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At least 721 records · Page 40Linked to original sources
PubMed1998

Regional dermolipectomy as treatment for sequelae of massive weight loss.

Dermolipectomy is the most important procedure for treatment of the deformities engendered by massive weight loss. It remains the only treatment for excising redundant skin. Although liposuction is useful for removing fatty deposits without traditional surgical incisions, its application is limited by the ability of the skin to contract and conform to the newly sculpted figure. Thus liposuction may serve as an adjunct when treating the sequelae of weight loss but not as a primary procedure. In response to changing expectations, reconstructive surgeons have developed increasingly ingenious and specific dermolipectomy procedures to minimize or hide scars, lessen morbidity, and enhance function. Liposuction in combination with dermolipectomy has expanded the applicability of traditional procedures to a wider variety of patients. Surgical history, patient selection, surgical planning, a spectrum of regional dermolipectomy procedures, and potential complications are discussed herein.

Dermatologic Surgical Procedures↗
PubMed1998

Liposuction: procedure for focal volume reduction and body contour remodeling.

Liposuction is the most commonly used procedure for focal reduction of body fat deposits and remodeling the body contour. The procedure consists in aspirating fat from lamellar deposits using a vacuum source connected to a cannula that is passed bluntly through fatty tissue. Adjuncts to the procedure include infiltration of solutions to aid in fat removal or to limit blood loss and the application of ultrasonic energy to lyse fat cells before suction aspiration. Surgical history, theory, procedures, indications, potential complications, and guidelines are discussed herein.

Adult↗
PubMed2005

Posttraumatic pseudolipoma: MRI appearances.

The goal of this study was to describe the MRI characteristics of posttraumatic pseudolipomas. Ten patients with previous history of blunt trauma or local surgery were investigated with MRI at the level of their deformity. The etiology was blunt trauma in eight patients and postoperative trauma in two. For all patients medical documentation, in the form of clinical history and physical examination, confirmed that a visible hematoma was present acutely at the same location following the injury and that the contour deformity subsequently appeared. All patients underwent liposuction. Preoperative bilateral MRI examinations were performed on all patients. The mean clinical follow-up was 17.8 months. MRI examinations were interpreted in consensus by two experienced musculoskeletal radiologists with attention to fatty extension (subcutaneous fatty thickness and anatomical extension), asymmetry compared with the asymptomatic side, the presence or absence of fibrous septae or nonfatty components, and patterns of contrast enhancement. Ten posttraumatic pseudolipomas were identified. Clinically, they showed as subcutaneous masses with the consistency of normal adipose tissue. Their locations were the abdomen (n=1), hip (n=1), the upper thigh (n=6), the knee (n=1), and the ankle (n=1). On MRI examinations, using the contralateral side as a control, pseudolipomas appeared as focal fatty masses without a capsule or contrast enhancement. Posttraumatic pseudolipomas may develop at a site of blunt trauma or surgical procedures often antedated by a soft tissue hematoma. Characteristic MRI findings are unencapsulated subcutaneous fatty masses without contrast enhancement.

Adipose Tissue↗
PubMed2003

Autologous stem cell transplantation for treatment of rectovaginal fistula in perianal Crohn's disease: a new cell-based therapy.

BACKGROUND AND AIMS: Rectovaginal fistulas in patients with Crohn's disease are difficult to resolve, and surgical failure is very frequent. Recent studies have shown that adult stem cells extracted from certain tissues, such as adipose tissue, can develop into different tissues, such as muscle. PATIENT AND METHODS: We report here the case of a young patient with Crohn's disease who had a recurrent rectovaginal fistula that was treated by autologous stem-cell transplantation with a lipoaspirate as the source of stem cells. RESULTS: Although Crohn's disease is the worst condition for a surgical approach in cases of rectovaginal fistula, we observed good closure. Since the surgical procedure 3 month ago the patient has not experienced vaginal flatus or fecal incontinence through her vagina. Thus our treatment seems to be effective. CONCLUSION: Cell transplantation to overcome healing problems is a new surgical tool, and careful evaluation of this new modality may provide an opportunity to define a new era in the treatment of surgical challenges associated with healing disorders. Ethical and safety items do not seem to be critical problems using autologous stem cells.

Adult↗
PubMed2004

[Surgical reduction of fat surplus leading to pulmonary embolism].

