Citations

BACKGROUND: Use of cold tumescent solutions in liposuction is hypothesized to enhance vasoconstriction, potentially reducing bleeding and improving clinical outcomes. However, evidence for its efficacy in arm liposculpture remains inconclusive. PURPOSE: To compare the effects of cold (4°C) and warm (37°C) tumescent solutions on postoperative outcomes in arm liposculpture, focusing on pain, bruising, and fat emulsification quality. METHODS: This double-blinded, randomized clinical trial enrolled patients undergoing bilateral arm liposculpture. One arm was infiltrated with a cold tumescent solution and the other with a warm solution, randomly assigned. Liposuction was performed using VASER-assisted fat emulsification followed by Power-Assisted Liposuction (PAL) or conventional suction-assisted liposuction (SAL). Outcomes included pain (Visual Analog Scale) assessed at Days 1, 8, 15, and 30; bruising, and lipocrit values. RESULTS: A total of 104 arms were analyzed from 52 female participants (mean age: 39.7 years; mean BMI: 24.7 kg/m²). Pain scores were similar between groups at all time points (Day 1: Cold = 5 [2–9], Warm = 6 [2–9]; p = 0.9). Bruising areas were comparable (Cold: 40,444 mm²; Warm: 41,212 mm²; p > 0.05). Lipocrit values for Microaire and SAL techniques showed no significant differences (p > 0.05). Patients reported high satisfaction, with 78.7% "very satisfied" and 96.1% recommending the procedure. CONCLUSIONS: Cold tumescent solutions do not significantly enhance outcomes in arm liposculpture compared to warm solutions. Surgeons should exercise caution with cold solutions due to potential hypothermia risks. Further research is warranted to assess the potential long-term effects of cold tumescent infiltration.

The treatment landscape of invasive early-stage and metastatic breast cancer is evolving constantly. These NCCN Guidelines Insights focus on recent updates included in the most recent version (version 5.2025) of the NCCN Guidelines for Breast Cancer specific to workup, locoregional therapy, surveillance, and systemic neoadjuvant/adjuvant therapy recommendations for invasive, nonmetastatic breast cancer.