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    1 OF 8

    Immediate liposuction could shorten the time for endoscopic axillary lymphadenectomy in breast cancer patients.
    World J Surg Oncol 2017 Jan 31;15(1):35. Epub 2017 Jan 31.
    Department of General Surgery, Zhujiang Hospital of Southern Medical University, 253, Gongye Dadao Zhong, Haizhu District, Guangzhou, China.
    Background: Endoscopic axillary lymphadenectomy (EALND) was introduced to clinical work to reduce side effects of conventional axillary lymphadenectomy, while the lipolysis and liposuction of EALND made the process consume more time. The aim of the study was to determine whether immediate liposuction after tumescent solution injection to the axilla could shorten the total time of EALND.

    Methods: Fifty-nine patients were enrolled in the study, 30 of them received EALND with traditional liposuction method (TLM), and the rest 29 patients received EALND with immediate liposuction method (ILM). Read More

    Effects of the intradiscal implantation of stromal vascular fraction plus platelet rich plasma in patients with degenerative disc disease.
    J Transl Med 2017 Jan 13;15(1):12. Epub 2017 Jan 13.
    US Stem Cell Inc, 13794 NW 4th Street, Suite 212, Sunrise, FL, 33325, USA.
    Background: Stromal vascular fraction (SVF) can easily be obtained from a mini-lipoaspirate procedure of fat tissue and platelet rich plasma (PRP) can be obtained from peripheral blood. The SVF contains a mixture of cells including ADSCs and growth factors and has been depleted of the adipocyte (fat cell) population. We evaluated the safety and efficacy of administering SVF and PRP intra-discally into patients with degenerative disc disease. Read More

    Tumescent Liposuction without Lidocaine.
    Plast Reconstr Surg Glob Open 2016 Aug 9;4(8):e829. Epub 2016 Aug 9.
    Division of Plastic Surgery, Department of Surgery, University of Nevada School of Medicine, Las Vegas, Nev.
    Background: Our previous study demonstrated that lidocaine has a negative impact on adipose-derived stem cell (ASC) survival. Currently for large-volume liposuction, patients often undergo general anesthesia; therefore, lidocaine subcutaneous anesthesia is nonessential. We hypothesized that removing lidocaine from tumescent might improve stromal vascular fraction (SVF) and ASC survival from the standard tumescent with lidocaine. Read More

    Effects of the intramyocardial implantation of stromal vascular fraction in patients with chronic ischemic cardiomyopathy.
    J Transl Med 2016 Jun 2;14(1):158. Epub 2016 Jun 2.
    Regenerative Medicine Institute, Tijuana, Mexico.
    Background: Stromal vascular fraction (SVF) can easily be obtained from a mini-lipoaspirate procedure of fat tissue. The SVF contains a mixture of cells including ADSCs and growth factors and has been depleted of the adipocyte (fat cell) population. We evaluated the safety and efficacy of administering SVF intra-myocardially into patients with chronic ischemic cardiomyopathy. Read More

    Adipocytes Viability After Suction-Assisted Lipoplasty: Does the Technique Matter?
    Aesthetic Plast Surg 2016 Aug 18;40(4):578-83. Epub 2016 May 18.
    The Department of Plastic and Reconstructive Surgery, Sheba Medical Center, Ramat-Gan, Israel.
    Background: Suction-assisted lipoplasty (SAL; liposuction) is an established aesthetic procedure in plastic surgery. The main parameters differentiating one method of lipoplasty from another are safety, consistency of results, and other more technical parameters. Due to the recent popularity of lipotransfer, the quality of extracted fat has become a relevant parameter. Read More

    First Dutch guidelines on lipedema using the international classification of functioning, disability and health.
    Phlebology 2016 Apr 12. Epub 2016 Apr 12.
    Dutch Expertise Centre of Lympho-vascular Medicine, Hospital Nij Smellinghe, Drachten, The Netherlands.
    Introduction: Lipedema is a chronic, progressive condition that can result in considerable disability. In 2011, the Dutch Society of Dermatology and Venereology organized a task force to create guidelines on lipedema, using the International Classification of Functioning, Disability and Health of the World Health Organization.