Surgical reduction of fat surplus is usually performed on healthy individuals and is reported as a safe procedure as it is not associated with a lethal outcome. Due to the anticipation of peri- and postoperative bleeding as a result of the large wound area, which may have a negative influence on the cosmetic result, patients often receive no or only inadequate anticoagulation. We report three cases in which surgical reduction of fat surplus led to sudden collapse and cardiac arrest. In all of our patients, fatal pulmonary embolism was the cause of cardiac arrest. These patients received only inadequate or no anticoagulation. Early postoperative mobilization, elastic stockings and compressive wound-dressing did not prevent pulmonary embolism. In addition to early postoperative mobilization of the patient and even though there is a risk of perioperative bleeding complications, the use of anticoagulation is highly recommended in surgical procedures like abdominoplasty or dermolipectomy. If sudden dyspnea, chest pain, collapse or cardiac arrest occurs after surgical interventions like these, pulmonary embolism should be considered and further diagnostic steps should be initiated.

Abdomen↗
PubMed2005

[The metabolic syndrome: effects of a pronounced weight loss induced by bariatric surgery].

The prevalence of obesity is rising worldwide dramatically, affecting up to 50 percent of the population. The epidemic of obesity leads to a marked increase in the metabolic syndrome, a cluster of cardiovascular risk factors characterized by visceral obesity, insulin resistance, low HDL-Cholesterol, hypertriglyceridemia, and a subclinical proinflammatory state. In the last years, the NCEP and the WHO highlighted and defined the key features of the metabolic syndrome to facilitate the clinical diagnosis and preventive interventions. The conservative therapy of obesity and the metabolic syndrome by life style intervention and pharmacological interventions leads only to moderate weight loss with inconstant long-term success. Intervention by bariatric surgery can serve as a model for the metabolic effects of permanent weight loss. In several studies the pronounced weight loss induced a reduction of almost all components of the metabolic syndrome, including glucose and lipid status and is followed by an improvement in the quality of life. Recent research suggested a decrease in mortality rate in addition to cost effectiveness of bariatric surgery.

Bariatrics↗
PubMed1992

The treatment of bulimia nervosa following surgery using a stimulus control procedure: a case study.

This single case report describes the treatment of a 35-year-old female, who was diagnosed as suffering from severe bulimia nervosa. Of interest were the frequent vomiting episodes which did not exist prior to two surgical operations performed on the client in order to reduce her overall body weight. The treatment, a stimulus control procedure, which spanned 20 sessions, lasted about 24 weeks and was deemed successful after a year follow-up. Of primary importance was the self-management aspect of the treatment program, which emphasized minimum therapist intervention. In addition, there was a complete absence of "cognitive components" deemed necessary by some authors for the long-term treatment success of bulimics. Different factors relating to the success of this treatment program are also reviewed.

Adult↗
PubMed1989

Liposuction in the treatment of lymphoedema; a preliminary report.

Liposuction was used in the treatment of primary and secondary lymphoedema in 19 patients. Seven patients had no previous surgical treatment and 12 had previously been treated with microlymphaticovenous anastomoses and/or surgical reduction. There was subjective improvement in 11 of the 13 patients available for follow-up. There was objective improvement in 10 of the 11 patients with unilateral lymphoedema, with an average reduction of 23% of the excess volume. Seven of the 13 patients were on conservative treatment prior to liposuction. The average reduction in this group was 20.5%. The average follow-up time was 9.5 months. From this preliminary report it can be concluded that liposuction, either as a primary procedure or as an adjunct, can be a useful procedure in the treatment of both primary and secondary lymphoedema.

Arm↗
PubMed1993

Abdominoplasty in paraplegic patients.

Obese paraplegics can suffer discomfort when they lie in a prone position and site in wheelchairs. Two paraplegic cases who underwent abdominoplasty to eliminate such complaints are presented, with satisfactory results.

Abdominal Muscles↗
PubMed1993

Extravasation injuries.

The leakage of cytotoxic drugs, intravenous nutrition, solutions of calcium, potassium, bicarbonate and even 10% dextrose outside the vein into which they are delivered is known not only to cause skin necrosis but also to precipitate significant scarring around tendons, nerves and joints. In this review of 96 patients with extravasation injuries seen between 1987 and 1992 at St Thomas' Hospital, Mount Vernon Hospital and The Hospital for Sick Children, Great Ormond Street, several patients required extensive reconstruction and in some, despite this, extravasation injury has rendered a limb virtually useless. Two techniques, liposuction and saline flushout, are described to remove extravasated material while conserving the overlying skin. Analysis of flushout material confirmed that the extravasated material was actually being removed. Forty four of the study group in whom noxious materials were known to have extravasated underwent such early treatment. The results in this group were quite striking--the majority (86%) healed without any soft tissue loss at all. The early referral and treatment of extravasation injuries is, therefore, recommended.

Adolescent↗
PubMed1993

Early experience with the Lejour vertical scar reduction mammaplasty technique.

