Lipoaspiração laser-assistida de alta definição / High-definition laser-assisted lipoaspiration

Introdução: Desde a introdução da técnica de lipoaspiração, a melhora do contorno corporal vem ganhando novos horizontes. O uso da lipoaspiração superficial passou a ser usado a favor da estética e, com isso, o uso de tecnologias, tais como o VASER e o laser de Diodo, nos comprimentos de 915 e 980 nn, diminuem as complicações, com melhora da dor pós-operatória, tempo de cicatrização e retração cutânea. Métodos: Foram estudados, inicialmente, 16 pacientes submetidos à laserlipólise de alta definição, entre o período de 2014 e 2016. O nível de satisfação em relação ao resultado foi questionado aos pacientes. Resultados: A maioria dos pacientes foi do sexo masculino, idade média 39 anos, com média de dor de 2,3 de na escala de visual de dor (0 a 10), apresentando resultados duradouros após 1 ano, sem complicações e retorno às suas atividades de trabalho e físicas precocemente. Conclusões: Desta forma, o uso do laser de Diodo com comprimentos de ondas de 915 e 980 nm, associado à Lipoescultura de Alta Definição, promoveu resultados satisfatórios, promissores devendo ser testado numa amostragem maior de pacientes.

Introduction: Since the introduction of the liposuction technique, the improvement of body contour has been gaining new horizons. Superficial liposuction has been used in favor of aesthetics; the use of technologies, such as VASER and diode laser at 915- and 980-nm wavelengths, helps reduce complications and improves post-time, healing time, and cutaneous retraction. Methods: Fourteen patients submitted to high-resolution laser lipolysis were studied between 2014 and 2016. The level of patient satisfaction regarding the treatment outcome was assessed. Results: The majority of the patients were men, with a mean age of 39 years and a mean pain score of 2.3 on the visual pain scale (0 to 10), presenting lasting results after 1 year, with no complications and an early return to work and physical activities. Conclusions: The use of diode laser at the wavelengths of 915 and 980 nm in high-definition liposculpture promoted satisfactory, promising results and should be tested in a larger sample of patients.

Lipomatose simétrica benigna: doença de Madelung: relato de caso / Benign symmetric lipomatosis: Madelung's disease: case report

JUSTIFICATIVA E OBJETIVOS: A lipomatose simétrica benigna (LSB) foi descrita inicialmente por Madelung em 1888 e possui patogênese ainda desconhecida. É caracterizada por múltiplos depósitos de gordura indolor não encapsulado com disposição simétrica, localizados preferencialmente na região cervical e tronco superior, podendo causar sintomas compressivos e aparência pseudoatlética. O tratamento cirúrgico é o mais efetivo, por ressecção ou por lipossucção. O objetivo deste relato foi apresentar a importância do caso descrito, devido à sua exuberância clínica, apesar de assintomática e sem alterações significativas laboratoriais.RELATO DO CASO: Paciente do sexo masculino, 77 anos, agricultor, natural de Pernambuco. Relatou que há oito meses apresentava crescimento progressivo de massa indolor na região cervical, occipital e superior do tórax, negando outros sintomas que pudessem acompanhar o crescimento e sem história familiar. Hipertenso, etilista e tabagista. Ao exame constatou-se massa volumosa simétrica cervical fibroelástica, na região cervical, não aderida a planos profundos e sem sinais flogísticos.CONCLUSÃO: A LSB foi classificada por Enzi e col. em dois tipos, o paciente em questão foi classificado como tipo I, lipoma predominantemente cervical. A ingesta de álcool consumida pelo paciente tem forte associação com a etiologia da doença de acordo com Enzi e col. Foi realizada lipectomia, com abordagem em dois tempos cirúrgicos devido a invasão de estruturas nobres. O paciente evoluiu bem clinicamente, sem complicações, com bom resultado estético. O presente caso apresentava uma exuberância clínica não condizente com os parâmetros laboratoriais e sintomatologia descrita na literatura.(AU)

