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At least 397 records · Page 22Linked to original sources
PubMed2004

Conventional liposuction-assisted debulking of muscle perforator flaps.

Late recontouring of the usual bulky cutaneous flap via conventional liposuction is an accepted practice and usually without fear of tissue necrosis. Muscle perforator flaps, on the other hand, initially depend only on often fragile, minuscule vessels that could readily be traumatized by any form of suction-assisted lipectomy. Single-staged muscle perforator flap debulking was thus performed with some trepidation for 8 flaps in 7 patients. All flaps ultimately remained successful, but in 2 cases obvious tissue ischemia delayed healing. It can only then be assumed that this adjunctive technique places all perforators at jeopardy for injury. Survival of the given flap may then depend solely on neovascularization from the recipient site, and that must be protected to retain pedicle independence, or otherwise flap necrosis would ensue. Thus, the timing of muscle perforator flap debulking could then be critical. Although that averaged 9.1 months (range, 3-15 months) after flap transfer in this series, the observed ischemia occurred at both ends of this spectrum.

Achilles Tendon↗
PubMed2004

TRAM flap breast reconstruction after abdominal liposuction.

The transverse rectus abdominis musculocutaneous (TRAM) flap has become the gold standard of autologous breast reconstruction. It is typically a low-risk procedure with few surgical contraindications. A relative contraindication, however, is prior liposuction of the abdomen. The contention has been that the trauma of the liposuction procedure can damage or destroy the musculocutaneous perforators that supply circulation to the TRAM flap skin paddle. The authors present 2 patients who previously underwent suction-assisted abdominal lipectomy and, after mastectomies, successfully underwent unilateral breast reconstruction using single-pedicle TRAM flaps. They also examine the literature that supports the feasibility of this procedure.

Adult↗
PubMed2003

Reductions in total body fat decrease humoral immunity.

Mounting an immune response requires substantial energy, and it is well known that marked reductions in energy availability (e.g. starvation) can suppress immune function, thus increasing disease susceptibility and compromising survival. We tested the hypothesis that moderate reductions in energy availability impair humoral immunity. Specifically, we examined the effects of partial lipectomy (LIPx) on humoral immunity in two seasonally breeding rodent species, prairie voles (Microtus ochrogaster) and Siberian hamsters (Phodopus sungorus). Animals received bilateral surgical removal of epididymal white adipose tissue (EWATx), inguinal white adipose tissue (IWATx) or sham surgeries and were injected with the antigen keyhole limpet haemocyanin (KLH) either four or 12 weeks after surgery. In prairie voles, serum anti-KLH immunoglobulin G (IgG) did not differ significantly at four weeks. At 12 weeks, serum IgG was significantly reduced in IWATx, but not EWATx animals, compared with sham-operated animals. In Siberian hamsters, both IWATx and EWATx animals reduced serum IgG at four weeks. At 12 weeks, EWATx hamsters displayed a significant compensatory increase in IWAT pad mass compared with sham-operated hamsters, and serum IgG no longer differed from sham-operated animals. There was no significant increase in EWAT in IWATx hamsters compared with sham animals and IgG remained significantly reduced in IWATx hamsters. These results suggest that reductions in energy availability can impair humoral immunity.

Adipose Tissue↗
PubMed1999

Penile elongation and thickening--a myth? Is there a cosmetic or medical indication?

Penile lengthening and thickening techniques can be performed in different ways for treatment of congenital penile hypoplasia and dysmorphophobia in terms of aesthetics or function. Particularly for penile lengthening, a combination of surgery and stretcher device is suggested. Surgery for lengthening comprises three different stages: suture with plane alternating edges of the pubo-penile skin, infrapubic lipectomy, and section of the suspensory ligament. Our approach to penile thickening differs depending on whether dysmorphophobia is related to aesthetics or function. While pericavernosal apposition of autografts is suggested in the first case, a technique developed by the authors is performed in the latter, which comprises bilateral longitudinal incision of the corpora cavernosa and enlargement of the tunica albuginea by means of saphenous grafts. The endothelial lining, which constitutes the internal surface of the veins, is highly compatible with the endothelium of the corpora cavernosa; therefore, the incidence of postoperative subareolar fibrosis and occlusive vein pathology is lower than after surgery performed with techniques using grafts of other material. The described procedure did not cause postoperative complications in terms of infection, wound healing and cosmetic appearance. All subjects resumed regular sexual activity after 4 months without any disturbance or functional limitation. Diametrical measurements at the 9-month follow-up revealed an increase of 1.1-2.1 cm. The reliability and efficiency of these procedures are strongly influenced by factors other than technical problems; however, expert diagnosis and psychological consultation in the case of dysmorphophobia will confirm and specify the indications.