Over a 19-month period 25 bilateral reduction mammaplasties were performed using the Lejour technique. Results were assessed retrospectively. The mean follow-up was 12 months. The study showed that minor complications were common (40%), that nipple-areolar sensation was frequently reduced and that minor revision surgery for persistent dog-ears was often necessary (20%). Comparison with complications and revision rates in a similar group of patients who had undergone reduction mammaplasty using an inferior pedicle technique showed remarkably similar results. The positive findings of the current study were that nipple-areola necrosis was not encountered, patient satisfaction was high and the aesthetic results were generally good.

Adolescent↗
PubMed1991

Simultaneous orthognathic surgery and cervicomental liposuction. Clinical and survey results.

Adjunctive soft tissue surgical procedures to enhance facial esthetics can be performed simultaneously with orthognathic surgery. Submental-submandibular liposuction was performed with orthognathic surgical procedures in 22 patients from April 1989 to May 1990. Patients ranged in age from 18 to 48 years. Fourteen patients had submental and eight patients had both submental and infralobular incisions. The average estimated amount of fat removed was 40 to 50 cc. In this series of patients there was a marked improvement in facial esthetics. Liposuction created greater definition of the submandibular region and a more distinct jawline, with an improved cervicomental angle. Patients appeared younger. No significant complications occurred, and patient satisfaction was high. A survey of oral and maxillofacial surgery training programs in the United States was conducted to determine experiences with liposuction. Survey results are presented. Our survey results are consistent with our clinical experiences with this procedure.

Adolescent↗
PubMed1994

Subureteric lipoinjection for vesicoureteral reflux in renal transplant candidates.

OBJECTIVE: Vesicoureteral reflux is a risk factor predisposing to infection after renal transplantation. Endoscopic correction of vesicoureteral reflux, a minimally invasive therapy, has been increasingly used with encouraging results. Although recent reports have described the successful use of Teflon paste in the endoscopic treatment of reflux, the choice of the material to be used is controversial. There is a need for finding an ideal substance for endoscopic injection for a simple and safe treatment of reflux. METHODS: Based on the good results of autologous lipoinjection in other situations, we performed lipoinjection for vesicoureteral reflux in 12 renal transplant candidates. There were 10 female and 2 male patients with grade III reflux or higher, accounting for 17 ureters treated by endoscopic lipoinjection. Voiding cystourethrography was performed in the operating room immediately after the procedure and again three months later. RESULTS: In 2 patients (16.2%) there was reduction of the grade of reflux, including the unique ureter that stopped refluxing. In the remaining 10 patients (83.3%) there was no change in the grade of reflux. CONCLUSIONS: These results suggest that although simple and attractive, lipoinjection alone is not a good alternative for endoscopic correction of vesicoureteral reflux.

Adipose Tissue↗
PubMed1995

[Systemic amyloidosis in the elderly: diagnostic value of the test of subcutaneous abdominal fat and the labial salivary glands. Prospective study in 100 aged patients].

Primary and secondary amyloidosis are not uncommon in aging but the diagnosis is rarely made on account of the risk of bleeding in the site of biopsies and the difficulty to distinguish senile from systemic amyloidosis on the biopsy samples. We have studied the frequency of amyloid deposition in the abdominal fat aspirate (AFA), the labial salivary gland (LSG), the temporal arteries (four cases), bone marrow (two cases), digestive tract (four cases) in 100 elderly patients (aged 80 or greater). AFA was positive in 15 percent of the patients and LSG in 5%; both samples were positive in 4%. Four cases of systemic amyloidosis were found (two of the AL and two of the AA type). Sensitivity of AFA was 75%, specificity was 87% and the positive predictive value was 20%. The values were respectively 100%, 99%, 100% for LSG. In 11 patients whose AFA biopsies samples were singly positive, amyloid deposits were found in temporal arteries in four of four cases. We conclude that AFA is too sensitive for the diagnosis of systemic amyloidosis in aging. The responsibility of senile amyloid deposition on AFA should require further investigations. LSG biopsies seem to be a more reliable test for the diagnosis of primary and secondary amyloidosis in elderly.

Abdomen↗
PubMed1994

Tumescent technique in cervicofacial rhytidectomy.

The tumescent technique of local anesthetic administration was originally spawned by the desire to facilitate full-body, large volume liposuction in a safe and efficient outpatient manner. The numerous advantages of this technique are readily applied to cervicofacial rhytidectomy. The method described creates an essentially bloodless field via hydrodissection with overall decreased surgical morbidity secondary to the decreased necessity of sharp surgical dissection.

Anesthesia, Local↗