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At least 37 records · Page 2Linked to original sources

PubMed1997

Standardization in photography for body contour surgery and suction-assisted lipectomy.

Despite the existence of basic clinical standards in plastic surgery, specific guidelines for body contour photography have not been detailed previously. In this report we propose standard and supplemental views for positioning of the subject for suction-assisted lipectomy and body contour surgery. Also demonstrated are specialty views for the face, where liposuction has become an integral component of the procedures. Finally, recommendations for photographic documentation of skin "textural" changes and "cellulite" improvement with liposuction, as well as regions requiring lipectomy, are discussed. A professional photographic studio and a model were utilized. Proper lighting, equipment, and backgrounds are described to achieve such standards. General principles for clinical photography are reviewed. We present standard and supplemental views for suction-assisted lipectomy and body contour surgery, with an emphasis on methods to address advanced liposuction techniques (i.e., superficial suction lipectomy) that may affect texture and contour of the skin. These techniques provide consistency for all practitioners, allowing comparison of results and techniques.

Female↗

PubMed1998

Effect of lipectomy on growth and development of hyperinsulinemia and hyperlipidemia in the Zucker rat.

The Zucker fat rat inherits obesity and hyperinsulinemia, exhibits insulin resistance, and is, therefore, a model of adult onset, or type II, diabetes. The purpose of this study was to determine if excision of fat depots from the infant Zucker (fa+/fa+) rat would affect growth, fat cell number, hyperinsulinism, and hyperlipidemia. In the experimental design, 10 percent of the total body weight (inguinal and interscapular depots) was excised at 6 weeks of age from 18 fat and 18 lean (fa+/fa-) litter mates, with 18 fat and 18 lean rats serving as nonoperated controls. At intervals, serum glucose, insulin, cholesterol, and triglycerides were measured. Initially, the operated fat group was significantly (p < 0.01) lighter than the nonoperated group. By 9 weeks postoperatively, the operated fat rat group had regained weight and continued to grow at the same rate as the nonoperated fat rats because of intra-abdominal fat depots. Lipectomy had no effect on growth rate of the lean rat group. Although lipectomy caused no consistent change in serum glucose or insulin levels, it caused a significant decrease in lipid levels. For example, the operated fat rats had a reduction in cholesterol from 876 to 171 mg/dl by 15 weeks postoperatively, and serum cholesterol persisted at about 50 percent of the nonoperated group throughout the rest of the study (38 weeks postoperatively). Even a greater reduction in triglyceride levels occurred, for example, from 7415 to 1082 mg/dl at 24 weeks postoperatively. Lipectomy did not cause a change in lipid levels in the lean group. It is concluded that the lipectomy in the Zucker fat group is an excellent model to evaluate the effects of changes in fat cell number on lipid metabolism.

Adipose Tissue↗

PubMed1996

Photoperiod-dependent fat pad mass and cellularity changes after partial lipectomy in Siberian hamsters.

Long day (LD)-housed Siberian hamsters show compensatory mass increases in nonexcised white adipose tissue (WAT) after partial lipectomy, whereas hamsters exposed to short days (SDs) for 22 wk do not. The purpose of this experiment was to determine the cellularity changes underlying lipectomy-induced WAT compensation and whether the duration of SD exposure affects this compensation. Male Siberian hamsters were epididymal (E) or inguinal (I) WAT lipectomized (x) or sham-lipectomized (Sham) and either remained in LDs or were transferred to SDs and killed 6 or 12 wk later. In LDs, lipectomized hamsters showed compensatory mass increases in retroperitoneal WAT (RWAT) due to hyperplasia. IWAT mass also was increased by approximately 40% in LD-housed EWATx hamsters because of nonsignificant increases in adipocyte size and number at weeks 6 and 12, respectively. SD-housed hamsters responded to lipectomy by delaying the SD-associated body fat loss so that RWAT mass was reduced only one-third as much in lipectomized as in Sham hamsters, and the IWAT adipocytes of EWATx hamsters were larger than in Sham hamsters at week 6. At week 12, there was little indication of fat pad compensation by SD-housed hamsters. Collectively, the results of the present experiment and our previous study (16) suggest that the inhibitory effect of SDs on fat pad compensation after lipectomy increases with prolonged SD exposure.

