ABSTRACT
UNLABELLED: Nuvaring (Organon, Kenilworth, NJ) is a vaginal contraception ring inserted by the patient. It was approved by the Food and Drug Administration in 2001 for the prevention of pregnancy. The intent of this paper is to increase the awareness of Nuvaring among plastic surgeons, and to explore the risks associated with its use. We report the cases of two cosmetic surgery patients. These patients developed deep venous thrombosis and pulmonary emboli in the postoperative period while using Nuvaring. The very advantages of the Nuvaring-the ease of use, the avoidance of daily administration, and the insertion and removal of the device by the patient-may lead to the failure of patients to recollect being on a vaginal ring for contraception. LEVEL OF EVIDENCE: 4 Risk.
Subject(s)
Abdominoplasty/adverse effects , Breast Implantation/adverse effects , Contraceptive Devices, Female/adverse effects , Desogestrel/analogs & derivatives , Ethinyl Estradiol/adverse effects , Pulmonary Embolism/etiology , Venous Thromboembolism/etiology , Venous Thrombosis/etiology , Administration, Intravaginal , Adult , Anticoagulants/therapeutic use , Desogestrel/administration & dosage , Desogestrel/adverse effects , Drug Combinations , Embolectomy , Ethinyl Estradiol/administration & dosage , Female , Humans , Pulmonary Embolism/diagnosis , Pulmonary Embolism/therapy , Risk Assessment , Risk Factors , Tomography, X-Ray Computed , Treatment Outcome , Venous Thromboembolism/diagnosis , Venous Thromboembolism/therapy , Venous Thrombosis/diagnosis , Venous Thrombosis/therapyABSTRACT
BACKGROUND: Radiofrequency-assisted liposuction involves the delivery of a controlled amount of energy to treated tissue resulting in fat liquefaction, accompanying hemostasis, and skin tightening. The purpose of this study is to report experience with a larger sample size using the BodyTite™ radiofrequency-assisted liposuction (RFAL) platform, and its first use with local tumescent anesthesia. The Bodytite™ device is currently awaiting FDA approval. METHODS: We prospectively included 97 patients who underwent radiofrequency-assisted liposuction under local anesthesia under IRB approval. We treated 144 anatomical areas in 132 operations and collected the following data: age, sex, height, weight, body mass index (BMI), anatomical area of treatment, operative time, amount of tumescent solution used, amount of fat aspirated, amount of kilojoules (kJ) delivered, and the incidence of infections, seromas, adverse effects from medications, and thermal injuries. Patients were asked to complete an online survey assessing the aesthetic outcome and quality of life after treatment with RFAL-assisted liposuction. Three independent plastic surgeons were asked to evaluate photographs of our 6-month postoperative results in comparison to the preoperative photos. RESULTS: The average age and BMI of our study population was 37.6 years and 28.2 kg/m2, respectively. The study population was 88% female. The mean amount of lidocaine given per treatment session was 32.7 mg/kg (range=3.8-83.3 mg/kg). The mean amount of tumescent fluid given per anatomical treatment area was 1,575 cc. The average amount of total aspirate across all anatomical treatment areas was 1,050 cc, with an average total aspirate of 1,146 cc per treatment date. The overall incidence of major complications was 6.25% and the incidence of minor complications was 8.3%. Overall patient satisfaction was 82% for the degree of skin tightening and 85% for the body-contouring result with the BodyTite™ device. Three independent plastic surgeons graded the improvement in body contour as good to excellent in 74.5% of patients and the improvement in skin tightening as good to excellent in 58.5% of patients. CONCLUSIONS: The BodyTite™ RFAL platform is a safe and effective device for use as an energy-based liposuction technique under local tumescent anesthesia in the awake patient. LEVEL OF EVIDENCE IV: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors at www.springer.com/00266.
Subject(s)
Anesthesia, Local/methods , Lipectomy/instrumentation , Lipectomy/methods , Radiofrequency Therapy , Subcutaneous Fat/surgery , Adipose Tissue/surgery , Adult , Body Mass Index , Female , Humans , Male , Middle Aged , Minimally Invasive Surgical Procedures/methods , Patient Satisfaction , Prospective Studies , Treatment OutcomeABSTRACT
We introduce a new technique for harvesting cancellous bone, the pubic bone graft. The pubic bone graft is a predictable and efficient technique that yields an ample harvest of rich cancellous bone. With experience gained from multiple fresh cadaver dissections, we present this technique in detail, including our most recent clinical application to graft alveolar clefts and its advantages over the traditional technique of bone graft harvesting.
