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PubMed1996

[Aspirative lipectomy in patients with alimentary-constitutional obesity].

The results of aspirative lipectomy in patients with 2nd and 3rd stage of alimentary-constitutional obesity are analysed. The effectiveness of lipectomy with surgical creation of a small ventricle and without previous surgery, has been demonstrated. The criteria of patients selection, based on their somatic and psychic features, are formulated. Aspirative lipectomy has certain advantages over other types of plastic surgery as it has the minimal rate of postoperative complications.

Adult↗

PubMed1998

Suction-assisted lipectomy for the correction of stomal dysfunction.

Poorly fitting appliances for urinary or fecal stream stomas can lead to frequent leaking and subsequent social embarrassment, stomal stenosis, hyperkeratosis, skin breakdown, and increased cost secondary to frequent changing. Obese patients with abnormal skin folds frequently are more prone to these problems. Herein is described the use of suction-assisted lipectomy for abdominal wall contouring in an effort to improve and simplify appliance application as well as lengthen appliance life. Between 1989 and 1996, five patients (three females, two males) ages 13 to 47 years, were treated with abdominal wall suction-assisted lipectomy in an attempt to improve stomal function. Preoperatively, an average of 1.25 appliance changes a day were required for leaking. Three patients had one procedure removing 400 to 600 cc of fat. Two patients had staged suction, removing a total of 900 to 1600 cc of fat. At 6-month follow-up, the average appliance life was 4 days, and the incidence of skin problems and leaking was markedly reduced. The technique of suction-assisted lipectomy is a simple outpatient procedure with low morbidity that can successfully be used to improve stomal function in obese patients with poorly fitting appliances secondary to skin folds, poor body habitus, or abdominal scarring.

Abdominal Muscles↗

PubMed1982

Anterior periosteal dermal suspension with suction curettage for lateral thigh lipectomy.

The standard excisional approach to lipectomy has now been expanded by the use of suction curettage either as an adjunct or a primary procedure. In severe cases of steatomeria (a term used to designate trochanteric obesity and eliminate the misuse of the term lipodystrophy), curettage serves to prepare and shape the flaps, while excision and "periosteal dermal suspension" are sometimes necessary to achieve adequate contour and lift. Periosteal anchoring ensures adequate permanent suspension and a tension-free closure. Achievement of lateral thigh contouring by an anterior approach is facilitated by the use of the suction curette. Undermining of the superior flap and contouring with suction, as well as overlapping the closure with buried dermal-fat suspension flaps, eliminates bulging above or below the incision. Periosteal dermal suspension decreases the possibility of scar widening and eventual ptosis, provides a fixation technique that permits more lift, and eliminates scarring from the lateral thigh. Lateral thigh suction lipectomy with periosteal dermal suspension has been done alone or in conjunction with buttock reduction or with medial thigh or abdominal lipectomy in 14 patients. The operating time was short, and the results were good with minimal morbidity.

Adipose Tissue↗

PubMed1988

Hypersensitivity dermatitis following suction-assisted lipectomy: a complication of local anesthetic.

We report a case of severe dermatitis involving the abdomen and thighs following suction-assisted lipectomy of these areas wherein local anesthetic containing the preservative methylparaben was used for infiltrative anesthesia. This use of local anesthetics with epinephrine can be of value in the performance of suction-assisted lipectomy to reduce blood loss, serve as an adjunct to other intraoperative anesthetic techniques, and for postoperative analgesia. Local anesthetic solutions commonly contain additives, which serve as antioxidants and antimicrobials. The most common of these preservatives is methylparaben, which can cause delayed hypersensitivity reactions. These reactions may be neither recognized nor clinically significant in small areas of infection, whereas in large body surface infiltrative procedures, such as suction-assisted lipectomy, these reactions may be of considerable consequence. This article reviews the pathophysiology and treatment of these reactions and gives recommendations for avoiding them.

Adipose Tissue↗

PubMed1986

Suction-assisted lipectomy for correction of 202 figure faults in 101 patients: indications, limitations, and applications.

