ABSTRACT
BACKGROUND: After massive weight loss (MWL), patients are known to experience significant improvement in obesity-associated comorbid conditions and metabolic disturbances, but almost two-thirds of them require reconstructive body-contouring surgery. METHODS: The authors present an anatomic study of surgical pieces obtained from 28 patients (17 women and 11 men) during torsoplasty and abdominoplasty procedures performed in their department from January 2007 to January 2008. The patients ranged in age from 39 to 52 years (mean, 43.3 years). The patients were divided into three groups. Group A consisted of 9 patients who had a normal body mass index (BMI) and stable weight (±5 kg) over the preceding 3 years. Group B consisted of 10 patients who had followed a nutritional diet over the preceding 3 years, achieving a mean weight loss of 42.2 kg (range, 38-52 kg). Group C consisted of 9 patients who had undergone bariatric surgery and insertion of a gastric band before 2004, achieving a mean weight loss of 47 kg (range, 40-57 kg). The authors evaluated the anatomy of the subcutaneous tissue in four body areas: the epigastric, umbilical, hypogastric, and lumbar regions. RESULTS: The macroscopic anatomic results of the subcutaneous tissue in the three groups are presented. The patients who underwent bariatric surgery (group C) had significant alterations of the subcutaneous tissue anatomy in all four body areas studied. Plastic surgeons who perform composite body-contouring procedures for this group of patients, combining truncal liposuction and lipoabdominoplasty procedures, should be aware of these anatomic changes. The possibility of a cannula perforating an internal organ during liposuction may have been higher for the group C patients than for the group A and group B patients. CONCLUSION: Knowledge concerning the anatomy of the subcutaneous fat in post-MWL patients allows a better choice of contouring procedure from an anatomic point of view, performance of a more rational and effective procedure, and differentiation of the technique depending on the area of the body, avoiding major complications.
Subject(s)
Adipose Tissue/anatomy & histology , Bariatric Surgery/methods , Diet, Fat-Restricted , Lipectomy/methods , Weight Loss , Adult , Body Mass Index , Cohort Studies , Female , Follow-Up Studies , Humans , Male , Middle Aged , Obesity, Morbid/surgery , Obesity, Morbid/therapy , Risk Assessment , Subcutaneous Tissue/surgeryABSTRACT
O presente trabalho tenta, a partir de dados colhidos no Setor de Saúde Ocupacional da Refinaria Duque de Caxias sobre os exames periódicos realizados nos funcionários da Petrobrás Distribuidora lotados naquela empresa, traçar o perfil de daúde de seus trabalhadores, assim como avaliar a importância da realização do exame periódico para a empresa e para o trabalhador. Na análise dos dados coletados, identificamos um percentual elevado de patologias diagnosticads, que apesar de não ter sido relacionado com a ocupação exercida, mostra indiretamente a qualidade de vida destes trabalhadores em uma empresa que é considerada de grande porte e que preocupa-se com a saúde de seus funcionários.
Subject(s)
Humans , Medical Examination , Occupational Diseases , Occupational Health , Occupational MedicineABSTRACT
Os autores apresentam sua experiência utilizando a abordagem subperiostal para o tratamento das rugas frontais, ptose das sobrancelhas, elevaçäo da ponta nasal, retirada de proeminências ósseas periorbitais e dorso nasal. Demonstram que, com a utilizaçäo desta técnica, os resultados säo altamente satisfatórios e o percentual de complicaçöes é mínimo
Subject(s)
Humans , Adult , Surgery, Plastic/methods , Face/surgeryABSTRACT
Os autores apresentam sua experiência, utilizando táticas anexadas a técnica de Arié-Pitanguy, com o objetivo primário de se diminuir a cicatriz do sulco submamário, mesmo em pacientes portadoras de hipertrofia, sem contudo haver prejuízo na forma, principal objetivo a ser almejado ao final da cirurgia
Subject(s)
Humans , Female , Adult , Breast/surgery , Cicatrix/surgery , Surgery, Plastic/methods , BrazilABSTRACT
The authors present the critical analysis about the use of the fat graft in the face and also show the indications and limitations of this procedure in large moving areas. Finally, they present their results in terms of slow follow up. (Photos 6 to 13) In the previous symposium we presented the procedure described by FOURNIER (MICROLIPOENXERTIA).(Photo 1) At that time we were using the procedure in all depressions and wrinkle of the face; nowadays we do not proceed this way and the purpose of this work is to bring up our conclusions and justifications about the election areas for the success of this method. As we said previously, some areas behaved in different way in relation to the profitting of the material although, technically, it has been used the same material and method. (Photo 2) In this case we have observed that areas with larger moving intensity absorbed with larger degree the grafted fat. Then, this has become the prime factor for the success of the treatment. Therefore, areas which we attained to immobilize for a seven days periodf(Photo 3) showed highly satisfavtory results. In this context we are now going to analyse the factors which refined our work and, as a consequence improved our results: Infiltrated Quantity - We think that by means of the "Washing" method the volume per area is in media of 20cc, this, a sufficient quantity to ger a satisfactory result. Aspiration and Injection Gauge - As we have already pointed out in our previous work, this gauge has to be always of same diameter. Granting Area - Preferably this should be the supra public and the inside face of the knee due to the great intensity of collagenous fibers existing in those resgions. Immobilization - For the sticking of the material it becomes necessary that the receiving area be motionless for seven days. Making use of all methodology described above we are now going to analyse the grafted areas as well as how they behaved as time passes by: Grafted Areas: Cheekbone, Glabellar, Genian, Mentonian, Periorbitals, Frontal, around the mouth (upper and lower labial)...
Subject(s)
Humans , Male , Female , Adipose Tissue/transplantation , Surgery, Plastic/methods , Face/surgeryABSTRACT
Os autores apresentam uma análise sucinta de sua conduta em relaçäo ao tratamento das rugas cervicofaciais, bem como a utilizaçäo de táticas com a finalidade de aprimorar os resultados obtidos até entäo. Däo ênfase aos métodos de microlipoaspiraçäo e microlipoinjeçäo que, pela simplicidade de execuçäo, podem ser utilizados várias vezes, se assim for necessário
Subject(s)
Humans , Female , Adipose Tissue/surgery , Surgery, Plastic/methods , Face/surgery , Suction/methodsABSTRACT
The authors present their methodology and results utilizing the technique of fat micrografting, aiming at eliminating depressions and sulci on the face. They also argue that, in case of absorption, the method can be reutilized countlessly, causing no harm to the patient