BACKGROUND AND OBJECTIVES: Benign symmetric lipomatosis (BSL) was first described by Madelung in 1888 and still has unknown pathogenesis. It is characterized by multiple unencapsulated painless fat deposits with symmetrical disposition, preferably located in the cervical region and upper trunk and may cause compressive symptoms and pseudoathletic appearance. Surgical treatment is most effective, and it could be done by resection or liposuction. The objective of this study was to present the importance to describe the case due to your clinical exuberance without symptoms or significant changes in laboratory tests.CASE REPORT: Male patient, 77 years old, farmer, born in Pernambuco. Reported that 8 months ago began progressive growth of a painless mass in the cervical region, occipital region and upper chest, with no family history. He has high blood pressure, alcoholic and smoker. On examination, it could be noticed a large fibroelastic symmetric mass, asymptomatic, in the cervical region, not adhered to deep planes and with no signs of inflammation.CONCLUSION: The benign symmetric lipomatosis was rated by Enzi et al. in two types, the patient in this case was classified as type I, predominantly cervical lymphoma. The intake of alcohol consumed by the patient is strongly associated with the etiology of this disease, according to Enzi et al. The patient underwent a lipectomy with a two steps approach due to surgical invasion of vital structures. The patient was stable clinically, without complications, with good aesthetic results. The clinical case described had an exuberance of clinical manifestations, not consistent with laboratory parameters and symptoms described in the literature.(AU)

Novas cânulas para lipoaspiração e lipoenxertias: compontas maciças fixas e pontas maciças rosqueadas / New liposuction cannulas: with fixed massive tips and or threading massive tips

Neste artigo, são apresentadas novas cânulas para lipoaspirações e lipoenxertias, com pontasmaciças fixas e ou pontas maciças rosqueadas.

In this paper, new liposuction cannulas with fixed massive tips and or threading massivetips were presented.

Lipoaspiración: conceptos generales / g

Actualmente la lipoaspiración es uno de los procedimientos quirúrgicos de mayor demanda en cirugía plástica, constituyéndose en una práctica muy habitual en nuestro quehacer profesional. Básicamente, consiste en la extracción de grasa del compartimiento subcutáneo, mediante aspiración. Concepto quirúrgico que ha evolucionado, desde sus inicios en 1977, período en que se utilizaban curetas y aspiración en seco, hasta la modalidad actual, con cánulas fenestradas e infiltración tumescente. Siendo un procedimiento con abordajes mínimos, prácticamente ciego, y controlado fundamentalmente por el tacto; es en esencia "operador dependiente" implicando una larga curva de aprendizaje. Al proceso de aspiración se puede agregar el autoinjerto de grasa en otras zonas, obteniendo así una corrección o mejoría tridimensional del contorno corporal. La lipoaspiración puede ser de magnitudes diversas, abarcando desde algunos centímetros cúbicos hasta más de dos litros de grasa decantada, razón más que suficiente para considerarla una intervención que debe cumplir con todo el protocolo de evaluación preoperatoria, medidas de manejo intraoperatorio y cuidado postoperatorio, como corresponde a toda intervención de gran envergadura susceptible de las complicaciones inherentes a la cirugía.

Tulip liposuction in plastic surgery.

Tulip liposuction is a recent modification of the classical Mayo liposuction, which is done by suction apparatus consisting of large cannula, non collapsible wide bore tubing and a big suction device. Tulip liposuction is an entirely hand operated device comprising of special syringes, designed to fit snugly to thinner metallic cannula, with proximal ends shaped like a Tulip hence the Tulip liposuction. This modification has many advantages over the Mayo type. This paper presents the experience 110 cases of liposuction in Bangladesh. The study was carried out at different hospitals in Dhaka from December 1997 to February 2001. One hundred ten patients underwent this procedure. Of them hundred and one were carried out for cosmetic reasons. The other nine for extraction of lipomas. The age range was 21 to 49 years. Twenty four were males and eighty six were females. Sixty seven patients received spinal anesthesia and thirty nine patients received general anaesthesia. Only four cases were done under local anaesthesia. Hyaluronidase, adrenaline and normal saline were injected in the subcutaneous fat. A small stab incision was made and then fat was aspirated. No stitches were required. Complications were minimal and insignificant.