Since its introduction in the United States, suction-assisted lipectomy has proven to be a safe, effective technique for correction of figure faults. It has been greeted with considerable skepticism by many practitioners, however, owing to the poor results many have obtained in their initial attempts to apply similar techniques. Suction lipectomy using the blunt technique is a safe procedure that can yield consistently good results when appropriately applied. It is suggested that the principal reason others have had difficulty involves problems in patient selection. The technique may not be effective for the correction of generalized obesity and cannot be expected to dramatically alter overall appearance. Patients should be selected for treatment of specific "figure faults" and educated as to what may realistically be expected. The patient's emotional and psychological condition must be taken into consideration. We report a series of 101 patients treated with a total of 202 separate suction lipectomy procedures with good results and only two minor complications. A survey of patients treated by the method reveals a generally high level of satisfaction and some of the ambivalence that might be anticipated from such a technique.

Adipose Tissue↗

PubMed1996

Effect of Abdominal Lipectomy on Lipid Profile, Glucose Handling and Blood Pressure in Patients with Truncal Obesity.

BACKGROUND: Previous studies have found that people with apple (android)-shaped body fat distribution are at risk of developing cardiovascular disease, impaired glucose tolerance and hypertension. METHODS: To investigate the effects of lipectomy, we measured lipid and lipoprotein levels, indices associated with glucose tolerance and blood-pressure. The tests were performed pre-operatively and 3 and 12 months post-operatively in 34 subjects (obese lipectomy patients with android-shaped body fat distribution) and 23 controls (obese breast reduction patients). RESULTS: In subjects, total cholesterol, LDL and blood pressure were significantly lower at 3 months follow-up, but returned to pre-operative levels at 12 months follow-up. Plasma insulin decreased significantly at 3 months follow-up, and continued to decrease at 12 months follow-up. Triglycerides, HDL, fasting blood sugar, glycosylated hemoglobin and C-peptide did not change at 3 and 12 months follow-up. There were no changes in controls. CONCLUSIONS: Lipectomy in patients with truncal obesity may reduce plasma insulin levels, but had no lasting effect on plasma lipids.

Journal Article↗

PubMed1987

Gynecomastia: suction lipectomy as a contemporary solution.

Suction lipectomy is adapted for the correction of gynecomastia. Previous attempts using suction lipectomy for gynecomastia still required the use of sharp dissection for removal of the glandular breast tissue as well as excision of redundant skin. With this new technique, gynecomastia is corrected solely with the use of suction lipectomy. The technique is successful if the gynecomastia is due to excess fat or parenchymal hypertrophy. A 7-mm cannula is inserted first, to remove the adipose tissue. Then a 2.4-mm cannula is used to remove the glandular and ductal tissue. The 7-mm cannula is then reinserted to remove subareolar parenchyma and to make final contour adjustments. The surrounding subcutaneous tissue is easily undermined to avoid a saucer deformity and to allow for skin contraction. Patients return to full activities in 48 hours. A compressive garment is worn for 4 to 6 weeks. The results of 10 patients are discussed.

Adipose Tissue↗

PubMed1990

Suction-assisted lipectomy in the management of obstructive sleep apnea.

Suction-assisted lipectomy is a valuable method of aesthetic recontouring of the neck. We report the successful use of suction-assisted lipectomy as an adjunctive procedure at the time of tracheostomy in the treatment of obese patients with severe obstructive sleep apnea. This functional procedure helps to maintain tracheostomy patency during sleep.

Adolescent↗

PubMed1995

A role for testosterone in the maintenance of seasonally appropriate body mass but not in lipectomy-induced body fat compensation in Siberian hamsters.

The purpose of this study was to test whether serum testosterone (T) concentrations characteristic of reproductively active, long-day-housed Siberian hamsters are necessary for compensatory increases in nonexcised fat pads following removal of epididymal white adipose tissue (EWAT) and/or for the maintenance of seasonally appropriate body weights in these hamsters. Long-day-housed hamsters were castrated or left intact, sham or EWAT lipectomized, and given T or cholesterol (C) implants. All groups had ad libitum food access except for two castrated T-treated groups that were pair-fed to their C-treated counterparts to control for effects of T on food intake. C-treated castrates had decreased body weights compared with all other groups, suggesting a role of T in the maintenance of seasonally appropriate body mass. Since the T-treated hamsters pair-fed to these T-deficient animals exhibited seasonally appropriate body weights and fat pad masses, T does not appear to affect these parameters through the modulation of food intake. All fat pads of C-treated animals were smaller than those of ad libitum- or pair-fed, T-treated castrates; however, EWAT was the only fat pad that was smaller in the C-treated sham-lipectomized group than in gonad-intact sham-lipectomized hamsters. This result may indicate an enhanced sensitivity of EWAT to T. The effects of T on fat pad mass were not associated with proportionate changes in lipoprotein lipase activity, suggesting that the major effect of T on fat accumulation occurs through other mechanisms in this species. C-treated lipectomized hamsters compensated for the body fat deficit 8 weeks after lipectomy via statistically non-significant increases in retroperitoneal and inguinal WAT mass. This finding suggests that, whereas T is necessary for maintenance of seasonally-appropriate body weight, it is not necessary for fat pad compensation after EWAT lipectomy.