Humans↗
PubMed1991

The treatment of atypical lipoma with liposuction.

Large lipomas may best be treated with liposuction. Once a lipoma enlarges to 4 cm or more, liposuction has several advantages over conventional surgery. A well-demarcated lipoma 15 cm in diameter and deep to muscle was treated by liposuction. Biopsy showed an atypical lipoma. Because the entire tumor was removed by liposuction, we feel that the prognosis is excellent. The cosmesis and morbidity results were far superior to those anticipated with conventional excisional surgery. Small superficial lipomas may be treated by suction lipectomy and the surrounding area can be contoured symmetrically at the same time, whereas large ones can be liposuctioned completely without extensive surgical extirpation and morbidity. Because such big lesions may represent atypical lipomas or liposarcomas, care must be taken to remove the entire tumor.

Adult↗
PubMed1997

Feeding patterns of S. crassicaudata (Marsupialia:Dasyuridae): role of gender, photoperiod, and fat stores.

Little is known about feeding regulation in marsupials. Sminthopsis crassicaudata is a small nocturnal marsupial, whose tail contains approximately 25% total body fat. We have characterized the effect of gender, photoperiod, food deprivation, and tail removal (lipectomy) on food intake in S. crassicaudata. Males and females maintained in captivity on long-day (LD, 16:8-h light-dark cycle) and short-day (SD, 9:15-h light-dark cycle) light regimens were studied. Feeding patterns under LD and SD photoperiods were initially measured under conditions of ad libitum food supply and then in groups of animals exposed to 24- and 36-h periods of food deprivation. Feeding occurred predominantly in the dark. Females maintained on SD photoperiods for 5 wk ate less (P < 0.005) than females on LD or males on either SD or LD, but this reduction in food intake was not associated with a decrease either in body weight or tail width. After both 24- and 36-h fasts, total food intake in the subsequent 24 h increased (P < 0.001) up to 100% in all groups, with no gender or photoperiod effect. SD females, however, ate less (P < 0.05) than LD females in the first 6 h after refeeding. Tail width decreased (P < 0.05) in all groups of animals after the 36-h fast but only in LD animals after the 24-h fast (P < 0.05). Body weight decreased similarly in all groups of animals after fasting. The effect of tail removal was studied in LD males. The procedure, which was well tolerated, resulted in an initial decrease in body weight (P < 0.005), which recovered within 3 wk. On day 45 in the animals whose tails were removed, body fat was approximately 30% greater than body fat of controls (P < 0.02). No significant increase in food intake occurred after tail removal. These data demonstrate in Sminthopsis crassicaudata 1) a photoperiod and gender-dependent effect on food intake, 2) the ability to regulate the amount and distribution of total body fat, and 3) a dissociation between the regulation of food intake and changes in body fat stores, which suggest alterations in energy expenditure.

Adipose Tissue↗
PubMed2006

Tumescent power liposuction in the treatment of the enlarged male breast.

BACKGROUND: Tumescent power liposuction is widely used on various parts of the body for minimal-access lipectomy. The undesired fat deposits are injected with tumescence fluid containing saline, epinephrine, bicarbonate and lidocaine; the latter is used as the only source of pain control. The fat is then removed using vibrating microcannulas. OBJECTIVE: To evaluate the value of tumescent power liposuction in the treatment of the enlarged male breast. METHODS: 38 male patients aged 23-64 years (mean age 39.8 +/- 9.7 years) with enlarged breasts were enrolled in the study. In 32 patients, breasts were enlarged due to fat tissue, and the ductal glands were not palpable (pseudogynecomastia). In 6 patients, the ductal glands were enlarged (gynecomastia). All patients were treated with tumescent liposuction over a 2-year period using a single entry site from the axillary fossa. Both fat as well as ductal and stromal tissue were removed by microcannulas. RESULTS: None of the patients had early postoperative complications of infection, hematoma or seroma. There were no treatment-induced asymmetries, contour deformities or irregularities. No open excision or skin reduction procedures were required. CONCLUSION: Tumescent liposuction using a single entry site in the axillary fossa is a minimally invasive technique to treat enlarged male breasts. Both fat (pseudogynecomastia in adipose patients) as well as ductal and stromal tissue (in gynecomastia) can be removed with tumescent liposuction, resulting in a high level of patient satisfaction.

