RSL sculpting in plastic surgery rehabilitation

Over the recent years, the concept of ERAS (Enhanced Recovery After Surgery), or fast-track surgery, has been gaining more and more popularity, and this implies the use of effective methods to accelerate postoperative recovery ^(1). It has been proven that effective and timely rehabilitation following plastic surgery minimizes consequences of tissue trauma, such as edema, bruising, algia, scarring, impaired circulation, and sensitivity ^{(2) (3).} Rehabilitation treatment of plastic surgery patients using physiotherapy is conducted both for early and late postoperative periods, taking into account the case history, the clinical picture, and the post-traumatic inflammation phase ^(4). It is also reasonable to implement physiotherapeutic procedures before the surgery itself in order to normalize blood circulation and metabolic processes in tissues.

Tissue damage causes a response, which is manifested by development of inflammatory edema, microcirculatory disorders, which leads to tissue trophic disorders.

Vessel functional disturbances are often combined with damage to the vessel wall structures and increase in the walls permeability, which inevitably results in tissue trophic disorders. In some cases, complications during the postoperative period may cause an unsatisfactory postoperative result ^{(5) (6)}.

In order to create optimal conditions for favorable postoperative tissue healing, reduce edema and associated pain, and reduce the disability period, it is necessary to implement an integrated approach to the rehabilitation treatment of such patients.

Along with widely used antibacterial and anti-inflammatory drugs, it is advisable to use hardware treatment methods. The RSL sculpting procedure performed using Beautylizer is one of the most advanced, effective, and safe procedures available. It is based on the vibration and compression effect of spheres and high-intensity red light on all skin layers, hypodermis, and also on muscles, due to which the following is achieved:

• vasodilating effect: compression and subsequent restoration of tissue volume due to its elastic properties provide vasodilation and a significant increase in microcirculation
• draining effect: rhythmic pulsation stimulates lymph flow, facilitating the removal of excess fluid
• relaxing effect: the device has a stretching effect on muscles, effectively relieving muscle spasms
• analgesic effect: exposure of the skin mechanoreceptors to vibration can significantly reduce intensity of pain
• improvement of skin mechanical properties: LED therapy is able to optimize the tissue healing process and stimulate cell turnover; it stimulates production of TGF-β by fibroblasts, which leads to the increased density of collagen and elastin fibers ^{(7) (8) (9) (10).}

A course of 3–5 procedures with a 2–3-day interval 14 days before the surgery allows achieving an optimal final result by increasing microcirculation, oxygenation, and tissue trophism (Fig. 1).

RSL sculpting can be started on the seventh day of the postoperative period to correct emerging microcirculatory disorders. Due to the pronounced vasodilating, lymphatic drainage, and inhibitory effect on sympathetic innervation of the vascular walls, perfusion in injured tissues efficiently increases, tone of various parts of the microvasculature normalizes, and venous congestion is reduced. This reduces the rehabilitation period; and the effect after surgery is visible at an earlier time (Fig. 2).

Fig. 1-2. RSL sculpting before tumescent liposuction. A - No RLS sculpting treatment. B - A course of 5 RSL sculpting procedures with a 2–3-day interval 14 days before tumescent liposuction. C - After the surgery.

To prevent formation of possible irregularities (impact on fibrosis), it is advisable to perform the technique over the period starting from the 21st–28th day after surgery. Due to the defibrosing effect, the scarring process can be controlled (Fig. 3).

Fig. 3. RSL sculpting after VASER liposuction. A - Before the surgery. B - On the 25th day after VASER liposuction. A course of 6 RSL sculpting procedures with a 2–3-day interval, started on the 5th day after the surgery.

This procedure also improves skin tone and reduces the severity of cellulite and stretch marks (Fig. 4). Light exposure improves skin elasticity by 19 percent by stimulating fibroblasts and TGF-β production, resulting in increase of collagen production ^{8, 9}. As a result of exposure, blood flow and lipolysis in underlying layers of dermis are increased. Dosed effect of local decompression and cyclic movements of the rollers on lymphatic vessels cause their expansion and increase in lymph outflow from tissues (lymphatic drainage effect). Mechanical action on underlying skeletal and smooth muscles increases the muscle tone (mechanical lifting) and peripheral vessels tone, as well as enhances venous outflow and metabolism of all skin layers.

Fig. 4. RSL sculpting after brachioplasty. A - Before the procedures. B - After a course of 12 RSL sculpting procedures with a 2–3-day interval, started on the 14th day after the surgery.

Fig. 5. RLS sculpting after abdominoplasty. A - Before the procedures. B - After a course of 15 Beautylizer massages with a 2–3-day interval, started on the 10th day after the surgery.