Adipose Tissue↗

PubMed1992

Suction lipectomy: the gold triangle at the neck.

Cervical suction lipectomy is a simple procedure that poses no technical problems. Evaluation of the amount of fat to remove is easy since the deposit is superficial and the skin considerably more supple than over the body. Although postoperative changes may be slow to develop, the skin usually exhibits outstanding adaptability in this area and this adaptability improves over time. On the basis of these favorable features occurring in the same location, a cervical gold triangle can be defined. In this area, where excellent results can be expected, indications of suction-assisted lipectomy can be very broad.

Aged↗

PubMed1992

Influence of suction-assisted lipectomy on coagulation.

Suction-assisted lipectomy is the most commonly performed surgical aesthetic procedure in North America today. The procedure is not without significant morbidity, as death as well as serious nonfatal complications have been reported. Thromboembolic disease as a complicating factor of various types of surgical procedures and trauma has been well documented in the literature. Stasis, injury, and hypercoagulation--the limbs of Virchow's triad--contribute to predisposition for morbidity. The effects of stasis and injury are experienced with most operative procedures. We questioned whether suction-assisted lipectomy, in the appropriately selected and managed patient, would demonstrate a predisposition toward a hypercoagulable state and subsequent thromboembolic disease. In our group of ten female patients who underwent large-volume liposuction, a carefully selected assay of hematological factors demonstrated alterations consistent with a controlled response to tissue injury, but did not demonstrate a predisposition to a hypercoagulable state or subsequent increased risk of thromboembolic sequelae.

Adult↗

PubMed1990

Suction-assisted lipectomy in the older patient.

A retrospective study of 158 suction-assisted lipectomy patients ranging in age from 50 to 81 years was completed in order to determine the success of the technique in this subset of older patients. These were primarily cosmetic procedures of the trunk and extremities. The patients presented with a typical wide spectrum of systemic medical disorders as one would expect in this age group. The study revealed no mortalities and limited suboptimal aesthetic results consisting of insufficient fat removal, requiring secondary suctioning, and waviness or asymmetry. We feel that with adequate preoperative explanation and planning suction-assisted lipectomy can be a rewarding procedure in patients of all ages.

Age Factors↗

PubMed2006

[Initial experience with transpalpebral orbital lipectomy].

PURPOSE: The aim of this study was to evaluate the short-term effectiveness of transpalpebral orbital lipectomy. METHOD: Using a transpalpebral approach, 2.0-6.5 ml connective tissue was removed from 50 orbits of 33 patients with mild to severe Graves' orbitopathy (25 females, 8 males) over a 5-year period. Indications for surgery comprised cosmetic correction of exophthalmos (27/33 patients), corneal damage (5/33), and rapid bilateral deterioration of visual acuity in 1 patient. RESULTS: In 27 patients undergoing correction for aesthetic purposes no change in visual acuity ensued; in 4 of 5 keratopathy patients an improvement in visual acuity was detected. Diplopia ceased in 4 of 13 patients, diminished in 3 of 13 cases, and constantly increased in 2 of 13 cases. The high intraocular pressure returned to normal in 8 of 13 patients. The proptosis was reduced at 3.2+/-1.3 mm. CONCLUSION: Transpalpebral orbital lipectomy is a low-risk, highly effective technique for orbital decompression in both acute and chronic cases of Graves' orbitopathy.

Adolescent↗

PubMed1989

Transoral submental lipectomy: an adjunct to orthognathic surgery.