Adult↗
PubMed2006

Overexpression of tissue inhibitor of matrix metalloproteinases-1 (TIMP-1) in mice does not affect adipogenesis or adipose tissue development.

In order to evaluate a potential functional role of tissue inhibitor of matrix metalloproteinases-1 (TIMP-1) in development of obesity, we studied the effect of overexpression of human TIMP-1 (hTIMP-1) in C57Bl/6J mice in vivo and in 3T3-F442A preadipocytes in vitro. Stable long-term overexpression of hTIMP-1 in mice was achieved by adenoviral gene transfer, yielding plasma levels exceeding 250 ng/ml at eight weeks after injection. Mice overexpressing hTIMP-1 and kept on a high fat diet for 14 weeks had body weights, adipose tissue weights, and adipocyte diameters that were somewhat, but not significantly, lower than those of control mice. Similar observations were made after overexpression of hTIMP-1 in mice with lipectomy of the subcutaneous adipose tissue, kept on a high fat diet for 20 weeks. In both in vivo models, blood vessels in the adipose tissues were significantly smaller after hTIMP-1 gene transfer than in control mice. Overexpression of hTIMP-1 in 3T3-F442A preadipocytes had no effect on their subsequent differentiation into mature adipocytes. Thus, overexpression of hTIMP-1 in mice had no significant effect on ongoing adipogenesis or adipose tissue development, although the blood vessel size in adipose tissues was reduced.

3T3 Cells↗
PubMed2000

Dermolipectomies following weight loss after surgery for morbid obesity.

BACKGROUND: Dermolipectomies play a major role in the functional and esthetic deformities which result from massive weight loss. METHODS: From June 1994 to June 2000, 148 morbidly obese patients underwent various bariatric surgical procedures. After at least 1 year, 33 patients underwent 51 regional dermolipectomies performed by the same plastic surgeon. RESULTS: All 33 patients underwent abdominal dermolipectomy. The average operative time was 194.2 min (110-420 min). The average amount of tissue excised was 2948.6 g (850-7525 g). 4 patients (12.1%) required blood transfusion. 6 patients (18.1%) developed complications, which included 1 case of postoperative bleeding, 3 wound infections and 2 skin dehiscences. Average length of hospital stay was 9.5 days (5-22 days). 15 of these patients (45. 4%) simultaneously underwent abdominal incisional hernia repair; in 9 (24.2%), a Gore-Textrade mark mesh was used. In 2 patients the procedure was performed under emergency conditions due to small bowel obstruction. In 2 patients, simultaneous cholecystectomy was also performed. In 1 patient, a suction-assisted lipectomy of both thighs was necessary. 7 patients (21.2%) had mammaplasty, with average operative time 175.7 min (140-210 min). In 1 of them, breast implants were placed. There was no morbidity, and the average hospitalization was 6 days (4-9 days). Flankplasty was done in 4 patients (12.1%), thigh reduction plasty in 4 patients (12.1%), and arm reduction plasty in 3 patients (9%). The average operative time was 302.5 min (160-420), 246.2 min (230-280) and 203.3 min (180-240) respectively. Average tissue excised was 1503 g (725-2400 g), 1342.5 g (1050-1550 g), and 572.6 g (400-848 g), respectively. Morbidity was related to wound infection in 1 patient, and persistent edema of the left lower extremity in another. 4 of these 18 patients required blood transfusion. Average hospitalization was 8.2 days (6-11), 8 days (7-9) and 6 days (5-7) respectively. CONCLUSIONS: Regional dermolipectomies constitute the only available treatment for deformities following massive weight loss after bariatric surgery. Based on our experience, these procedures are safe, without serious complications and with good functional and esthetic results.

