Reducing blood loss associated with lipectomy.
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This article discusses the basic concepts of the aesthetics of the ankle area, emphasizing the lower limb's proportions, and looking for the greatest proportional fineness in this area. The normal ankle is schematized as if it were a rhomboid prism whose major axis is anteroposterior, and circumferential liposuction is discussed in order to avoid reproduction of the same ankle's lipodystrophic shapes. To do so, the roundness of the ankle is divided as if it consisted of the rectangular faces of a rhomboid prism to get the anatomic and aesthetic shapes of this area. The article also discusses the details of the anesthesic infiltration, the surgical technique, and ways to avoid any damage in the noble structures when liposuction is performed in the ankle area. This technique may be applied when the orthostatic axis of the lower limbs is deflected; it can be optically corrected in the leg or aligned through exaggerated liposuction of the convex lipodystrophic areas.
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This technique or its modification (using other dyes) may play a beneficial role in other clinical scenarios where the reconstructive plastic surgeon preoperatively needs to know the integrity of vessels that are too small to image using standard angiographic techniques. In addition, flap perfusion mapping can demonstrate the pattern of skin that is physiologically perfused by the intact vessels. Knowledge of the perfusion characteristics of the tissues to be transferred before surgery may, at the least, alter the design of the tissues to be transferred and, in the extreme case, could affect the nature of the operative choice altogether.
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During the past decade, many combinations of operative techniques for abdominoplasty have evolved to suit the individual requirements of the patient. The purpose of this study was to present a safe alternative to conventional abdominoplasty for appropriate patients, namely, those with minimal skin laxity, moderate fatty tissue distribution, musculofascial diastases, and no concern for abdominal stretch marks. The procedure consists of circumferential ultrasound-assisted liposuction and direct abdominal wall plication through a periumbilical incision. Thirty-two patients were evaluated on overall patient satisfaction and complication rates, including seroma (five, 15.6 percent), major sensory loss (none), skin slough (none), skin burns (none), end hits (i.e., a small, partial-thickness, subdermal burn; one, 3 percent), and limited results (two, 6 percent). The patients expressed that avoidance of the abdominal scar and diminished recuperative time outweighed the benefit of tighter skin associated with conventional abdominoplasty. This technique may provide another avenue for appropriate contouring of the abdomen in properly selected patients.
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