Individuals undergoing the surgical correction of dentofacial deformities are becoming both older and more discriminating. Consequently, they often request specific esthetic improvements. To meet the desires of such patients, adjunctive surgical procedures to the planned orthognathic surgery are becoming more commonplace. One of the more frequent procedures performed is the transoral submental lipectomy. This article discusses the evaluation of the submental region, the indications for transoral submental lipectomy, and the surgical technique. Several case indications illustrate the results of this procedure.

Chin↗

PubMed2003

Combined surgical lipectomy and liposuction in the treatment of benign symmetrical lipomatosis of the head and neck.

Benign symmetrical lipomatosis (Madelung syndrome) is a rare disease of unknown aetiology, which is characterised by diffuse growth of non-encapsulated lipomas. Between 1995 and 2000 we treated 11 patients with benign symmetrical lipomatosis in the head and neck. The group comprised 10 men and one woman aged 34 to 62 years (mean 47). The most common complaints were reduced range of movement of the head and obstruction when eating or speaking. Combined lipectomy and liposuction were done for all patients, with liposuction being done at a second session. The mean follow-up period was 2.7 years. The functional results were satisfactory in all patients. Nine of the 11 patients were also satisfied with the aesthetic outcome. Two patients developed recurrence 1.5 and 2 years after the operation, respectively. There were no serious complications. We think that combined lipectomy and liposuction is a successful procedure for treating benign symmetrical lipomatosis in the head and neck region. Nevertheless, the advantages and drawbacks of the two techniques should be considered preoperatively.

Adipose Tissue↗

PubMed2001

Belt lipectomy: procedure and outcomes.

Belt lipectomy includes the traditional abdominoplasty or panniculectomy with excision extended laterally around the entire trunk. This technique yields a lateral thigh and buttock lift, and when combined with liposuction is used to improve contour of the thighs. The focus of this paper is to describe current surgery for body contouring of the entire trunk and our experience at University of Iowa Hospitals and Clinics (UIHC) with 32 belt lipectomies.

Abdomen↗

PubMed1991

Skin retraction following suction lipectomy by treatment site: a study of 500 procedures in 458 selected subjects.

I identified 500 suction lipectomy procedures involving sites on the body and in the cervicofacial region in 458 selected patients and studied the influence of treatment site on postoperative skin retraction by comparing preoperative and postoperative skin condition. Postoperative skin condition was evaluated first in the immediate postoperative period (second or third day); then at a more remote date (after at least 2 months of follow-up). On the body, restoration of the preoperative condition of the skin was obtained in 94.6 percent of treatment sites in the immediate postoperative period; after a longer follow-up, this proportion was 87.9 percent because of delayed development of modifications. The time interval needed to obtain a stable result increased with increasing age, regardless of the nature of this result, as well as with the total amount of fat removed. On the neck, liposuction improved or even eliminated preexisting skin looseness, and this improvement was even more noticeable as follow-up increased. The neck thus appears as the site of choice for suction lipectomy. On the face, in contrast, favorable results deteriorated over time, a finding that leads me to advocate combination with a face-lift whenever ptosis is present. Thus treatment site obviously has a substantial impact on the potential of the skin for retracting postoperatively.

Abdomen↗

PubMed1991

The trauma of suction-assisted lipectomy cannula on flap circulation in rats.

The effect of suction-assisted lipectomy on cutaneous blood vessels of inguinal skin flaps was studied and compared in 191 rats. Different types of cannula tips were used; the number of passes was standardized. In one experiment, following suctioning, 3 X 2 cm groin island flaps based on inferior epigastric pedicles were raised and then reattached. Fluorescein dye study and microangiography were performed to evaluate flap viability. Flap survival was determined clinically and by histologic examination on the fifth postoperative day. Three-sided inguinal random-pattern flaps were raised in a second experiment and reattached following suctioning. On the fifth postoperative day, surviving flap areas were measured using standard photographs and an imaging computer and were compared with controls. Results showed that cannula passes accompanied by vacuum are harmful to vessels, while those unaccompanied by vacuum are not. The greater the number of suctioning passes, the more trauma there is to vessels and the greater is the likelihood of flap necrosis. Conical and spatula tips were more harmful to vessels than spherical, cobra, keel cobra, or Fournier tips. These results support the conclusion that suction-assisted lipectomy enhances the possibility of skin necrosis by traumatizing the vascular pedicle of a flap, especially when it is used as an adjunct to flap elevation.

Animals↗