Adipose Tissue↗

PubMed1993

Circulation of blood and viability after blunt suction lipectomy in pig buttock flaps.

Bilateral buttock flaps were raised in 13 Yorkshire pigs, and the viability and superficial blood flow were assessed by injection of fluorescein and laser Doppler flowmetry. One flap was then chosen at random from each pig to be defatted by blunt suction lipectomy. The opposite flap served as the control. Five and 30 minutes after lipectomy, the experimental flaps showed a 31% and 37% decrease in laser Doppler values (p < 0.05 and p < 0.01, respectively), measured 6 cm proximal to the margin of the fluorescein dye. There was no reduction in the values in the controls. One week after liposuction, the median area of flap necrosis in treated flaps was 4,615 mm2 (range 735-6,748) and in controls 4,104 mm (1,576-5,879). This difference was not significant (p = 0.24). Blunt suction lipectomy of the skin flaps did not significantly decrease the viability. The decreased skin circulation shown by laser Doppler soon after lipectomy may be a minor or temporary phenomenon.

Animals↗

PubMed1985

Reduction suction mammoplasty and suction lipectomy as an adjunct to breast surgery.

Suction lipectomy has become an accepted procedure and its full use is still being elucidated. The author herein describes the use of suction lipectomy as an adjunct in refining the results of established surgical procedures on the breast. The authors also explain the use of suction lipectomy in doing "suction reduction" mammoplasty. The advantages of the use of suction lipectomy as an adjunct to breast surgery and for reduction mammoplasty are explained.

Adipose Tissue↗

PubMed1985

Suction lipectomy of the neck.

Suction lipectomy of the neck has been advocated in other reports. However, because of skin laxity, a simultaneous face/neck lift has been performed usually. In this series of 49 patients, ages 18 to 73, removal of submandibular fat was performed by suction lipectomy. A simultaneous face/neck lift was not done. In addition, no skin was excised. On the contrary, the apparent excess skin was found to be required for contouring. Approximately one-third of the patients had a simultaneous chin implant. Others had different aesthetic surgical procedures performed during the same operation. The removal of neck fat by suction has proven to be more efficacious than excisional methods of lipectomy. The risks of operation have been found comparable to suction lipectomy performed in other anatomic locations.

Adipose Tissue↗

PubMed1985

Suction lipectomy: complications and results by survey.

In October of 1983, we sent a questionnaire on suction lipectomy to 2524 U.S. and Canadian members of the American Society of Plastic and Reconstructive Surgeons. Six-hundred and twelve plastic surgeons returned questionnaires (24.2 percent response rate). One-hundred and seven responding surgeons reported 1573 operations in which suction lipectomy with or without skin excision was used for 2685 procedures on various parts of the body. In the subset of 1249 operations in which suction lipectomy only was used to treat 2261 anatomic areas, surgeons reported greater than 80 percent good or excellent aesthetic results. The overall complication rate was 9.3 percent. The most frequent complications were persistent hypesthesia (2.6 percent), seroma (1.6 percent), and persistent edema (1.4 percent). Skin pigmentation, pain, hematoma, infection, and slough each occurred with an incidence of 1.0 percent or less. Based on the results of this survey, suction lipectomy is a valuable new modality for surgical improvement of body contour.

Adipose Tissue↗

PubMed1990

Suction lipectomy: an excellent adjutant to improve the results of breast reconstruction with RAM flaps.

