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PubMedDate not supplied

Liposuction to debulk the pectoralis major myocutaneous flap.

Pectoralis major myocutaneous flaps are very useful for head and neck reconstruction. However, excess bulk in these flaps due to subcutaneous fat can be a disadvantage in oral cavity, oropharyngeal, and cervical esophageal reconstruction. A variety of surgical modifications have been tried in an effort to overcome this problem. Liposuction was proposed by a member of this research group as a means to debulk such flaps. The purpose of this fresh cadaver study was to determine what effect this procedure might have on blood supply to the skin overlying the pectoralis major muscle. Gross and histologic observations suggest that liposuction would not significantly affect the vascular perfusion of these flaps. This report represents a preliminary study previous to a clinical trial using a potentially useful technique. It is hoped by the authors that this report will stimulate others to evaluate it's possible clinical utility.

Humans↗
PubMed1996

Madelung's disease: an uncommon disorder of unknown aetiology?

A case of Madelung's disease (benign multiple symmetrical lipomatosis, Launois-Bensaude syndrome) is described. The characteristic clinical features, associations with chronic alcoholism and a review of the current literature is reported.

Alcohol Drinking↗
PubMed2000

Free fat transplantation for facial tissue augmentation.

PURPOSE: This article reviews the lipofilling technique using a fat tissue suspension obtained by manual or vacuum machine-assisted suction. PATIENTS AND METHODS: Between 1989 and 1997 14 patients were treated by lipofilling. All patients were female; 6 were treated for cheek and zygomatic area augmentation for Romberg syndrome (2 cases) and bilateral facial lipodystrophy (4 cases); 4 were treated for nasolabial fold correction, 3 for lip augmentation, and 1 for correction of systemic lupus erythematosus (LES) scars. RESULTS: Good results were obtained in the treatment of the moderate Romberg syndrome case, with 3 stages of fat tissue transplantation from the abdominal area, in the severe Romberg syndrome case that was treated with 3 stages of lipofilling after a primary surgical procedure consisting of augmentation of the zygomatic region using a composite temporal flap of calvaria bone and temporal muscle, in the 4 cases of bilateral facial lipodystrophy, and in the 4 cases of nasolabial fold correction with 3 to 4 stages of lipofilling. Poor results were obtained in lip augmentation, and bad results were obtained in correction of the LES scars. CONCLUSIONS: Using the lipofilling technique with cannulas of 3 to 4 mm in diameter and low-power manual aspiration to preserve the integrity of the fat cells, good results were achieved in 10 of the 14 patients treated. The poor results occurred in areas of reduced vascularity and high motility.

Adipose Tissue↗
PubMed2003

[An unusual risk of liposuction: liposuction of a malignant tumor. About 2 patients].

Liposuction is a simple and elegant way to treat fatty excess; it has been even used for the treatment of lipomas and some gynecomasties. The goal of this article is to present 2 patients with an unusual complication of this use: the liposuction of a malignant tumor. The first patient consulted following the liposuction of a "gynecomasty", which was in fact a breast cancer. The second was treated by liposuction for an ankle "lipoma"; it proved to be a liposarcoma. In order to avoid liposuction and dissemination of a malignant tumor, the pre-operative investigations have to search clinical peculiarities evoking the diagnosis: an unilateral "gynecomasty", irregular, hard or painless, in a 50-years-old patient, must incite the surgeon to perform a classical excision, just as a recurrent "lipoma", deeply located, voluminous or quickly extensive, situated on the limbs or in the humeroscapular area. Paraclinic investigations may be indicated; doubtful cases must be right away rejected for liposuction, and treated by a surgical excision with strict safety margins and complete anatomopathologic examination of the lesion. Liposuction has become a very useful technique for the plastic surgeon; however, we must not forget, despite of its many advantages the risk for dissemination of an unknown malignant tumor. Every surgeon must keep it in mind and prefer a surgical removal in atypical cases.

Breast Neoplasms↗
PubMed2001

EPR analysis of radicals generated in ultrasound-assisted lipoplasty simulated environment.

The generation of various radicals by application of continuous wave (CW) high-intensity ultrasound energy (HIUE) to an aqueous biologic medium containing spin traps, under conditions simulating ultrasound-assisted lipoplasty (UAL), was demonstrated by EPR spectroscopy. The addition of water- soluble antioxidants, ascorbic acid and glutathione to the wetting solution substantially reduces the levels of hydroxyl radicals in the sonicated medium. These findings provide direct evidence for the generation of cavitation in the simulated intercellular environment, corroborating previous data, and pointing out that generation of transient cavitation in clinical UAL and other therapeutic and surgical applications of ultrasound is possible. The findings indicate that the effect of transient cavitation in aqueous biologic media may be similar to the effects of ionizing radiation, and raise the question of the long-term biosafety of the use of CW HIUE in UAL. The introduction of biocompatible water-soluble antioxidants to the sonicated medium may be utilized to suppress accumulation of radicals and reduce their possible adverse effects.