Estudio comparativo entre lipoaspiración convencional versus ultrasónica / Comparative study between conventional versus ultrasonic lyposuction

Se presenta una orientación general histórica y conceptual acerca de la técnica de lipoaspiración y los métodos de uso actual. Se presenta un estudio prospectivo comparativo clínico e histológico entre los métodos de lipoaspiración convencional y ultrasónico en la región abdominal. Se concluye que la lipoaspiración ultrasónica requiere mayor tiempo quirúrgico en relación a la técnica convencional, aspira semejante cantidad de tejido adiposo, presenta un adelgazamiento similar en el panículo cutáneo adiposo, pero comparativamente presenta una mayor facilidad técnica, preserva la trama conjuntiva, ocasiona menos sangrado y una menor respuesta inflamatoria fibrótica secundaria

Uso en cirugía plástica de la bioprótesis de pericardio bovino tratado con gluteraldehído / Use in Plastic Surgery of bovine pericardium treated with gluteraldehyde

Presentamos nuestra experiencia en la obtención, preparación, preservación y aplicación clínica de una bioprótesis de pericardio bovino tratada con gluteraldehído como curtidor y preservador, comparándolo con otros materiales sintéticos. En este trabajo, se incluyen 51 casos con 80 bioprótesis aplicadas para reparar defectos abdominales, donadores del colgajo musculocutáneo del recto anterior, para reforzar las reparaciones y aplicaturas musculares en dermolipectomías abdominales para definir mejor la silueta. También se ha utilizado para crear un brassiere (sostén) interno en casos de mamoplastias reductivas y en un caso de reparación de vandeletas y poleas de tendones flexores. La experiencia acumulada previamente a nivel experimental y la adquirida a nivel clínico, confirman la buena tolerancia, resistencia y estabilidad de este material a tres años de su utilización, por lo que podemos concluir que es recomendable su uso y que su campo de aplicación en cirugía reconstructiva, es prácticamente ilimitada

Injeçäo de gordura ou lipo-enxertia / Injections of fat or fat graft

Os autores apresentam um sistema para enxertia da gordura lipoaspirada retirada da regiäo peripatelar (joelho). É a que melhor se presta para esses autotransplantes. O procedimento é simples, de baixo custo, isento de complicaçöes e pode ser repetidos sem morbidade

Syringe liposculture

Groups of ten patients each were evaluated to compare syringe and machine powered lipocontouring, In each group, between 1,200 and 1,500 ml was removed. The patients undergoing the syringe technique had less blood loss and appeared to recover more rapidly, requiring fewer analgesic agents. The advantage to the surgeon with the syringe was the accurate removal of fatty tissue with quantitation in different areas, avoidance of vaporization of material increasing the safety to the operating team and a quiet operating room. The new syringe, which is a modification to that originally designed by Fournier, obviates many of the earlier problems associated with the technique.

Superficial syringe liposculture: a personal technique

"Superficial Syringe Liposculpture" - SSL allows for the treatment of localized fat deposits in patients with flaccid skin, skin irregularities, depression, cellulite and liposuction sequaelae. We have developed a special cannula - the Toledo cannula - a fork tipped needle-dissector with a single lateral hole. The tips of the fork are blunt, so as not to perforate the skin while workin in the superficial layer of fat, and the inner part of the "V" is sharp, to cut the septi or flbrous adherences. It can also suction and inject fat. This technique changes the concept that it is only possible through liposuction to alter the conditions of the deep layer of fat in young patients with good skin tone. With our development of working in the superficial layer of fat using fine cannulas, we provoke skin retraction. Now flaccid skin patients can also opt for body contour surgery. We can remodel the entire body with disposable syringes and fine cannulas, improving not only contour defects, but also superficial irregularities.

Beautifying the hands

Fat tissue implantation to treat signs of ageing of the hands was conducted in 72 patients. Local or general anesthesia can be employe, according to indication or patient's wishes. Incidence of satisfaction with the results is high (71 in 72 cases) and of complications is low (3 in 72 cases)