Author's Reply

Sir,

Thank you very much for the comments on our recent publication in JCAS. It is a good sign that the topic has gained significant interest from the readership.

The study we performed included photographic and objective measurements as stated in the chapter on patients and methods. The standardized objective measurement of the upper arm circumference was done before treatment and in a follow-up period of 3 months. The data were analyzed using appropriate statistical tools and software to evaluate the objective and mathematical percentage of tissue retraction and the difference between the two treated groups. These data could have been documented in detail in the tables and were evaluated based on scientific and ethic criteria.

There have been investigations on subdermal laser that could not demonstrate an add-on effect of laser. In these studies, however, not only the type of laser but also the way how this energy acted in the fat was completely different from the technique and laser used in our report. It is also true that after these initial studies dated back approximately 15 years a lot of serious scientific studies were published demonstrating the evolution of tissue laser interaction and some positive effects related to tissue tightening such as neocollagen formation and coagulation of reticular dermis, and some important details regarding tissue temperature.[1–3]

Fortunately, the evolution of laser technology represented by new wavelengths and the opportunity to work with different wavelengths at the same time, and new laser sources as well as better knowledge of the laser effects in different tissues open new fields in medical science. We are sure that this development will go on.

We completely agree with the comment regarding the cost of the equipment. But it is also true that, based on the conclusion of the study, laser-assisted liposuction is an effective tool to achieve a better skin-tightening effect in the treatment of upper arms without the need of a surgical arm lift.