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no significant subcutaneous fat are not appro-
priate candidates for the LANC procedure. Patient
age is not a major determining factor with regard to
successful outcomes—very good LANC results
have been obtained with patients into their late
60s.
Mild to moderate PIE is expected. Early on PIE
seems to have blunted or limited the submental/
neck tissue contouring response; however, the tis-
sue contour and cervicomental angle improve over
time as PIE gradually resolves and the skin
contracts. Early on (eg, weeks 2 through 6), weekly
lymphatic massage sessions for the LANC treat-
ment area may help reduce PIE and improve sub-
mentum/neck contour. Significant PIE may be
treated with staged escalating-dose intralesional
triamcinolone (eg, 10 mg/mL initially, gradually
moving to 40 mg/mL) beginning at post-
treatment month 1 or 2 and continuing monthly
as needed until final desired contour is achieved
or until no further tissue response is seen.
Although this approach is successful in a majority
Fig. 3.
Before (
A
,
C
,
E
) and 25 months after (
B
,
D
,
F
) photos in a 49-year-old woman after LAFC of the mid- and
lower face and LANC (percutaneous). Treatment parameters for the mid- and lower face included 3.0 mL local/
tumescent anesthetic, laser power 5.4 W, treatment speed 30 Hz, pulse energy 180 mJ, total energy delivered
400 J and 1.0- to 1.5-mL lipoaspirate. Treatment parameters for the submentum included 12.0-mL local/tumescent
anesthetic, laser power 8.0 W, treatment speed 40 Hz, pulse energy 200 mJ, total energy delivered 1000 J and
5.0-mL lipoaspirate.
Holcomb