Adipose Tissue↗
PubMed1998

New directions in surgical therapy.

Surgical dermatology continues to evolve rapidly. The field is blessed with a number of bright and enthusiastic young surgeons who are willing to spend to necessary time investigating new techniques. The horizon has changed dramatically over the last 5 years and promises to change even more in the years to come.

Dermatology↗
PubMed1999

The history of liposuction and fat transplantation in America.

Dermatologists have played an important role in the development of both liposuction and fat transplantation in the United States. Dermatologists were among the earliest physicians to embrace these new procedures and have been responsible for a number of breakthroughs and refinements in these techniques. Klein's development of the tumescent technique has profoundly altered the way liposuction and fat transplantation are performed. These procedures continue to be increasingly popular among dermatologic surgeons.

Adipose Tissue↗
PubMed1999

Preoperative evaluation of the liposuction patient.

Tumescent liposuction is a safe and effective procedure. It is best used in normal individuals with localized areas of adiposity and good overlying skin tone. Patients must have realistic goals and expectations. Meticulous surgical technique is essential, and care must be taken to remove the correct amount of fat in the appropriate plane. Careful patient selection following a preoperative assessment will result in a very satisfying procedure for both the patient and physician.

Adipose Tissue↗
PubMed1999

Instrumentation for liposuction.

This article presents a comprehensive review of instrumentation for liposuction. It discusses equipment for achieving anesthesia and aspirating fat. In addition, techniques for maintaining sterility, patient monitoring, and postoperative care are presented. Emphasis is made on patient safety.

Anesthesia, Local↗
PubMed1999

Anesthetic formulation of tumescent solutions.

There is no standard or official recipe for the tumescent anesthetic solutions. The actual concentrations of lidocaine and epinephrine should depend on the areas to be treated and clinical situation. This article discusses the safe usage of tumescent solutions and the proper procedures and precautions to take when mixing these solutions.

Anesthetics, Local↗
PubMed1999

Ultrasonic-assisted liposuction. Internal and external.

UAL has not provided the promised ideal of "fat dissolution without surgery." In extremely fibrous areas and second procedure liposuction, internal UAL may be a valuable tool once it is further perfected. UAL equipment continues to evolve and as it improves we hope to see a better safety profile, a mechanism for smaller entrance sites, and greater time efficiency in the procedure.

Adipose Tissue↗
PubMed1999

"Cook Weekend Alternative to the Facelift". Liposculpture of the face, neck, and jowls with laser dermal resurfacing and platysmal plication.

The "Cook Weekend Alternative to the Facelift" is a combined liposculpture and laser surgical procedure which produces excellent cosmetic results, in many cases comparable to the results of traditional surgical rhytidectomy, without the extensive surgical intervention and prolonged recovery time needed for rhytidectomy. The procedure consists of liposculpture of the face, neck, and jowls; laser resurfacing of the platysma and underside of the dermis; vaporization of subcutaneous fat; resection of a small ellipse of excess submental skin; separation of the neck septa; and plication of the platysma, with or without chin augmentation. Cosmetic results can be dramatic, and most patients return to normal activities approximately three days postoperatively.

Adolescent↗
PubMed1999

Liposuction of the arms.

Liposuction of arms when properly performed with realistic expectations is almost always a "patient pleaser." Patients routinely marvel at the degree of skin contraction that typically occurs. Before and after photos, even as early as 1 week, routinely show dramatic skin contraction when significant volumes of fat are removed although textural changes may evolve for weeks to months (Figs. 14-19). Only the lower abdomen and neck consistently obtain such profound and predictable contraction. I am convinced that historically liposuction of the arms has been performed in a substandard fashion. Inadequate fat removal will often produce irregularity and will always result in less than maximal skin contraction. As I have performed progressively larger-volume cases, the indications for brachioplasty, in my opinion, are nearly nonexistent. My present approach, except in the most extreme cases, is to initially recommend liposuction and possibly even a second liposuction prior to performing or recommending brachioplasty. Even massive arms with good skin tone will usually obtain an aesthetically pleasing result when treated properly. Massive arms with poor skin tone, however, may not. One does not "burn bridges," however, by performing liposuction alone in these questionable candidates. If brachioplasty is subsequently desirable, in spite of the major drawback of the resultant scar, it can be performed at a later date. In summary, the key concepts for maximizing the potential of liposuction of the arms are to perform thorough but gentle fat removal and to avoid immediate subdermal fat removal or trauma to the underside of the dermis.

Anesthesia, Local↗