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At least 451 records · Page 25Linked to original sources
PubMed1986

Free autogenous pearl fat grafts in the face--a preliminary report of a rediscovered technique.

Free autogenous fat grafts between 4 and 6 mm (the size of a pearl) have been used successfully to correct pitting acne, nasolabial folds, eyelid depressions, facial atrophy, facial wrinkles, depressed scars, and in chin augmentation. Theoretical measures taken to ensure the maximum amount of survival of donor fat include exogenous vitamin E, treatment with insulin, small size of grafts, and atraumatic antiseptic technique. Numerous supportive clinical, historical, and laboratory references are cited, dating from 1893. Considering the abundance of fat tissue available and the prolific amounts discarded during blepharoplasty, liposuction, lipectomy, and platysma cervical lift, fat should be reconsidered as the soft tissue substitute. This is a preliminary report and further study is needed.

Adipose Tissue↗
PubMed1987

Suction cannula assisted placement of traction sutures.

Many reconstructive techniques require placement of autogenous tissues or temporary implants into large subcutaneous cavities. This procedure may be facilitated by using traction sutures for their insertion. The blunt suction lipectomy cannula in turn can simplify this tedious step by providing a means to pass these sutures over long distances. The technique for this simple and time-saving procedure is described.

Humans↗
PubMed1987

Suction extraction of lipomas.

With the use of suction-assisted lipectomy techniques in treatment of lipomas, the length and number of surgical scars may be minimized. The procedure is reviewed and several clinical applications are presented. Because no long-term recurrence rates are known, caution must be exercised in recommending this procedure to the patient.

Adipose Tissue↗
PubMed1990

Parotid salivary fistula following rhytidectomy.

With the advent of suction-assisted lipectomy and superficial muscular aponeurotic system procedure for face-lift, the risk of parotid injury increases. A case of parotid salivary fistula is presented and its management discussed.

Aged↗
PubMed1976

Breast reconstruction after a radical mastectomy.

A method of breast reconstruction, following a radical mastectomy, used a tubed flap of the tissue usually discarded during an abdominal lipectomy. This places the donor scar in an unnoticeable position. After migration, maneuvers such as denuding portions for insertion and overlap, and using a wrist attachment, have been of benefit in supplying adequate cover for an implant and in recreating an anterior axillary fold. The areola and nipple are obtained from the opposite breast. When indicated, a subcutaneous mastectomy of the opposite breast and insertion of an implant there equalizes the breasts and comforts the patient.

Abdomen↗
PubMed1980

Visual criteria for success in restoring the youthful neck.

We have suggested visual criteria for achieving and assessing success in platysma cervical lift. We believe it is now possible to satisfy these criteria in most patients, even those with a low-lying hyoid. Anterior adjustment of the platysma is more important for desirable results than posterior adjustment or posterior closure alone. If present in a heavy neck, the subplatysma fat pocket must be excised. A posterior submental incision as well as a more radical submental lipectomy with platysma sling (submental neck lift) is helpful for patients who are not yet candidates for an upward lift. The cutting of the platysma and fashioning of the sling, as well as defatting, may possibly add to the longevity of the lift, but this can be ascertained only by long-term follow-up.

Adult↗
PubMed1981

Suction curettage to remove excess fat for body contouring.

We have significantly expanded the use of a lipectomy procedure which heretofore had been restricted to the removal of strictly localized excess fat deposits by curettage through a small incision. By modifying the suction curette and utilizing it for extensive body contouring, we have been successful in correcting relatively major fat deformities without causing any postoperative surgical deformities. All our results to date have been satisfactory. This procedure may be helpful to those surgeons who have been seeking a simplified method for removing excessive fat without extensive scarring. The improvement in body contour is often beyond the preoperative expectations of both the surgeon and the patient.

Adipose Tissue↗
PubMed1982

Breast reconstruction with a transverse abdominal island flap.