It has been said about breast reconstruction with implants that a patient should not expect more than a mound that will fill out her brassiere or bathing suit. Autogenous tissue breast reconstruction has changed this. One of the great advantages of autogenous reconstruction over implants is that the breast remains soft, supple, and warm, improving with time as the scars begin to fade and becoming more natural and pendulous. Furthermore, since the new breast is made of fat, we can change its size, enhance its shape, and sculpture it with a suction lipectomy cannula to make it look practically identical to the opposite. We look upon breast reconstruction with rectus abdominis myocutaneous (RAM) flaps as a torsoplasty because of the improvements to the two areas involved: the reconstructed breast and the resulting abdominal lipectomy. This torsoplasty is done in two stages: One is the actual transfer of the rectus abdominis flap in which the skin and fat involved is designed to try to give an aesthetic dermolipectomy but without compromising the vascularity of the flap. Three or four months later, we perform the second-stage torsoplasty where the suction-assisted lipectomy plays a fundamental role and which is the subject of this article.

Abdominal Muscles↗

PubMed1991

Functional applications of suction-assisted lipectomy: a new treatment for old disorders.

Ever since the introduction of suction-assisted lipectomy in the United States in 1981, the technique has been applied to an increasing number of disorders of the subcutaneous tissues. Indeed, suction-assisted lipectomy has evolved into the method of choice in the treatment of certain pathological entities. While the extraction of lipomas is the most common functional application, suction-assisted lipectomy has also been used successfully to treat such conditions as gynecomastia, axillary hyperhidrosis, benign symmetric lipomatosis (Madelung's disease), congenital body asymmetry, congenital or acquired lymphedema, flap defatting, traumatic or postoperative hematomas, and fat necrosis. We have successfully treated patients presenting with the above disorders. No morbidities or mortalities were encountered in our series of 18 patients. The final results were considered favorable by the majority of patients. Acceptance by the patients of this treatment modality was extremely high because of the smaller incisions required, the exactness in contouring, the simple and minimal postoperative care needed, and the ease with which the procedure can be repeated to refine the results. A comprehensive review of the literature is presented along with our own patient management and long-term results.

Adult↗

PubMedDate not supplied

Effect of ultrasonic assisted lipectomy (UAL) on breast tissue: histological findings.

As the use of ultrasound-assisted liposuction (UAL) increases, the technique grows more popular in breast surgery, especially in reduction mammaplasty and treatment of gynecomastia. The aim of our study was to investigate the effect of UAL on breast tissue using histological examinations, and analyze the effect of this technique on a cellular level. Biopsies from 10 patients undergoing ultrasonically assisted lipectomy prior to classic reduction mammaplasty were taken from the treated areas of the breast. Biopsies were fixed in formalin and embedded in paraffin. Sections were stained with hematoxilin-eosin, and analyzed for defective adipocytes, and the effects of UAL on breast tissue. Untreated breast tissue and breast tissue that had been treated only with conventional aspiration lipectomy served as controls. Sections were analyzed using light microscopy. Compared to the breast tissue treated only with conventional lipectomy, a stronger destruction of the cellular structure of adipocytes could be detected. The destruction was visible even in areas more distant from the aspiration channel. In contrast, the breast tissue was mostly intact, no signs of ultrasonic-induced cellular destruction were visible. The glandular structure was kept intact. Beside the direct mechanical destruction by the probe and the canula, no further alterations of the cellular integrity of the glandular parts were visible. In conclusion our results indicates that UAL is also a safe technique for use in breast surgery. Besides easy handling and improved modelling, the destructive effect of the ultrasound does not include the glandular breast tissue.

Breast↗

PubMed1990

Perioperative warfarin therapy in combined abdominal lipectomy and intraabdominal gynecological surgical procedures.

The combination of multiple surgical procedures is attractive and convenient to the patient. Increased awareness of wound healing difficulties and pulmonary complications, however, suggest caution with this approach, particularly when combining abdominal lipectomy with intraabdominal procedures. This study confirms the high risk of pulmonary emboli in patients with combined abdominal lipectomy and intraabdominal gynecological procedures. The use of perioperative warfarin may reduce the incidence of pulmonary embolism in patients who have combined abdominal lipectomy and gynecological surgical procedures, and it is not associated with increased bleeding or other postoperative complications.

Adult↗

PubMed1995

Superficial suction lipectomy: something old, something new, something borrowed....

