ABSTRACT
Introdução: A lipoaspiração, procedimento cirúrgico com cerca de 30 anos desde sua sistematização por Fournier, Illouz e outros, atingiu, em 2011, o total de 211.108 cirurgias realizadas no Brasil e 325.332, nos Estados Unidos. Ao longo dos anos, foi reputado como procedimento seguro, baseado em conceitos da técnica tumescente. Realizado também por outras especialidades, já foi descrito como método ambulatorial, inclusive em instituições públicas no Brasil, por dermatologistas. Motivada por essa lacuna de dados, a Sociedade Brasileira de Cirurgia Plástica criou uma comissão composta por dez membros titulares, com o objetivo de realizar uma pesquisa para reconhecer a presença de possíveis fatores envolvidos nas intercorrências graves e nos óbitos, após uma cirurgia de lipoaspiração no Brasil. Métodos: Foi elaborado um questionário on-line através de um link anônimo e disponível para consulta, no site da SBCP. O questionário foi enviado, através dos e-mails de cadastro, para 4.441 membros associados e titulares da SBCP. A primeira questão indagava sobre a ocorrência de intercorrências em lipoaspiração. Somente a resposta positiva era então direcionada ao restante do questionário. Além do questionário, foram enviadas cartas pela SBCP às instituições oficiais estaduais e federais, nas quais prováveis registros de processos ou cadastro de fatos relacionados a intercorrências e/ou óbitos após lipoaspiração poderiam existir. A significância da associação entre óbito e os diversos fatores foi medida com aplicação do teste qui-quadrado. As variáveis significantes foram incluídas em Modelos de Regressão de Poisson. Foi considerado o nível de significância de 5%. Os dados foram analisados com auxílio do programa STATA versão 10.0. Resultados: Fenômenos tromboembólicos, associação de cirurgias e o local de realização da cirurgia demostraram ser fatores de risco envolvidos na mortalidade de lipoaspiração. Conclusão: Programas visando à normatização na realização das lipoaspirações podem ser eficazes na diminuição da mortalidade em lipoaspiração. Acreditamos que este artigo pode promover um impacto positivo educacional e, futuramente, gerar protocolos de segurança em lipoaspiração.
Introduction: Liposuction is a surgical procedure that was developed approximately 30 years ago by Fournier, Illouz, and others. In 2011, a total of 211,108 liposuction procedures were performed in Brazil versus 325,332 in the United States. Over the years, liposuction performed with the tumescent technique has had a good safety profile. It is also performed by other specialists, including dermatologists, and has been described as an outpatient procedure in public institutions in Brazil. The scarcity of data on the subject has led the Brazilian Society of Plastic Surgery (BSPS) to create a commission composed of 10 full members with the aim of investigating the factors involved in severe liposuction-related complications and death in Brazil. Methods: An online questionnaire was created using an anonymous link on the BSPS website. The questionnaire was sent to the registered email addresses of 4,441 associate and full members of the BSPS. The first question was about the occurrence of liposuction-related complications. The respondents could only continue to answer the questionnaire if the answer to this question was "yes." In addition to the questionnaire, the BSPS sent letters to the official state and federal institutions in which the case or complication/death-related records and/or deaths as a consequence of liposuction were expected to exist. The significance of the association between death and the various factors was determined using the chi-square test. The significant variables were included in Poisson regression models. The significance level was set at 5%. The data were analyzed using STATA software version 10.0. Results: Thromboembolic events, combined surgical procedures, and the facilities where the procedure was performed were risk factors involved in liposuction-related mortality. Conclusion: The implementation of programs that aim to standardize liposuction procedures may effectively reduce liposuction-related mortality rates. This study aimed to make a positive educational impact on the development of future safe liposuction protocols.
Subject(s)
Humans , History, 21st Century , Postoperative Complications , Lipectomy , Surveys and Questionnaires , Mortality , Evaluation Study , Postoperative Complications/surgery , Postoperative Complications/mortality , Lipectomy/methods , Lipectomy/mortality , Surveys and Questionnaires/standardsABSTRACT
Liposuction is one of the most frequently performed cosmetic surgeries worldwide for reshaping the body contour. Although liposuction is minimally invasive and relatively safe, it is a surgical procedure, and it carries the risk of major and minor complications. These complications vary from postoperative nausea to life-threatening events. Common complications include infection, abdominal wall injury, bowel herniation, bleeding, haematoma, seroma, and lymphoedema. Life-threatening complications such as necrotizing fasciitis, deep vein thrombosis, and pulmonary embolism have also been reported. In this paper, we provide a brief introduction to liposuction with the related anatomy and present computed tomography and ultrasonography findings of a wide spectrum of postoperative complications associated with liposuction.