A rectus abdominis musculocutaneous island flap for breast reconstruction following mastectomy is presented. The vascular anatomy of the abdominal wall has been clinically studied in patients undergoing abdominal lipectomy. Cadaver dissections are shown, demonstrating the anatomy, arc of rotation, and design alternatives of the rectus abdominis flap. The surgical technique is demonstrated and representative patients are shown.

Abdominal Muscles↗
PubMed1986

Individual modifications in body contour surgery: the "limited" abdominoplasty.

Stretching of the abdominal wall and skin following pregnancy or excessive weight gain may be limited to the infraumbilical area. In these patients, abdominal repair may be accomplished with a shorter incision and without the necessity for relocating the umbilicus with its attendant visible scar. Forty patients are presented in whom excellent aesthetic repairs were effected through short curvilinear, low abdominal incisions with removal of a modest amount of excess skin. Fascial plication from pubis to umbilicus or above is facilitated by buried figure-of-eight sutures. Suction-assisted lipectomy may be employed as an adjunct. Recovery is facilitated by the reduced incision line length, reduced undermined area, and absence of tension in the midline skin incision, such as may occur in a standard abdominoplasty in which large amounts of panniculus and skin are removed with a complete repair of the abdominal wall. The limited abdominoplasty may be safely performed with ketamine-diazepam anesthesia in an office surgical center. Major complications are few and generally reflect the unpredictable nature of the elasticity of the abdominal skin.

Abdomen↗
PubMed1994

The multiplane face lift.

The technique and experience with multiplane face lift are reviewed. The multiplane face lift can be thought of as a fourth-generation rhytidectomy, combining features of the extended SMAS and deep-plane face lifts. It is felt that this lift can more adequately address the problem of the nasolabial fold and can effect better bidirectional pull. Though difficult to quantify, it is expected that this lift will produce a longer-lasting result with no greater risk of complications than the more conventional lift. The multiplane face lift also can be used safely with ancillary procedures, such as blepharoplasty, rhinoplasty, and suction lipectomy.

Female↗
PubMed1994

Nipple placement in simple mastectomy with free nipple grafting for severe gynecomastia.

Severe gynecomastia with excessive skin is difficult to treat by only periareolar excision or suction-assisted lipectomy or both. In these patients, total mastectomy and free nipple grafting may be the best option. Placement of the nipple, however, has been arbitrary. With use of 20 "aesthetically perfect" men as models, standard nipple distances were identified. The average sternal notch-to-nipple measurement was 21 cm. In addition, two consistent ratios were identified. The nipple plane was located 0.33 times the distance from the sternal notch to the pubis, and the internipple distance was 0.23 times the chest circumference. With use of preoperatively obtained measurements of the sternal notch to pubis and chest circumference, accurate nipple placement can be accomplished.

Adult↗
PubMed2000

The effect of hyperbaric oxygenation on the viability of human fat injected into nude mice.

Autologous free-fat injection for the correction of soft-tissue defects has become a common procedure in plastic surgery. The main shortcoming of this method for achieving permanent soft-tissue augmentation is the partial absorption of the injected fat, an occurrence that leads to the need for both overcorrection and repeated fat reinjection. Improving the oxygenation of the injected fat has been suggested as a means of helping to overcome the initial critical phase that occurs postinjection (when the fat cells are nourished by osmosis), increasing phagocyte activity, accelerating fibroblast activity and collagen formation, and enhancing angiogenesis. In addition, the hyperbaric oxygen-mediated decrement in endothelial leukocyte adhesion will decrease cytokine release, thereby reducing edema and inflammatory responses. The purpose of the present study was to examine the effect of hyperbaric oxygenation on improving the viability of injected fat. Adipose tissue obtained from human breasts by suction-assisted lipectomy was injected into the subcuticular nuchal region in nude mice. The mice were then exposed to daily hyperbaric oxygen treatments, breathing 100% oxygen at 2 atmospheres absolute (ATA) for 90 minutes. The duration of the administered hyperbaric oxygen therapy was 5, 10, or 15 days, according to the study group. Mice exposed to normobaric air alone served as the control group, and each group included 10 animals. The rats were killed 15 weeks after fat injection. The grafts were dissected out, weight and volume were measured, and histologic evaluation was performed. In all of the study groups, at least part of the injected fat survived, giving the desired clinical outcome. No significant differences could be found between the groups regarding fat weight and volume. Histopathologic examination of the dissected grafts demonstrated a significantly better integrity of the fat tissue in the group that received hyperbaric oxygen for 5 days (p = 0.047). This finding was manifested by the presence of well-organized, intact fat cells, along with a normal appearance of the fibrous septa and blood vessels. The worst results were found in animals treated by hyperbaric oxygenation for 15 consecutive days. An inverse correlation was found between an increased dose of the high-pressure oxygen and fat tissue integrity (r = -0.87, p = 0.076). The toxic effects of highly reactive oxygen species on fat cells might explain the failure of an excessively high dose of hyperbaric oxygen to provide any beneficial outcome. The clinical relevance of these results should be further investigated.