Superficial suction lipectomy has been proposed for the treatment of flaccid skin and for irregular-appearing, peau d'orange skin. For the purposes of diagnosis and treatment, this represents two entities for which superficial suction lipectomy is applicable: type A and type B conditions. A series of 20 patients who had contour problems amenable to liposuction and either of these two skin conditions were evaluated concurrently. Results suggested that superficial suction lipectomy is a feasible extension of traditional liposuction using smaller cannulas as the subdermal fat layer is approached. It is likely that it represents an additional tool for specific situations seen in a spectrum of disorders that multiply and overlap with age rather than a replacement for dermolipectomies or a definite treatment for skin textural disorders.

Bandages↗

PubMed1989

En bloc cervical lipectomy for treatment of the problem neck in facial rejuvenation surgery.

The treatment of cervical fat in facial aesthetic surgery has received much attention in recent years. Suction lipectomy has become a very popular technique for removing cervical fat because it is easy to perform and results in few complications. This paper describes the en bloc excision of cervical fat in conjunction with rhytidectomy. The senior author has treated 1,000 patients over 17 years using this technique with a high degree of patient satisfaction and minimal morbidity. Although suction lipectomy alone may be indicated for the younger patient, our experience suggests that the en bloc excisional technique is the treatment of choice in the older patient in whom a rhytidectomy is also indicated. In contrast with suction lipectomy, we have found that the en bloc excision of cervical fat allows for more anatomic dissection and facilitates removal of greater amounts of fat and better redraping of the cervical skin.

Adult↗

PubMed1993

Long-term results of blunt suction lipectomy assessed by a patient questionnaire survey.

A questionnaire was sent to 1339 consecutive patients who had undergone blunt suction lipectomy during the period between April 1984 and April 1987. Seventy-four percent replied, thus providing information about the results of 1929 procedures. The overall reported rate of satisfaction was 76 percent, with no significant difference between males and females. Highest satisfaction referred to pseudogynecomastia, submental area, iliac crest, and lower extremities on females. The rate of dissatisfaction was 6 percent. Dissatisfaction was associated most frequently with lipectomy of the buttocks. Underresection was reported for 30 percent and over-resection for 2.2 percent of the procedures. The latter, in particular, seemed to lead to dissatisfied patients. Asymmetry was reported for 19 percent of the procedures. Recurrence ("return") of fatty tissue was reported for 29 percent at the resection site. Thirty percent of the patients reported compensatory increase ("came back elsewhere") in fat deposits in nontreated locations. Self-reported weight gain was found to be a significant risk factor for both types of "regrowth." Irregularities were the most frequently reported permanent changes to skin. There were twice as many negative as positive changes to skin. Most of the patients had benefited personally from the surgery and were willing to consider undergoing lipoplasty again. All in all, the long-term results of blunt suction lipectomy are satisfactory.

Adult↗

PubMed2005

Circular belt lipectomy: a retrospective follow-up study on perioperative complications and cosmetic outcome.

The purpose of this study was to evaluate the perioperative complications and cosmetic outcomes of circumferential belt lipectomy in patients with evident truncal excess. In 21 women, a circumferential belt lipectomy was performed between April 2002 and March 2004. The mean weight loss before surgery was 44 kg, and the mean body mass index before surgery was 28.1 (range, 22.3-36.5). Patients scored cosmetic results on a visual analog scale. The average reduction weight was 3616 g (2110-7525 g). The average duration of the operation was 132 minutes (range, 79-210 minutes). Patients were discharged from the hospital between postoperative days 6 and 10 (average, day 8). Minor complications occurred in 7 patients and major complications in one. Smoking was a statistically significant cause of postoperative complications. The majority of patients judged the cosmetic outcome as good to excellent (15 patients > or =8, 5 patients = 7, 1 patient =6). Patients with truncal skin and fat excess on both the ventral and dorsal side can obtain a good cosmetic result with a circular belt lipectomy.

Abdomen↗

PubMed1997

Short-day-like body weight changes do not prevent fat pad compensation after lipectomy in Siberian hamsters.

