Liposuction and scar placement.
A simple methodology is described that addresses liposuction procedures and the placement of scars. Natural body creases are employed to disguise scarring.
Cicatrix↗
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Ten year evolution of liposuction.
The author very briefly reviews the evolution of liposuction beginning with the pioneering work of Yves-Gerard Illouz, through the contributions of Doctors Toledo, Gasparotti, Klein, and Zocchi. This brief historical review is accompanied by cases demonstrating his experiences with these techniques.
Humans↗
Breast reduction: shortening scars with liposuction.
The authors describe a mammaplasty reduction technique they believe is safe due to modern cutaneous resection and adequate areolar nourishment. It is made possible by maintaining a large pedicule which is also versatile since it can be used on all kinds of breasts. Good results can be reproduced by other surgeons.
Adult↗
Is there any real advantage in the double-lumen cannula?
The author demonstrates one of liposuction's great problems, what he calls the "contra-vacuum," which forms inside the cannula while it is inserted under the skin. To keep liposuction effective, an ascending pressure is needed while the holes of the cannula are deep inside the tissues. The results are higher pressure, more tissue trauma, less effectiveness. To prevent these problems, the author developed a double-lumen cannula in 1983; because of a secondary tube outside it, there is no contra-vacuum formation. He presents here his experience in large liposuctions with a new cannula model, thinner than the first one, but also very effective.
Abdomen↗
Treatment of the before and after images in aesthetic surgery.
The author presents a new system of treatment using instant photographs for imaging body and facial recontouring before and after aesthetic surgery. The surgeon draws on photocopies of the photograph, blotting out in black to get a sense of reduction and adding with a white corrector to get a sense of enlargement.
Adult↗
Benefits of the rotating cannula in the treatment of lipodystrophies.
The combination of traditional suction and the use of a cannula which can achieve up to 400 rotations per minute can enable the practitioner to treat lipodystrophies at an angle of 360 degrees. The torque limitation device puts an immediate end to rotations if the cannula meets a resistance, thereby eliminating any risk of lesions to non-fatty tissues. The use of this device over a one year period has proved its efficiency in the treatment of major lipodystrophies and certain areas, which are usually considered difficult because of their density. It is of limited interest, however, in the correction of moderate, classical lipodystrophies.
Adipose Tissue↗
Morpho-histological analysis of abdominal skin as related to liposuction.
The analysis of the abdominal skin on cadavers has made it possible for the authors to evaluate the skin's regional characteristics, taking into consideration the age group to be lipoaspirated regardless of race or sex. In this way, norms are established which in the future may be used to comparatively analyze results related to the cutaneous retraction after plastic surgery lipoaspiration.
Abdomen↗
CAST liposuction of the arm improves aesthetic results.
Lipocontouring the arm has a lower degree of patient satisfaction compared to other regions since untoward sequelae such as sagging and wrinkled skin may result. Circumferential para-Axillary Superficial Tumescent (CAST) liposuction was offered as an alternative to traditional arm liposuction or brachioplasty to 59 patients. Fifty-three of 59 patients (89.9%) were satisfied or very satisfied with the procedure; six patients (10.2%) requested secondary procedures; four, further liposuction (6.8%); two, brachioplasty (3.4%). Although temporary untoward sequelae (15.3%) and minor complications (8.5%) were not infrequent and more vigorous postoperative care necessary, the final aesthetic result was rarely compromised and patient satisfaction was high.
Adult↗
Cutaneous hyperpigmentation caused by liposuction.
A wide range of sequels have been described as derived from a bad technique or a bad indication of liposuction. We present the cases of three patients who underwent a syringe liposuction of hips and lower limbs and had cutaneous hyperpigmentation as a sequel in the treated zone. We review the ethiopatogenic circumstances and their evolution.
Adult↗
Deep planed torso-abdominoplasty combined with buttocks pexy.
This new procedure was created for aesthetic purposes with the intention of creating a longer and more slender waist and at the same time treating neighboring areas. This procedure also is used to raise or change the position of a previous abdominoplasty scar. In addition it is also beneficial for treating gestation sequelae of the torso-abdominal wall, ptosis of the abdomen, vertical and horizontal enlargements of the musculoaponeurotic system, lipodystrophy, stretch marks, rhytidosis of the inguinal region, and ptosis of the external quadrant of the gluteous and the external trochanter area in one surgical procedure. It is not always necessary to apply the entire procedure to each case. The deep planed torso-abdominoplasty offers a broader selection of techniques for creating aesthetic contouring of the torso-abdominal wall, flanks, inguinal region, and outer thighs. It also creates pexy of the external quadrant of the gluteous region.
Abdominal Muscles↗
The mini rhytidectomy.
A technique is described in which superficial musculoaponeurotic system (SMAS) is plicated from the deep temporal fascia above the zygoma to the level of the earlobe. This procedure requires only an extended preauricular incision. The neck is dealt with by liposuction. This technique is ideally suited to the younger patient requesting facelift and is based on a sound understanding of the anatomy of SMAS. The outcome of 35 patients who underwent this procedure during a 3.5-year period are described. There were no cases of facial nerve paresis or hair loss. There were no cases of skin necrosis but two patients developed small hematomas and one patient complained of a stretched preauricular scar. The mini facelift leads to a satisfactory result in the younger patient requesting rhytidectomy. The technique is simple and safe and can easily be performed on an ambulatory basis. Complications are uncommon and of a minor nature.