Adipose Tissue↗
PubMed2004

Periareolar approach for the correction of congenital symmastia.

This report elucidates the continued and relatively rare problem of congenital symmastia and its surgical repair without concomitant bilateral breast reduction. This case highlights the use of suction-assisted lipectomy techniques to address the excess fat in the presternal web and a periareolar approach for access to the intermammary space. The periareolar incision allows for the use of a concealed approach and the avoidance of a central scar that could result in hypertrophy or keloid formation, especially in this patient who is more prone to hypertrophic scarring. Furthermore, plication of the central web dermis to the sternal periosteum in a more superior position serves to not only correct the symmastia but also redrape the excess skin and restore the blunted inframammary folds.

Adult↗
PubMed2004

TRAM flap breast reconstruction: tumescent technique reduces blood loss and transfusion requirement.

The tumescent technique has been shown to be efficacious in reducing both operative and postoperative bleeding without significant deleterious side effects in suction lipectomy. In this study, the effects of the tumescent technique on postoperative complications in transverse rectus abdominis myocutaneous (TRAM) flap breast reconstruction are investigated. All women who underwent a TRAM flap breast reconstruction by the senior author (J.B.) at the Emory Clinic during the years 1990 to 1996 were pooled (n = 386). Any woman who had a preincision infiltration of 0.25% epinephrine-containing saline solution (>200 cc) around the donor site was included in the tumescent group (n = 59). Medical records were reviewed, and rates of partial flap loss, fat necrosis (> or =10 percent flap volume), flap full-thickness skin loss, donor-site complication (skin loss, hernia, or infection), and blood transfusion were determined. Group rates were compared. The infiltrated group had a significantly lower transfusion rate as compared with the control group (0.34 units versus 1.32 units, p < 0.001). The rates of partial flap loss and fat necrosis were less in the tumescent group, but not significantly (0 percent versus 4 percent, p = 0.232; and 1.7 percent versus 10.4 percent, p = 0.058). There were no significant differences in the incidence of full-thickness skin loss or donor-site complications. Donor-site infiltration before incision with a 0.25% epinephrine-containing saline solution significantly reduced the transfusion requirement in TRAM flap breast reconstruction patients without adversely affecting either breast mound or abdominal donor-site complication rates.

Abdominal Wall↗
PubMed2005

The effect of interleukin-8 on the viability of injected adipose tissue in nude mice.