    Guideline Development: Clinical questions on significant issues in lipedema care were proposed, involving (1) making the diagnosis of lipedema; (2) clinimetric measurements for early detection and adequate follow-up; and (3) treatment. Read More

    Lipedema – lack of evidence for the involvement of tyrosine kinases.
    J Biol Regul Homeost Agents 2016 Jan-Mar;30(1):161-3
    Department of Dermatology and Allergology, Academic Teaching Hospital Dresden-Friedrichstadt, Dresden, Germany.
    Lipedema is a chronic disorder characterized by abnormal distribution of subcutaneous adipose tissue on the proximal extremities, pain and capillary fragility. Its etiology is unknown but in analogy to central obesity, chronic low-level inflammation in adipose tissue has been suggested. There seems to be an increased propagation of pre-adipocytes into mature adipocytes contributing to the massive enlargement of subcutaneous adipose tissue. Read More

    Specialist approaches to managing lipoedema.
    Br J Community Nurs 2016 Apr;Suppl:S30-5
    Freelance journalist and consultant specialising in health and sustainability.
    While there is no proven cure for lipoedema, early detection is key as specialist treatments, complemented by self-management techniques, can improve symptoms and prevent progression. There is no universal approach as the correct treatment or treatments will depend on each patient's particular circumstances; however, when chosen early and appropriately, interventions can provide huge benefits. The most common treatments in the management of lipoedema include compression, manual lymphatic drainage (MLD), tumescent liposuction, intermittent pneumatic compression therapy (IPC), kinesio taping, deep oscillation therapy, and cognitive behavioural therapy (CBT). Read More

    Estimated Maximal Safe Dosages of Tumescent Lidocaine.
    Anesth Analg 2016 May;122(5):1350-9
    From the *Department of Dermatology, University of California, Irvine, Medical Sciences, Irvine, California; and †Department of Statistics, University of California, Riverside, Riverside, California.
    Background: Tumescent lidocaine anesthesia consists of subcutaneous injection of relatively large volumes (up to 4 L or more) of dilute lidocaine (≤1 g/L) and epinephrine (≤1 mg/L). Although tumescent lidocaine anesthesia is used for an increasing variety of surgical procedures, the maximum safe dosage is unknown. Our primary aim in this study was to measure serum lidocaine concentrations after subcutaneous administration of tumescent lidocaine with and without liposuction. Read More

    On Beyond Lidocaine: Reconsidering Local Anesthetics in Tumescent Liposuction-A Critical Review.
    Ann Plast Surg 2016 Feb;77 Suppl 1:S66-9
    From the Section of Plastic Surgery, Yale School of Medicine, New Haven, CT.
    The use of tumescent solution in liposuction is now considered standard of care; however, much debate still exists regarding its ideal components, especially surrounding the inclusion of local anesthetics. This article reviews the discussion regarding the use of local anesthetics in tumescent liposuction and how it may evolve in the future. The need for local anesthetic additives in tumescent liposuction has been questioned, and the use of longer-acting agents discouraged; however, increasing number of reports in recent years have described the increasingly widespread use of tumescent anesthesia where a wetting solution is infiltrated to achieve anesthesia in an operative field for procedures other than liposuction. Read More

    Buttock Lifting with Polypropylene Strips.
    Aesthetic Plast Surg 2016 Apr 22;40(2):215-22. Epub 2016 Jan 22.
    Program of Plastic Surgery Under Carlos Chagas Institute at Hospital Casa de Portugal, Av. Nossa Senhora de Copacabana 1175, Rio de Janeiro, 1201, Brazil.
    Background: The purpose of this study was to evaluate the results of gluteal suspension with polypropylene strips.