Female↗
Should diastasis recti be corrected?
The plication of the anterior rectus sheath is a procedure that is performed by most surgeons during abdominoplasty. A main concern is whether the correction of recti diastasis is really effective and if it is stable. In order to verify the position of the rectus muscle, a CT-scan was used in 14 patients who underwent abdominoplasty with rectus plication to compare the preoperative situation of these muscles with their position 3 weeks and 6 months postoperatively. None of these patients had had previous abdominal surgery. The recti diastasis was corrected with a two-layer 2-0 Nylon suture. A dynamometer was used to measure the resistance force of the anterior aponeurosis of the rectus. In all cases the CT data shows that correction of the diastasis was achieved completely after 6 months.
Abdominal Muscles↗
Abdominal etching.
The development of blunt liposuction by Illouz [1] in 1978 ushered in a new era in body sculpting. For the first time it had become possible to dependably remove large amounts of subcutaneous fat and decrease saddlebags and bulges to provide a smoother contour. Refinements in liposuction techniques have made it possible to dramatically resculpt the subsurface plane and improve body contour virtually from head to toe -2-4-. Mark Gilliland first performed abdominal etching by removing specific grooves of subcutaneous fat to accentuate the appearance of the abdominal musculature [5-8]. We have developed a new cannula for precision etching. This technique has been used in 25 patients with good results and has resulted in only one complication, which was the result of placing one of the horizontal etching lines at the level of the umbilicus. This created an unseemly fold that is best avoided.
Abdomen↗
Submental skin: morphohistological study of interest to liposuction.
Skin study of the submental region in cadavers made possible the evaluation of its regional characteristics. Sex or race were not reported, but the age group most appropriate to liposuction was considered. In this way, the authors believed that through standards established at the time, results, as to the skin retraction in liposuction, will be able to be analyzed in a comparative form in the future.
Adipose Tissue↗
CAST liposuction: an alternative to brachioplasty.
The aging female with excess arm fat and poor skin tone frequently refuses a brachioplasty scar due to permanent detectability. Traditional deep liposuction localized to the posterolateral aspect of the arm frequently leaves sagging, wrinkled skin. Circumferential para-Axillary Superficial Tumescent (CAST) liposuction was developed to maximize skin retraction and create regional harmony by preparatory compartment magnification with dilute lidocaine and epinephrine followed by circumferential treatment of the arm and adjacent areas utilizing superficial and/or subdermal liposuction. Early CAST liposuction results in patients with moderate fat and excess skin revealed excellent skin retraction. CAST liposuction was then offered as the first of two stages to patients with excess fat and poor skin tone to avoid or shorten the brachioplasty scar. Twenty-six patients underwent CAST liposuction with 9-22 months follow up. Only two patients (7.7%) eventually required brachioplasty. Although postoperative seromas were frequent (38.5%) and preexisting skin wrinkling usually returned, the final result is acceptable to the vast majority of patients (84.6%) who refuse a brachioplasty scar.
Adult↗
Counting method of live fat cells used in lipoinjection procedures.
It has been possible to determine the number of live fat cells available in samples of aspirated fat which are going to be used in lipoinjection procedures. It has been possible to develop a technical procedure that quantifies the number of live fat cells in 1 mm of injection. Without taking into account different methods for fat injection, there is a 95% correct conclusion that it is immaterial whether the syringe or a cannula with a pump is used. However, the higher the amount of blood found in the samples being used for injection, the less amount of live fat cells found.
Adipocytes↗
Liposuction breast reduction.
All breast reductions since 1996 have been performed with only liposuction. Removal of up to 2250 ml per breast has been obtained in 45 patients, without any complications. Significant skin retraction results from a very superficial subcutaneous liposuction, with a significant volume reduction of the gland. One bilateral mastopexy was performed subsequently.
Adolescent↗
Blood loss and hematological recovery following reduction mammaplasty and dermolipectomy: a prospective study.
A study was made to assess the impact of surgery on the hematological status and postoperative hematological recovery of 75 consecutive patients undergoing either reduction mammaplasty or dermolipectomy. Blood losses were estimated the morning after surgery, measuring decreases in hemoglobin level and hematocrit, while postoperative recovery was evaluated in terms of hemoglobin level and hematocrit at 10 weeks. The postoperative hemoglobin decrease was 2.69 g%, and the hematocrit dropped 7.25%. By 10 weeks, however, the patients had recovered their preoperative values. We found no significant differences in the evolution of hemoglobin level and hematocrit during the study between reduction mammaplasty and dermolipectomy patients. A significant positive correlation between surgical piece weight and postoperative reduction in hemoglobin concentration and hematocrit was observed. Conversely, at 10 weeks, a significant but negative correlation between surgical specimen weight and hemoglobin concentration and hematocrit was recorded. The anticipated weight of the surgical piece could thus be used as a predictor of intraoperative blood loss and of the speed of postoperative recovery. Since patients with surgical resection of > 3 kg remained anemic at 10 weeks, oral iron supplements could benefit this subset of patients.
Adolescent↗