Adipose tissue injection as a free graft for the correction of soft-tissue defects is a widespread procedure in plastic surgery. The main problem in achieving long-term soft-tissue augmentation is partial absorption of the injected fat and hence the need for overcorrection and re-injection. The purpose of this study was to improve the viability of the injected fat by the use of interleukin-8. The rationale for the use of interleukin-8 was its abilities to accelerate angiogenesis and attract inflammatory cells and fibroblasts, providing the injected adipocytes more feeding vessels and a well-established graft bed to enhance their viability. Human adipose tissue, obtained by suction-assisted lipectomy, was re-injected into the subcutis in the scalp of nude mice. Interleukin-8 (0.25 ng) was injected subcutaneously to the scalp as a preparation of the recipient site 24 hours before the fat injection and was added to the fat graft itself (25 ng per 1 cc of injected fat). In the control group, pure fat without interleukin-8 was injected and no interleukin-8 was added for the preparation of the recipient site. One cubic centimeter of fat was injected in each animal in both the study and control groups. There were 10 animals in each group. The animals were euthanized 15 weeks after the procedure. Graft weight and volume were measured and histologic evaluation was performed. In addition, triglyceride content and adipose cell sizes were measured as parameters for fat cells viability. Histologic analysis demonstrated significantly less cyst formation in the group treated with interleukin-8. No significant differences were found between the groups with regard to graft weight and volume or the other histologic parameters investigated. No significant differences were demonstrated in adipose cell sizes and their triglyceride content. In conclusion, less cyst formation, indicating improved quality of the injected fat, can be obtained by the addition of interleukin-8. Further studies of various dosages of interleukin-8 and their long-term effect are required before these encouraging results could be applied clinically.

Absorption↗
PubMed2003

Clinical analysis of malar fat pad re-elevation.

Primary suture suspension of the malar fat pad has been described as a safe and simple component of global facial rejuvenation. This review evaluates the efficacy and indications for re-elevation of the malar fat pad elevation. A retrospective review of the medical records of patients who underwent malar fat pad elevation was performed between 1994 and 2000. Of 472 procedures, 14 involved re-elevation of the malar fat pad. These cases were examined for complications, risks, and results. Secondary midface elevation was performed using a subcutaneous approach to the malar fat pad through a pre-hairline incision and vertical suspension of the malar fat pad to the temporoparietal fascia. The indications for re-elevation of the malar fat pad included nasolabial asymmetry, malar fat pad malposition, and malar fat pad asymmetry. Primary elevation of the malar fat was performed in 472 patients. Fourteen of these patients had suboptimal results that necessitated re-elevation of their malar fat pads. Their average age was 57.5 years. Of the 14 malar fat pad elevations, 12 included SMAS procedures, nine were combined with platysmal plication/submental lipectomy, six with forehead lift, and three with eyelid procedures. The average interval between original malar fat pad elevation and the re-elevation was 40 months. Average follow-up was 15 months. Complications were seen in five patients, with the most significant being persistent eye irritation. Two patients had some minimal scar hypertrophy, which was self-limiting. Minor preauricular skin slough developed in one patient. Restoration of the youthful position of the deep structures in patients with a previous mid-facelift was successfully achieved by re-elevating the malar fat pad in a vertical direction. Re-elevation of the malar fat pad demonstrated effective and reliable long-term results. It is appropriate in the small number of patients who require revision or improvement of midface rejuvenation using the malar fat pad suspension technique.

Adipose Tissue↗
PubMed2004

Gynecomastia: an outcome analysis.

BACKGROUND: Gynecomastia refers to the presence of femalelike mammary glands in a male. This disorder can lead to significant psychologic stress and self-consciousness. This study consists of a chart review of 174 patients treated surgically between July 1, 1976, and February 27, 2001. RESULTS: Operative procedures were excision, excision with suction-assisted lipectomy (SAL), SAL, skin excision (skin) and skin excision with SAL. Overall complication rate was 20%. No significant difference in complication rates was found between grades or procedures. Revision rates between grades were I = 10.3%, II = 14.5% and III = 34.8% (P < 0.001). In grade III, gynecomastia revision rates for excision +/- SAL was 29% and skin +/- SAL was 38.1% (P = 0.644). Of the 8 revisions in the skin-sparing procedures, 6 were revised with a scar-forming procedure. Therefore, 77% of patients with grade III gynecomastia were adequately treated with a skin-sparing procedure. CONCLUSION: Skin-sparing operations should be the initial procedure chosen for most grade III gynecomastia patients.

Adolescent↗