    Patients And Methods: Ninety healthy female patients between the ages of 20 and 50 years (mean, 26 years), who wished to remodel their buttocks from December 2004 to February 2013 were studied retrospectively. All 90 patients were treated with 2 strips of polypropylene on each buttock using the following procedures: 27 (30 %) patients were suspended with polypropylene strips; 63 (70 %) patients were treated with tumescent liposuction in the sacral "V", lower back, supragluteal regions, and flanks to improve buttocks contour (aspirated volume of fat from 350 to 800 cc); 16 (18 %) patients underwent fat grafting in the subcutaneous and intramuscular layers (up to 300 cc in each buttock to increase volume); 5 (6 %) patients received implants to increase volume; and 4 (4. Read More

    [Recognising and treating lipidema OMIM 614103].
    Ann Dermatol Venereol 2015 Aug-Sep;142(8-9):523-9. Epub 2015 Aug 6.
    Service de dermatologie, centre hospitalier régional de Metz-Thionville, 1-3, rue du Friscaty, BP 60327, 57126 Thionville cedex 1, France.
    Lipedema is a poorly understood clinical entity that is frequently under-diagnosed and neglected or else confused with lymphoedema. However, in most cases, diagnosis is simple and does not usually necessitate laboratory examinations. There is an extremely high demand for therapy since the condition causes major morbidity and affects quality of life. Read More

    Laser-Assisted Liposuction Using the Novel 1,444-nm Nd:YAG Laser for the Treatment of Gynecomastia: A Pilot Study.
    Dermatology 2015 15;231(3):224-30. Epub 2015 Jul 15.
    Department of Dermatology, College of Medicine, Catholic Kwandong University, International St. Mary's Hospital, Incheon, South Korea.
    Background: Laser-assisted liposuction (LAL) is currently widely used to reduce localized fat. A novel Nd:YAG laser that uses a wavelength of 1,444 nm, which is better absorbed by fat, has recently been introduced. In this study, we investigated the efficacy of 1,444-nm Nd:YAG LAL for the treatment of gynecomastia. Read More

    The Current State of Fat Grafting: A Review of Harvesting, Processing, and Injection Techniques.
    Plast Reconstr Surg 2015 Oct;136(4):897-912
    New Orleans, La.; Ann Arbor, Mich.; Pittsburgh, Pa.; and New York, N.Y. From the Center for Stem Cell Research and Regenerative Medicine, Tulane University School of Medicine; the Department of Surgery, Division of Plastic Surgery, and the Burn Wound and Regenerative Medicine Laboratory, University of Michigan; the Department of Plastic Surgery, University of Pittsburgh Medical Center; and the Department of Plastic Surgery, New York University Langone Medical Center.
    Background: Interest in and acceptance of autologous fat grafting for use in contour abnormalities, breast reconstruction, and cosmetic procedures have increased. However, there are many procedural variations that alter the effectiveness of the procedure and may account for the unpredictable resorption rates observed.

    Methods: The authors highlighted studies investigating the effects of harvesting procedures, processing techniques, and reinjection methods on the survival of fat grafts. Read More

    Gluteoplasty with autologous fat tissue: experience with 106 consecutive cases.
    Plast Reconstr Surg 2015 May;135(5):1381-9
    Goiás and São Paulo, Brazil; and New York, N.Y. From the Department of Plastic Surgery, Federal University of Goiás, Brazil; the Department of Plastic Surgery, at University of São Paulo, Ribeirão Preto School of Medicine; and the Department of Ophthalmology and Clinical Trials Unit, Edward S. Harness Eye Institute, Columbia University Medical Center.
    Background: The female waist-hip ratio of around 0.7 is reachable through liposuction and gluteal fat grafting. The authors evaluated the reliability of this technique. Read More

    Acute pulmonary edema following liposuction due to heart failure and atypical pneumonia.
    Wien Med Wochenschr 2015 May 21;165(9-10):189-94. Epub 2015 Jan 21.
    Department of Dermatology and Allergology, Academic Teaching Hospital Dresden-Friedrichstadt, Friedrichstrasse 41, 01067, Dresden, Germany,
    Microcannular liposuction in tumescent anesthesia is the most effective treatment for painful lipedema. Tumescent anesthesia is an established and safe procedure in local analgesia when performed according to guidelines. Major adverse effects are rare. Read More