Long-day (LD)-housed Siberian hamsters show compensatory increases in white adipose tissue (WAT) weight after lipectomy, whereas hamsters exposed to short days (SDs) for a long duration (22 wk) do not. We tested whether SD-induced body weight changes prevent fat pad compensation after lipectomy. In experiment 1, hamsters with lesions of the paraventricular nucleus of the hypothalamus (PVNx) rapidly increased body weight similarly to 22-wk SD-exposed hamsters. In experiment 2, LD-housed hamsters were food restricted for 22 wk and then pair fed with SD-housed hamsters for 12 wk to produce body weight changes mimicking those of ad libitum-fed SD-exposed animals. Epididymal WAT (EWAT) lipectomy (EWATx) of PVNx or food-restricted hamsters elicited compensatory increases in retroperitoneal and inguinal WAT (RWAT and IWAT) weights. Unlike other fat pads, EWAT was less affected by food restriction or PVNx than by SD exposure. In general, food restriction decreased adipocyte number, whereas SD exposure decreased adipocyte size. PVNx increased RWAT adipocyte size and IWAT adipocyte number. These results suggest that the lack of body fat compensation by EWATx hamsters exposed to SDs for a long duration is due to SD-associated responses other than body weight changes per se.

Adaptation, Physiological↗

PubMed1997

Fat pad-specific compensatory mass increases after varying degrees of lipectomy in Siberian hamsters.

Long day-housed Siberian hamsters show compensatory mass increases in inguinal (I) white adipose tissue (WAT) after epididymal WAT pad (EWAT) removal (x) but do not increase EWAT mass after IWATx. This study tested whether EWAT is specifically unresponsive to IWATx or whether EWAT lacks responsiveness to body fat deficits in general. We also tested whether the compensatory mass increases that occur after side-specific body fat removal are unilateral or bilateral. Therefore EWAT and/or IWAT was removed unilaterally or bilaterally. The compensatory changes in WAT mass by the intact fat pads were measured 12 wk later. EWAT did not compensate for removal of its contralateral mate. Retroperitoneal WAT and IWAT showed greater compensatory mass increases ipsilateral to the side of fat pad removal when EWAT or IWAT pads were removed unilaterally but not after removal of larger amounts of body fat. These results suggest the following: 1) in general, the greater the lipectomy-induced lipid deficit, the greater is the relative fat pad mass compensation; 2) the restoration of body fat content after lipectomy may involve mechanisms that can detect the side of the lipid deficit and enhance fat deposition on this side; and 3) EWAT does not show compensatory mass increases after lipectomy.

Adipose Tissue↗

PubMed1992

Large-volume suction lipectomy: an analysis of 108 patients.

Suction lipectomy was initially advocated for the treatment of localized collections of fat and for the removal of less than 1500 ml of material. However, many patients wished to have multiple areas treated or had diffuse collections of fat. In such instances, the removal of over 1500 ml of material and circumferential lipectomy are necessary to provide optimal aesthetic results. However, when over 1500 ml of material is removed, anesthetic requirements, fluid replacement, and treatment of blood loss become important if the operation is to be performed safely. We have treated 108 patients who had over 1500 ml of material removed. Eight-eight percent of the patients were female; 12 percent were male. Using the body-mass index, 3 percent of patients were underweight, 70 percent were normal weight, and 27 percent were overweight. Fifty-five patients (51 percent) had 1500 to 2499 ml of material removed, 26 patients (24 percent) had 2500 to 3499 ml removed, 16 patients (15 percent) had 3500 to 4499 ml removed, and 11 patients (10 percent) had over 4500 ml removed. All patients were treated in the hospital; 44 percent were admitted after surgery. A total of 227 units of autologous and 2 units of homologous blood were transfused. As measured by a computerized monitor, the average amount of blood in the material removed from thighs was 30 percent; from abdomens, the blood loss was 45 percent. The aesthetic results were generally excellent. No complications were encountered. A few patients developed undesired sequelae, the most common of which was seroma formation, which occurred in 19 percent of those who had suction of abdominal-wall fat. We believe that large-volume suction lipectomy is safe and efficacious, provided attention is directed to such important aspects of patient care as anesthesia, fluid replacement, and blood loss.

Adolescent↗