A Comparative Multimodal Approach to Post-Inflammatory Hyperpigmentation After Energy-Assisted Liposuction: Laser Therapy With or Without Hyperbaric Oxygen.
retrospective_cohort · Level III
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- Record sourced from PubMed, PMID 42139544.
- Also identified by DOI 10.1093/asj/sjag097.
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Abstract
Post-inflammatory hyperpigmentation (PIH) is a frequent but underrecognized complication following energy-assisted liposuction and may compromise aesthetic outcomes, particularly in procedures marketed as minimally invasive and scarless. Although Q-switched Nd:YAG laser therapy is considered a standard treatment, incomplete resolution and recurrence remain common, suggesting the need for adjunctive therapies targeting the inflammatory tissue microenvironment. To evaluate whether hyperbaric oxygen therapy (HBOT) enhances the efficacy of Q-switched Nd:YAG laser therapy in the treatment of post-liposuction PIH. A retrospective observational study was conducted on 186 patients who developed clinically relevant PIH (Post-Aspiration Hyperpigmentation Index [PAHPI] >10) after ultrasound-assisted liposuction (VASER®) between 2019 and 2024. Patients were divided into two groups: Group A (laser therapy alone, n=93) and Group B (HBOT followed by laser therapy, n=93). HBOT consisted of 20 sessions at 2 ATA for 45 minutes. PIH severity was assessed using PAHPI scores at baseline and after treatment, with a minimum follow-up of 6 months. Multivariable analyses evaluated the influence of procedural variables. Both groups demonstrated significant PAHPI reduction after treatment (p<0.0001). However, the combined HBOT and laser group showed significantly greater improvement compared with laser alone (p<0.001). The greatest improvements were observed in the abdomen and back, while lower limbs showed higher residual pigmentation. In the combined group, a significant inverse correlation was observed between lipoaspirated volume and PAHPI reduction (p<0.001). VASER application time was not independently associated with baseline PIH severity. Adjunctive HBOT significantly enhances the efficacy of Q-switched Nd:YAG laser therapy in post-liposuction PIH treatment without increasing adverse events.