Abdomen↗
PubMed1999

Dual-plane lipoplasty for the superficial and deep layers.

Two embryologically and histologically distinct layers of the subcutaneous adipose tissue were treated individually by different modalities. The authors performed ultrasound-assisted lipoplasty at the superficial layer and traditional suction-assisted lipectomy in the deep subcutaneous tissue. The ultrasound procedure allowed tissue-specific destruction of the superficial layer supported by dense fibrous networks without disrupting them. Skin retractions caused by this procedure could diminish the necessity of surgical dermolipectomy such as an abdominoplasty in moderately deformed cases. On the other hand, the traditional liposuction was performed to remove the excessive deep fat contained in the loose fibrous network in a limited area. Although the advancement of ultrasound devices and regimens has now reduced their operating times significantly, the ultrasonic lipoplasty was slower than traditional liposuction at the beginning of our procedure. In the abdominal wall, the procedure was performed only in a confined area, because the skin retractions made over the locally managed areas created a circumferential tightness around the trunk, using the nontreated area as a bridge. Confinement on the managed area prevented unnecessary blood loss and tissue destruction. It was less a matter of fat volume to remove in the superficial layer; rather, a precise application to the exact target area was required to get a more natural result. Dual-plane lipoplasty was performed for 2 years in 35 patients, mostly for the abdomen. No serious complication such as seromas or skin loss was observed in our series of patients.

Abdominal Muscles↗
PubMed1992

Problem neck, hyoid bone, and submental myotomy.

Despite significant attention to the cervical region over the last two decades, the hyoid bone has not received deserved recognition. In this report, the anatomy and role of the hyoid bone and suprahyoid muscles in cervicomental morphology are reviewed. From an analysis of cephaloxerograms on 54 patients, it was concluded that on a balanced neck, the most caudal border of the hyoid body is located at or above a line parallel to the Frankfort horizontal line passing through the most caudal border of the mandibular symphysis (menton). Of the muscles that control the position of the hyoid bone, the anterior belly of the diagastric, geniohyoid, and mylohyoid muscles pull the hyoid bone cephalad and anteriorly. The stylohyoid muscles, on the other hand, pull this bone cephalad and posteriorly, while the sternohyoid and omohyoid muscles pull it caudally. Transection of the first three muscles at their attachment to the posterior aspect of the mandible in patients with dysmorphic necks due to caudal and anterior hyoid position will allow posterior and cephalad relocation of this bone, which improves the neck contour. Sixteen patients, with an average follow-up of 27 months, have undergone this procedure, with cervicomental contour improvement in all cases. The degree of improvement ranged from 1 to 5 (5 being excellent): One patient was ranked 1, two patients were ranked 2, two patients were ranked 3, and the rest were ranked 4 or 5. One patient had overcorrection as a result of an aggressive concomitant submental lipectomy. Another patient had central depression in the submental area. None of the patients had difficulties with mandibular movement or swallowing.

Adult↗
PubMed1992

[Cutaneous retraction. Data from liposuction and other clinical procedures].

The remarkable capacity of the skin to stretch is used in the skin expander technique. In parallel, the skin is also able to retract, which is very useful for the plastic surgeon. This ability to retract may open the road for new techniques. Suction lipectomy, which allows removal of large volumes of fat without skin resection, is a privileged technique for the study of retractability characteristics. This study compares the pre and postoperative conditions in 392 cases of body liposuction and 108 cases of cervicofacial liposuctions, to determine the factors which influence skin retraction. It appears that age and the total amount of fat removed have an incidence on the time needed to obtain the final result. However the treatment site emerges as a determinant factor on the potential of the skin to retract postoperatively. In practice, the skin elasticity appears to be very different in different treatment sites, and considerable variations can even be observed between two neighbouring regions. In the neck and cheeks the skin seems considerably more retractable than in other sites, and we can trace the boundaries of the optimal retractability for the liposuction: "the golden triangle at the neck". The considerable plasticity of the skin overlying the neck contrasts with the poor ability of facial skin to retract. On the body, the skin resumes its previous form in the vast majority of patients (90%). These data, derived from a liposuction study, may be compared with other clinical observations.(ABSTRACT TRUNCATED AT 250 WORDS)

Burns↗
PubMed2003

[Plastic surgery and obesity: why, when, how?].