Subject(s)
Humans , Abdomen/diagnostic imaging , Fasciitis, Necrotizing/etiology , Hematoma/etiology , Lipectomy/adverse effects , Postoperative Complications/etiology , Pulmonary Embolism/etiology , Tomography, X-Ray Computed , Venous Thrombosis/etiologyABSTRACT
The 635-nm low-level laser therapy was reported to "liquefy" or release stored fat in adipocytes by causing a transitory pore in the cell membrane to open, which permitted the fat content to go from inside to outside the cell. But some data do not support the belief that low-level laser therapy treatment before lipoplasty procedures disrupts tissue adipocyte structure. The purpose of this study was to determine the effectiveness of low-level laser- assisted liposuction. The use of low-level laser-assisted lipoplasty was evaluated in a series of 90 cases. There were 2 treatment groups in the clinical study. Subjects in the test group(39 patients; 31 thighs and 17 abdomen) received only liposuction on one side and laser-assisted liposuction on the other side during early 1liter aspiration time. 51 patients in the operated group received laser-assisted liposuction on both side. After adequate infiltration was obtained in all targeted body areas, a 635-nm electric diode laser was applied to the targeted areas for 12 to 15 minutes to liquefy the fat which was extracted immediately after laser treatment. On the side which received laser-assisted liposuction of the 39 test-group patients, we could gain much fat component(71+/-7.2 vs 63+/-8.6%) and it took short time(26+/-5.7 vs 31+/-7.7 minutes). Postoperative recovery was rapid, and complications were minimal. Low-level laser-assisted lipoplasty can be a valuable adjunctive tool for the performance of lipoplasty.
Subject(s)
Humans , Adipocytes , Cell Membrane , Low-Level Light Therapy , Lasers, Semiconductor , Lipectomy , ThighABSTRACT
Many people desire body contouring. Liposuction is a powerful tool for plastic surgeons in body contouring and widely used in many countries. The ideal liposuction technique allows greater volumes to be aspirated while minimizing blood loss, operative time, and complication. The mechanism of liposuction involves mechanical suctioning, followed by destruction of fat tissue by cannula movement. In PAL, a cannula powered by compressed nitrogen gas or an electric power source reciprocates between 2000 and 4000 cpm with a 2-3mm amplitude. We have treated 12 patients by PAL during 2001 January-September with excellent results. PAL made surgeons less fatique and discomfort, and resulted in shorter operation times, and decreased seroma formation and less scars at the incision site. PAL is also effective in fibrous fat aspiration in case of gynecomastia, superficial suction, large volume removal, and secondary liposuction. Conclusively the technique is safe, fast and capable of producing results comparable to those achieved with traditional or ultrasonic-assisted lipoplasty.
Subject(s)
Humans , Male , Catheters , Cicatrix , Electric Power Supplies , Gynecomastia , Lipectomy , Nitrogen , Operative Time , Seroma , SuctionABSTRACT
Objective To study the clinical effects of abdominoplasty using ultrasound assisted liposuction and dermolipectomy. Methods With the patient standing, the relative areas of maximal adipose fullness in the abdomen and waist were marked topographically. With the patient in the supine position, the "pinch test" was performed by surgical operator advancing the tissue in the infraumbilical area toward the pubic region in order to estimate how much skin needed to be resected before operation. Inter-operatively tumescent technique with the transduction of ultrasound into fatty areas was applied in the first place, following classic abdominoplasty including excessive skin and fat resection, musculoaponeurotic plication and umbilical transposition. Results Sixteen patients followed up from six months to two years were satisfied with aesthetic effects because of smoothness of the operated areas, good sensory recovery and obvious shrinkage of skin with fewer complications. There were no infection, skin necrosis, and wound dehiscence. Conclusion The excellent effects of abdominal profile sculpture can be reproduced with the new method using UAL in vivo and dermolipectomy.