Emerging Treatments in Cosmetic Surgery - Medical Fibers Liposuction

Keywords:medical, fibers, liposuction,  Time:29-01-2016

The limits are obese cases, as these procedures can only reduce limited amounts of fat. Body contouring is most commonly achieved via liposuction or lipolysis, which can be invasive or noninvasive. Parts of the body usually targeted for sculpting are the hips, inner thighs, abdomen, knees, flanks, buttocks, chin, arms, and back. A variety of surgical techniques and procedures have been employed to enhance body appearance. Some of these may cause more aftereffects than others such as scarring, infection, burns, hypopigmentation, bruising, or persistent edema, which may cause discomfort or disturb aesthetic appearance. Therefore, refined body sculpting procedures should aim to reduce complication rates and recovery downtime, decrease operator fatigue, reduce bleeding, and promote skin contraction.

Medical Fibers Liposuction, also known as lipoplasty, involves the penetration of surface layers and comprises techniques including: suction-assisted liposuction (SAL), power-assisted liposuction (PAL), ultrasound-assisted liposuction (UAL), laserassisted liposuction (LAL), and waterjet-assisted liposuction (WAL). Liposuction should not be confused with laser fibers lipolysis.1 Both LAL and SAL are invasive and have been known to cause complications. In a retrospective study of liposuction involving 26 259 patients, 18% reported anemia and 90% reported postoperative pain. There was a 0.01% mortality rate mostly attributed to pulmonary embolism, an adverse outcome reported in 0.03% of patients;2 there is no doubt that Liposuction under local anesthesia is performed using tumescent solutions, and is the most common liposuction modality in the United States. Compression garments are usually required during the extensive downtime following the procedure, usually for 6 weeks. Better liposuction results have been reported with: marking, positioning, small stab incision, pretunneling, cross-tunneling, and indication of complete suction.4 Unlike other techniques, UAL has the benefits of not requiring compression garments and minimal downtime.

A common form of liposuction, TL is a variation of ‘‘wet’’ liposuction that involves local anesthesia and infiltration of a high volume of tumescent fluid, which prepares the tissue by hydrodissection. Larger total volumes of fat (up to 4 L) can be removed per session and larger volumes of wetting solution (up to 6 L) are infiltrated before. The solution used usually consists of lidocaine or the less toxic articaine and epinephrine and bicarbonate. Epinephrine causes intense constriction of capillaries, which reduces blood loss and prolongs the effect of local anesthetic. Bicarbonate neutralizes the pH of the local anesthetic and eliminates infiltration pain. By maintaining anesthesia and vasoconstriction, the patient is conscious and the surgeon can suction fat out from multiple areas through a cannula. There are various dilutions and combinations of tumescent formula. In the study by Saleh et al,6 modified Klein’s solution (also known as modified tumescent local anesthesia) was used; this consists of 20 ml of 2% lidocaine, 1 ml adrenaline (1:1000), 5 ml of sodium bicarbonate solution (8.4%), and mixed in 500 ml of lactated Ringer’s solution.

Proper history taking is important as potential physiologic effects of TL include postoperatively decreased blood glucose, pulse rate, and systolic blood pressure. Significant decreases in blood urea, serum creatinine, and uric acid have also been reported. In their study of 60 female patients, Saleh et al observed adverse effects such as skin irregularities (20%), seroma (15%), garment pressure sores (10%), and cutaneous hyperpigmentation (5%).6 Unlike methods such as ultrasound, power, and laserassisted devices, which cause extensive lipocyte fragmentation, fat harvested from TL is suitable for autologous fat transfer.7 With TL, the potential complications of general anesthesia are avoided.7 There have been no reported deaths.8 In SAL, a manual-driven cannula is used to suction fat from the desired area. SAL, under tumescent local anesthesia, is among the safer forms of liposuction, with potential side effects similar to those of any surgery, for example, infections, hematoma, nerve damage, and fibrosis.9 Although SAL is a standard procedure, less surgically traumatic ways to achieve similar outcomes are available.