The role of ultrasound technology in plastic surgery.

[INTRODUCTION] The modern medical era is in part characterized by the increased availability of portable imaging devices. Ultrasound devices are used for either high-resolution non-invasive imaging or as a focused acoustic energy source capable of sculpting and shaping tissue. Given the broad scope of the field, plastic and reconstructive surgeons have the unique ability to implement and tailor the use of ultrasound in a variety of clinical situations. This article will review novel uses for ultrasound in the field of plastic surgery.

[METHODS] A systematic electronic search was performed using the PubMed database. Search terms used were "ultrasonography" or "ultrasound" and "plastic surgery". Two independent reviewers subsequently reviewed the resultant articles based on strict inclusion and exclusion criteria. Selected manuscripts were analyzed and grouped by procedure categories.

[RESULTS] 303 articles were included in the study, spanning six procedure categories. The categories included breast, head and neck, microsurgery and reconstruction, skin, aesthetic, and other innovative applications. Ultrasound imaging was shown useful in vascular mapping, dermal and adipose volumetric evaluation, and postoperative flap monitoring. As an energy source, ultrasound has been described for skin tightening, adipose tissue removal, facial rejuvenation, increased neocollagenesis, and bone healing. Reported benefits of incorporating ultrasound into routine clinical practice included promising procedural outcomes, minimal complications, comprehensive patient follow-up and quantitative anatomic evaluation of results.

[CONCLUSION] Ultrasound offers a portable and non-invasive bedside means to obtain real-time visualization of patients' anatomy, while also providing an effective, focused and safe energy source for procedures. This review highlights novel applications of ultrasonography in the hands of a modern plastic surgeon, across the entire breadth of the specialty.