Complications from laser Endolift use: Case series and literature review

Introduction: The endolift technique has become known for using a laser beam with a 1470 nm wavelength emitted through an optical fiber inserted into the subdermal tissue with the aim of reducing subcutaneous fat and/or toning the skin through neocollagenesis. In Brazil it became popular and commonly called endolaser or endolift laser, as in addition to 1470 nm it also uses a length of 980 nm with the same therapeutic goals. Few complications have been previously reported, most of which include mild and transient erythema, edema, ecchymosis, and nerve palsy. However, the incidence of most serious cases has increased in Brazilian territory. Objective: This study aimed to describe the authors' experience through several cases of complications resulting from endolift or endolaser technique application in Br0061’zil, and which brought to light to some important complications after the procedure. Also, it brings a brief review of the world literature on the subject. Materials and methods: It was carried out exploratory research presented in a narrative review, to highlight the action of the endolift (1470 nm) or endolaser (980 nm) technique used in the treatment of aesthetic dysfunctions. The review explored scientific articles published and available in the following databases: MEDLINE (Online Medical Literature Analysis and Recovery System), PubMed (National Library of Medicine), SCIELO (Scientific Electronic Library Online), LILACS (Latin American Literature and of the Caribbean in Health Sciences), and Google Schoolar. Furthermore, it was were added to this study a series of complications cases from the using endolift/endolaser technique which happened in Brazil in a multicentric manner and developed with the use of various commercially available devices. Results: It was found that the endolift laser technique has the potential to cause important injuries during and after its use when used without suitable criteria for antisepsis, dosimetry and skin temperature controlling. The most common complications described in this study are peripheral neuropathies, burns, local infection and steatonecrosis, the latter considered the main one. However, it was also identified general complications such as hematoma, edema, hyperchromia and optic fiber breaks. Conclusion: Despite the few reports in the world literature, serious secondary complications to the use of subdermal laser using fiber optics (1470 nm and/or 980 nm) are totally possible of happening and have become common in Brazil. Therefore, deserving full attention to the adoption of appropriate application techniques to minimize such complications, among them: greater dosimetric control, adoption of appropriate instruments to better control skin temperature, and greater rigor regarding biosafety measures (mainly antisepsis) when handling the required instrument to perform the technique.