In this review, we describe the main surgical procedures used in the plastic surgery of obesity: lipectomies and removal of excess fat tissues after weight loss, liposuction of localised fat deposits, surgery of breast hypertrophies. The main surgical procedures, their indications, their techniques and their long-term results are described. Such surgery should be part of a coherent and structured therapeutic project, defined together with the patient. The management and follow-up should be maintained on the long term after the initial weight loss and the surgical procedure, in order to reinforce the benefit and to prevent a weight regain.

Abdomen↗
PubMedDate not supplied

[Variation of intraabdominal pressure caused by abdominoplasty in healthy women].

OBJECTIVE: To study pressure changes of the abdominal compartment during abdominoplasty in healthy women. PATIENTS AND METHODS: A prospective cohort of 14 women between 30 and 57 years old, who underwent abdominoplasty for aesthetic purposes wer included in this study. All patients were free of any associated medical disorder with a body mass index less than 30 kg/m2. The surgical procedure consisted of the plication of internal borders of the abdominal anterior rectal muscles with non absorbable sutures. Lipectomies were performed according to the flap shape and were sutured in two planes. Abdominal pressure was indirectly measured through the urinary bladder (Kron's technique). before the surgical procedure, after the plication of the aponeurotic muscle plane and after the adipocutaneous flap closure. A full written agreement was obtained from all patients before the surgical procedure. RESULTS: Average age was 39.5+/-8.06 years. The anterior rectal muscle diastasis was 6.2+/-2.17 cm and the plicature 8.0+/-2.0 cm. The basal pressure was 0.1+/-0.3 mm Hg, whereas, after the plication it increased to 4.9+/-0. 7 mm Hg. An intraabdominal pressure was of 6.56+/-1.1 mm Hg was found after the adipocutaneous closure the A significant statistical difference (p < or = 0.001) was found. We did not observe any pulmonary complication during the first 30 days following the surgical procedure. CONCLUSIONS: In our series, the closure of the adipocutaneous flaps increased the intraabdominal pressure 31%, but no pulmonary complication was observed during the follow-up period. Since intraabdominal pressure above 10 mm Hg induces hemodynamic changes and lung restriction, the increment produced after the adipocutaneous closure should be considered to prevent morbidity associated to intraabdominal hypertension.

Abdominal Cavity↗
PubMed1992

Corset platysmaplasty.

This method represents a nontraditional approach to platysma tightening in which the muscle is moved primarily in an anterior direction. A long infolded, multilayered midline seam approximates the two platysma halves into a single sheet of shaped muscle across the entire front of the neck. Vertical submandibular muscle pleats and sling sutures further refine neck contour. No muscle is resected or transected. Subplatysmal lipectomy can be done without the risk of central neck depression or laryngeal skeletonization. A bulging submandibular salivary gland can often be corrected.

Female↗
PubMed1990

[Surgical treatment of Launois-Bensaude disease. The value of liposuction].

Launois-Bensaude adenolipomatosis or Madelung's disease was described in 1898. Typically, the lipomatosis affects chronic alcoholic patients with a symmetrical distribution around the neck and occiput. The mass gradually diffuses into the scapular, deltoid, chest wall or abdominal areas. Cosmetic deformity and the difficulty of obtaining clothes, lead patients to seek surgical treatment. This surgical management (only effective treatment) has a severe tendency to haemorrhage and dissection is complicated by infiltrations of neighbouring tissue. Suction curettage lipectomy associated with classical surgical resection were performed in three patients, in different sites. Respective indications for the various techniques are studied in this paper.

Adult↗
PubMed1990

[En bloc abdominoplasty: a new, safer and more esthetic technique].

Suction abdominoplasties are associated with a number of surgical complications, mainly in obese people and diabetic patients. The aesthetic results is often spoiled by a poor equilibrium due to an incorrect distance between the "guide points" of an harmonious abdomen (e.g. min 10 cm between the pubic scar and the umbilicus). The author thinks that almost all surgical complications are induced by the extensive undermining and can be avoided by a "en bloc" resection without any undermining (the suction lipectomy of the upper flap creates a "Mesh Undermining" which is almost as efficient). A new neoumbilicoplasty described by the author can be situated in the "right position" with a good aesthetic result.

Abdominal Muscles↗