    Adipose Tissue-Derived Regenerative Cell-Enhanced Lipofilling for Treatment of Cryptoglandular Fistulae-in-Ano: The ALFA Technique.
    Surg Innov 2015 Dec 20;22(6):593-600. Epub 2015 Feb 20.
    North Tees and Hartlepool NHS Foundation Trust, University Hospital of North Tees, Stockton-on-Tees, UK.
    Background: The treatment of complex fistulae-in-ano is challenging and often includes a number of operations due to high rates of recurrence. Recently, techniques using in vitro expanded adipose tissue-derived stem cells have been described. We describe a novel treatment for cryptoglandular fistulae used in 7 patients, using a combination of surgical closure of the internal opening and real-time autologous adipose tissue-derived regenerative cells (ADRC)-enhanced lipofilling, without need for in vitro expansion. Read More

    Electrolyte and Haemogram changes post large volume liposuction comparing two different tumescent solutions.
    Indian J Plast Surg 2014 Sep-Dec;47(3):386-93
    Department of Plastic Surgery, Sir Ganga Ram Hospital, New Delhi, India.
    Background: The most common definitions of large volume liposuction refer to total 5 l volume aspiration during a single procedure (fat plus wetting solution). Profound haemodynamic and metabolic alterations can accompany large volume liposuction. Due to paucity of literature on the effect of different tumescent solutions on the electrolyte balance and haematological changes during large volume liposuction, we carried out this study using two different wetting solutions to study the same. Read More

    Local anesthetic use in tumescent liposuction: an American Society of Plastic Surgeons survey.
    Ann Plast Surg 2015 Feb;74(2):145-51
    From the *Department of Plastic and Reconstructive Surgery, Brown University Alpert Medical School, Providence, RI; †Division of Plastic Surgery, Department of Surgery, Rutgers New Jersey Medical School, Newark; and ‡Division of Plastic Surgery, Department of Surgery, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ.
    Background: Current guidelines favor the use of lidocaine in liposuction wetting solutions. The use of bupivacaine as an alternative remains controversial despite reports of its use with safe and favorable outcomes suggesting faster postoperative recovery time secondary to improved pain control. The goals of this study were to determine the prevalence of bupivacaine use, examine liposuction practices of bupivacaine users, and elucidate opinions regarding bupivacaine use. Read More

    A review of the aesthetic treatment of abdominal subcutaneous adipose tissue: background, implications, and therapeutic options.
    Dermatol Surg 2015 Jan;41(1):18-34
    Westlake Dermatology Clinical Research Center, Westlake Dermatology & Cosmetic Surgery, Austin, Texas.
    Background: The demand for aesthetic body sculpting procedures has expanded precipitously in recent years. Subcutaneous adipose tissue (SAT) deposits of the central abdomen are especially common areas of concern for both males and females.

    Objective: To review the available literature regarding the underlying pathophysiology of subcutaneous fat accumulation in the abdominal area and available treatment options. Read More

    Tumescent analgesia in plastic surgery.
    Plast Reconstr Surg 2014 Oct;134(4 Suppl 2):50S-7S
    Columbus, Ohio From the Department of Plastic Surgery, The Ohio State University.
    Background: Tumescent analgesia (TA) is commonly used for liposuction without needing sedation or general anesthesia.

    Methods: A literature review of current use of TA in plastic surgery was done to determine other procedures where TA can be useful and present a standard protocol for use.

    Results: TA is used for breast, body, face, and extremity procedures, both with and without supplemental anesthesia. Read More

    Role of Combined Circumareolar Skin Excision and Liposuction in Management of High grade Gynaecomastia.
    J Cutan Aesthet Surg 2014 Apr;7(2):112-6
    Department Preventive and Social Medicine, PGIMSR & ESIC Medical College, Kolkata, West Bengal, India.
    Introduction: High-grade gynaecomastia (Simon IIb and III) has tissue excess (skin excess, enlarged areola, and displaced nipple), which is best managed surgically; however, results of conventional breast reduction surgeries and liposuction is not very good. Aim of our study was to describe a combined technique to manage these problems to produce a good result.

