Cool therapyCool therapy

Key Points

NATIONAL REPORT — In the high-tech world of cosmetic surgery in which laser devices and surgical equipment become more cutting-edge every day, patients are typically sent home with astonishingly low-tech post-op tools — ice, painkillers and sometimes the herbal remedy arnica. Of course, ice melts, painkillers either wear off or pile up in the kidneys, and arnica cannot really be tweaked to be tissue specific.

The makers of a new recovery system decided there had to be a better way. Taking a cue from orthopedic and sports medicine, they developed a device to allow for the continuous delivery of cool water therapy that could be maintained at a safe and effective temperature, between 50 and 61 degrees. The device, called the AqueCool Rapid Recovery System, includes a toaster oven-sized thermo-electric cooling device and form-fitting mask outfitted with tiny microchambers through which cold water continuously circulates. Various masks suitable for cosmetic surgery procedures are available, including periorbital, mandibular and full-facial masks. Tubes connect the masks to the water cooling device for water circulation.

ANECDOTAL EVIDENCE There is currently no published data on results achieved using the device, but its maker, San Francisco-based Aqueduct Medical, Inc., says the controlled cooling helps to reduce post-operative swelling, bruising and pain, and contributes to an overall reduction in downtime. Some doctors who have used the device concur. Glenn H. Weissman, M.D., a board-certified facial plastic surgeon based in Arcadia, Calif., tells Cosmetic Surgery Times that he observed impressive results in the 12 patients who had used the system in the six weeks since it was introduced at his practice. "Patients may not have anything to compare this to, but I've been in practice for 26 years and when I compare this to what I used before, there is significant improvement in post-op comorbidities," says Dr. Weissman. "Pain, swelling and bruising are dramatically reduced from what I've seen before." Dr. Weissman says his patients appreciate the fact that the device is easier to use than ice, and the uniform exposure to the cool water is more conducive for recovery. "Ice is variable, and as it melts, it goes from cold to hot, and it requires constant attention. This, on the other hand, is consistent and continuous."

MASK VS DRESSING Conventional bandaging following facial plastic surgery might include "Q-tip" dressing, with the head wrapped in heavy cotton or gauze to deliver pressure and decrease swelling and possible bleeding. Dr. Weissman says the AqueCool masks can represent a handy alternative. "[With conventional dressing], the wrap attempts to reduce bleeding and bruising, but in doing so, it insulates the tissue. This causes heat at the surface of the skin, which, in some cases, can lead to increased bruising," he notes. "The mask removes that problem and completely obviates the need for such a heavy bandage." Malcolm Paul, M.D., a board-certified plastic surgeon practicing in Irvine, Calif., has used the device on about 20 patients and says he observed the best results when the mask was used in the jaw and neck area. "I was really impressed with the jaw and neck area results," says Dr. Paul, a clinical professor of surgery at the University of California, Irvine, Aesthetic and Plastic Surgery Institute. "In almost all of the patients, the recovery seemed faster. They looked good the very next day, rather than days later, and they had virtually no bruising or swelling."