Effects of Optimal Temperature Control in Body Contouring Surgery: A Non-Randomized Controlled Clinical Trial.

BACKGROUND: Perioperative hypothermia in plastic surgery has underestimated risks, including increased risk of infection, cardiac events, blood loss, prolonged recovery time, increased nausea, pain, and opioid usage. Inadequate preventive measures can result in up to 4 hours of normothermia restoration. OBJECTIVES: Compare the impact of different strategies for normothermia during plastic surgery procedures and its relationship with clinical outcomes. METHODS: A non-randomized clinical trial was conducted in a single center in Bogota, Colombia. We enrolled adult patients undergoing body contouring surgery and divided them into four intervention groups with different measures to control body temperature. Univariate and Bivariate analyses were performed comparing several clinical symptoms to evaluate outcomes. RESULTS: A total of 197 patients were analyzed. Most of them were women (84,3%). Mean age was 38.6 years, and a median procedure duration of 260 minutes. Demographic and clinical characteristics did not exhibit significant differences between the groups. However, there were notable variations in temperature measurements at crucial moments during the surgical procedure among the groups, attributed to the implementation of distinct thermal protective strategies. Group comparisons showed a relationship between hypothermia with increased nausea, vomiting, shivering, pain, and additional analgesia requirements. CONCLUSIONS: Incorporation of active thermal protective measures, such as Blanketrol or HotDog, during body contouring procedures, markedly diminishes the risk of hypothermia and enhances overall clinical outcomes. Implementing these active measures to maintain the patient in a state of normothermia not only improves operating room efficiency but also leads to a reduction in recovery room duration.

Mesh-like External Suture Splint: A Way to Improve Results and Reduce Postoperative Complications after High-definition Liposculpture.

High-definition liposculpture with variable degrees of muscular definition allows both patients and surgeons to broaden the procedure to fit almost any individual preferences; however, skin laxity and those secondary cases still represent a big challenge for the surgeon to achieve optimal outcomes. We are reporting our experience with a new suture-splint procedure to reduce edema, avoid skin laxity, and increase muscular definition after liposculpture. We enrolled patients undergoing HDL with any risk factor that could compromise aesthetic outcomes. Tumescent technique with VASER fat emulsification and power-assisted liposuction were used to complete HDL. We performed a continuous suture over the midline and other areas of muscular definition right before patients awakened from anesthesia. Real-time ultrasound imaging was performed to ensure the safety of the procedure. A total of 52 consecutive patients were treated with MesHD in our study. Only two patients voluntarily dropped off from postoperative analysis due to geographical limitations. Postoperative edema was referred by only one patient after surgery. No major complications were reported. Three patients complained of stabbing pain over one of the stitches, which resolved completely after suture removal. All patients were satisfied with postoperative results. Mesh suture-splint at body areas with high risk of adverse effects after body contouring surgery may be an effective procedure to improve recovery by decreasing edema formation, enhancingmuscular definition, decreasing risk of fibrosis, and avoiding skin laxity postoperative appearance.

Ultrasonic- and Ultrasound-assisted Improvement of Silhouette of the Torso: Bone Structure High-definition Remodeling (Part I).

Background: High-definition liposculpture allowed plastic surgeons to achieve better aesthetic results by carving the underlying muscles and contours in a new way. Several authors have improved the original technique by adding other procedures and new technologies. We designed a new improvement by incorporating bone transformation surgery to overcome the lack of silhouette at the waist and, as a result, optimize the breast-waist-hip ratios. Methods: We carried out a prospective multicenter study, with five different surgeons performing the same rib remodeling technique for waist definition. We used an ultrasonic piece for costal corticotomy and real-time ultrasound imaging to perform green-stick fractures over the last two or three floating ribs. Ours is a new technique based on the prior one described by Kudzaev. Results: We reported 131 consecutive patients who were enrolled in this study. Waistline diameter decreased an average of 8 cm after surgery (P < 0.05). Most patients were women (n = 125, 95.4%). No major complications were reported. Most common complication was prolonged pain, with only three cases of contour asymmetry, all of which were attributable to noncompliance of constantly wearing the corset + compressive garments. Patients reported a high satisfaction rate and fast recovery (Body-QoL survey). Conclusions: Ultrasonic- and ultrasound- assisted indentation surgery of the thorax is a safe and reliable technique for waistline definition, with a high satisfaction rate, almost-invisible scars, and minimal risk for complications. Incorporation of high-definition liposculpture to rib remodeling opens up a new horizon for bone structure modification surgery (S-high-definition remodeling) that can be safely performed for patients who seek better aesthetic outcomes in body contouring.