surgery 
as well as in the removal of polyps from the nose.
     The study cites information that liposuction is the most commonly 
performed cosmetic procedure in the United States.
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For more information on Dr. Gross's study: contact Marguerite Beck at 
804-924-5679.