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Hello community. How are we today? We have Dr. Roberto Barcenas, Luis here with us

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evaluating a buttock with ultrasound to be able to see the superficial extension of biopolymers, which is a

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fairly simple protocol, but I wanted to invite Dr. Roberto so that he can tell us what works

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for him in ultrasound to plan and what technology he uses in his procedure. Doctor,

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tell us about ultrasound and about what you are currently doing in biopolymer resection in

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Colombia. Well. Hello, good afternoon. Thank you very much for the invitation. Well, uh, currently I am

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a plastic surgeon, I dedicate myself to biopolymer removal and since the ultrasound came out I have been

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implementing it in all my biopolymer surgeries, because it is a dynamic, precise and exact guide

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in real time. At least here we made a marking of biopolymers of the area,

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we located them in real time, we see the siliconomas and we see if there is involvement, both muscular, of

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soft tissues or if there is a deeper involvement. When they have already migrated to deeper planes

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we can perform all that exploration prior to surgery with the ultrasound.

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During surgery we can see the areas where we need to resect more biopolymers. As we know,

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we cannot always resect them sometimes in one surgical time. And we also use the ultrasound as a

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pre-surgical guide and as a surgical guide in the resection of open biopolymers. I also

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go accompanied by what is the X one plasma scalpel, which is the one I use, which performs all the

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cold resection. We prevent the biopolymers from melting, we avoid more

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inflammation and at the same time we also get the tissue to make less seroma and recover faster.

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Perfect. So it is important how the ultrasound gives us the ability to plan, to have

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anatomical awareness, pre-surgical and during surgery to be able to make decisions, because they

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can also do intraoperative ultrasound. Doctor Barcenas, thank you very much and I don't know if you want to

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tell us anything else about how you use the ultrasound here in the protocol that you are doing of

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our patient. Well, look, I have the Clarius L15, what I use is due to background

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history, I do the MRI images and then I reinforce with the ultrasound. Before

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surgery, both the patient standing and in the surgical position that she will go in, I do a

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marking of the area where I find more biopolymers. As we know, some are seen in this

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case. Notice that here the whole image is erased, but this is really biopolymers in the entire

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gluteal area. So if we locate in real time before the surgery, then

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we see all the planes where we have made the dissections. Here we can see that the ultrasound supports us

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to see depth and involvement of structures such as muscles, subcutaneous tissue and that

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they can reach nerve structures such as the sciatic nerve or the piriformis muscle. And with that

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we make a safer, more effective, more precise surgery and accompanied by a plasma scalpel. The

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surgery is less harmful and the recovery is much better. Suddenly it has fewer complications.

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Perfect, as always. So it is important that you standardize the ultrasound concepts and that

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you can perform your ultrasounds to plan, to guide and to solve complications, whether

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in plastic, reconstructive, microsurgery and cosmetic surgery. See you in another

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episode of Clarius and Ultrasound Tips.