Non-Surgical Alternative to Facial Liposuction
Liposuction is one of the most frequently performed operations in aesthetic plastic surgery. In men, liposuction is primarily requested for the abdominal hip area in women, it is for the lateral and medial thigh, buttocks and hips ( saddle area ). This infrastructural supporting tissue is maintained when the tumescence technique is used, so that there is no chewing gum effect following liposuction, i.e., the skin does not have depressions in it but instead is tightened. The patient should be monitored for 24 h after the operation. He she may leave the hospital with a special girdle, which must be worn for 3 weeks. The injection sites may be treated with scar ointment for 3 weeks after the operation. Then the region treated by liposuction should be exercised in a gym under supervision. In the video, the manual tumescence liposuction technique with Mang's solution is presented as a basic technique. Auxiliary devices of whatever type (MicroAire, ultrasound, reciprocator, etc.) may be...
Cross Section of the Tissue 6 Months After Liposuction with Preservation of the Infrastructural Connective Tissue ICT
Six months after liposuction using the tumescence technique and cannulas less than 4.0 mm in size you can see that the infrastructural connective tissue has been preserved. The endoscopic image shows the intraoperative findings. The most important point when carrying out liposuction is that a so-called fat film is preserved in the upper section and that the connective tissue below it is preserved. This causes the chewing gum effect whereby the undamaged connective tissue septa contract after liposuction, tightening the skin.
Liposuction of the abdominal hip region is the most frequently requested procedure, particularly by men. Only individual zones should ever be treated with liposuction, i.e., abdomen hips or outer and inner thighs and buttock region (saddle area), as first the amount of tumescence that can be injected is limited (maximum 61) and second the procedure would be too stressful for the patient. As the navel region is particularly sensitive, a lot of tumescence must be used here. Liposuction of both hips or the upper and lower abdomen is carried out in a fan shape with the patient frequently changing position. Liposuction should be carried out carefully in the upper abdominal area, and a thin layer of fat should be left below the skin, as otherwise dimples will form and there can be loose skin.
With a quantity of tumescence solution of 300-500 ml the entire submental region extending deep into the neck area can be removed by liposuction. If required, the lateral cheek areas can also be removed. The procedure is often combined with a facelift. After the operation a compression dressing is worn for approximately 1 week so that the submental skin that has been detached in the neck area can adapt after liposuction to the areas where fat has been removed. Just by tunneling with the 2 mm cannula, scar contractions occur, which result in a tightening effect.
Unfortunately, fat calves often result from muscular hypertrophy. When performing liposuction of the calves the surgeon must have a lot of experience and be very careful to avoid causing dimples. For this reason caution must be exercised during liposuction of the calves and ankles. A 2-mm cannula with a vacuum that is not too high must be used (no higher than 0.6 at). After the operation immediate mobilization and the fitting of a compression girdle are advisable.
Tives and risks of the procedure on the day of the first consultation. A written record is kept of this. All the risks are set down in writing at this time. It should be made clear that the patient may experience pain during the operation and that occasionally pressure damage may occur to the nerves and soft tissue. This will subside again in the space of a few weeks. The loss of a large amount of blood necessitating blood transfusions does not normally occur when the tumescence technique is used. Bloody effusions and a feeling of numbness in the operation site can occur after the procedure. Dimpling and the limits of the possibilities of liposuction must also be explained to the patient, as must the risk of thrombosis and embolism as well as the small scars that will occur at the insertion sites. In rare cases allergic reactions can occur in the skin, mucous membranes, heart, circulation, kidneys, or nerves. For this reason liposuction should be carried out on an inpatient basis with...
Many new techniques are at our disposition and the number is constantly growing. Apart from basic techniques, detailed technical points become more and more important for the successful outcome. It is nearly impossible to provide a complete survey of all techniques available today in a single textbook, not to mention the variety of technical details that are frequently not described. It is to W. L. Mang's credit that he elected the forum of a manual instead of a large textbook to present his great personal experience. In the first volume of his manual, W. L. Mang described his personal experience with rhinoplasty, rhytidectomy, eyelid surgery, and otoplasty. His techniques and his tricks are presented in the form of very instructive sketches, and any surgeon who wants to enter the field of aesthetic surgery can do this easily following the impressive illustrations. Now the second part of the Manual of Aesthetic Surgery is available. It covers liposuction, breast implants, hair...
Suction-assisted lipectomy procedures, whether conventional or ultrasonic, have now become the single most requested elective aesthetic procedures in the United States. Approximately 145,000 of these procedures were performed in the year 1997, according to ASPRS statistics (1). However, the rising popularity of this procedure has brought with it a host of problems. To begin with, because this is not a surgical procedure in the traditional sense, it is being performed by a wide variety of practitioners, some of them with no surgical background or clear understanding of the surgical anatomy involved. Second, it is a procedure most commonly done on an outpatient basis outside of the control of any regulatory authorities (2). Additionally, with the advent of tumescent techniques, an unseemly race has developed to see who can suction out the most fat. The net result has been a dramatic rise in severe morbidity and fatal outcomes from highvolume liposuction. What is high volume It is...
The limit of the indications for liposuction in the area of the abdomen hips is exceeded if either the skin is slack and cracked (severe cellulite) following pregnancies or all the skin of the lower abdomen is slackened as a result of the aging process or extreme weight loss.
The new chapters Implantation and Adjuvant Treatment of Wrinkles , Hair Transplantation , Liposuction and Body Contouring, Including Aesthetic Breast Surgery and Abdominoplasty provide basic guidelines for safe and proper procedures and step-by-step operative details for different body regions.
An experienced aesthetic surgeon must look carefully at the indications for liposuction and for tightening of the abdominal wall. At present, unfortunately, a decision is taken to carry out liposuction too often, and the patient is later disappointed if the skin then hangs down loosely. Frequently, tightening of the abdominal wall is requested by patients who have increased skin accumulation around the umbilical area and a slack lower abdominal wall following pregnancies. It is also frequently requested by patients who have lost a lot of weight (20-40 kg) and by older patients who have a slack abdominal wall.
In males, gynecomastia is a common condition that occurs during adolescence and usually regresses spontaneously within 1 year, but moderate to severe cases that do not resolve may undergo reduction mammoplasty surgery for cosmetic and psychological sequelae. While surgery in the past has used open excision techniques, newer liposuction technology has been used with the aim of avoiding large areas of scarring and nerve and vessel injury. Ultrasound-assisted liposuction (UAL) has been recently used to treat gynecomastia in both adolescent and adult males. UAL selectively destroys adipose
The art of a good aesthetic surgeon is in choosing the right indication. He needs many years of experience to do this. It is possible to achieve good results without making large incisions with the new method of tumescence liposuction, particularly with collections of fat in the abdomen hip area. If, however, there is a lot of surplus skin and the patient has lost more than 30 kg in weight, or pregnancies have severely stretched the upper abdomen and periumbilical region, abdominoplasty is indicated. If it is necessary to tighten only the lower abdomen, it may be possible to avoid moving the navel. However, it is usually necessary to make an incision around the navel and reimplant this in the correct position.
In some plastic surgery practices, approximately 95 percent of the surgery caseload can be performed in a properly equipped operating suite within the office. Liposuction has become one of the most commonly performed procedures for removing unwanted fat from the stomach, buttocks, thighs, or other areas. Briefly, in this procedure, an incision is made in the skin, a cannula (tube) is inserted, and the fat is suctioned out. Other procedures commonly performed by plastic surgeons include facelifts, breast augmentation (or reduction), rhinoplasty (reshaping the nose), hair transplants, hand surgery, skin grafts for burn survivors and repair of cleft palate (both usually done in a hospital setting), breast reconstruction associated with cancer surgery, and other disfiguring malformations of the face and head. The top three cosmetic procedures in the United States are liposuction, breast augmentation, and eyelid lifts.
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