    Material And Method: This was a 2-year study among 12 patients of high grade gynaecomastia. Read More

    Lidocaine-induced ASC apoptosis (tumescent vs. local anesthesia).
    Aesthetic Plast Surg 2014 Oct 7;38(5):1017-23. Epub 2014 Aug 7.
    Division of Plastic Surgery, Department of Surgery, University of Nevada School of Medicine, 2040 W. Charleston Blvd., Suite 301, Las Vegas, NV, 89102, USA,
    Background: The purpose for the present study was to determine which anesthetic method, local anesthesia versus tumescent, is superior for liposuction in terms of adipose-derived stem cell (ASC) survival in lipoaspirate; which component, lidocaine versus lidocaine with epinephrine, in anesthetic solutions could affect ASC survival; and which mechanism, necrosis versus apoptosis, is involved in lidocaine-induced ASC death.

    Methods: Human lipoaspirates were harvested using standard liposuction technique. Individuals scheduled for liposuction on bilateral body areas gave consent and were included in the study. Read More

    Autologous fat graft and bone marrow-derived mesenchymal stem cells assisted fat graft for treatment of Parry-Romberg syndrome.
    Ann Plast Surg 2014 Sep;73 Suppl 1:S99-103
    *Department of Plastic Surgery, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi; and †Department of Plastic Surgery, Chinese PLA General Hospital, Beijing, China.
    Background: Progressive facial hemiatrophy, also called Parry-Romberg syndrome (PRS), is characterized by slowly progressive atrophy of one side of the face and primarily involves the subcutaneous tissue and fat. The restoration of facial contour and symmetry in patients affected by PRS still remains a challenge clinically. Fat graft is a promising treatment but has some shortcomings, such as unpredictability and low rate of graft survival due to partial necrosis. Read More

    A simple and cheap system to speed up and to control the tumescent technique procedure: the Tedde's system.
    Eur Rev Med Pharmacol Sci 2014 Jun;18(11):1647-8
    Department of Medicine and Surgery, University of Salerno, Salerno, Italy.
    We have devised a low cost system to quickly infiltrate tumescent solution: we call it the "Tedde's system". This low-cost system offers an improvement in quality and quantity of the infiltration because all the procedure depends on the operators, reducing also the time of the infiltration and consequently of the whole surgical procedure. Moreover, this system can be applied to other surgical procedure that requires large infiltration volumes. Read More

    Invasive group A Streptococcus infections associated with liposuction surgery at outpatient facilities not subject to state or federal regulation.
    JAMA Intern Med 2014 Jul;174(7):1136-42
    Division of Healthcare Quality and Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia.
    Importance: Liposuction is one of the most common cosmetic surgery procedures in the United States. Tumescent liposuction, in which crystalloid fluids, lidocaine, and epinephrine are infused subcutaneously before cannula-assisted aspiration of fat, can be performed without intravenous or general anesthesia, often at outpatient facilities. However, some of these facilities are not subject to state or federal regulation and may not adhere to appropriate infection control practices. Read More

    Debulking surgery for elephantiasis nostras with large ectatic podoplanin-negative lymphatic vessels in patients with lipo-lymphedema.
    Eplasty 2014 28;14:e11. Epub 2014 Feb 28.
    Department of Anesthesiology and Intensive Medical Care, Emergency Medicine and Pain Management, Academic Teaching Hospital Dresden-Friedrichstadt, Dresden, Germany.
    Objective: Elephantiasis nostras is a rare complication in advanced lipo-lymphedema. While lipedema can be treated by liposuction and lymphedema by decongestive lymphatic therapy, elephantiasis nostras may need debulking surgery.

    Methods: We present 2 cases of advanced lipo-lymphedema complicated by elephantiasis nostras. Read More

    Treatment of elderly patients with advanced lipedema: a combination of laser-assisted liposuction, medial thigh lift, and lower partial abdominoplasty.
    Clin Cosmet Investig Dermatol 2014 23;7:35-42. Epub 2014 Jan 23.
    Department of Anaesthesiology and Intensive Medical Care, Emergency Medicine and Pain Management, Academic Teaching Hospital Dresden-Friedrichstadt, Dresden, Germany.
    Background: Lipedema is a rare female disorder with a characteristic distribution of adipose tissue hypertrophy on the extremities, with pain and bruising. In advanced stages, reduction of adipose tissue is the only available effective treatment. In elderly patients with advanced lipedema, correction of increased skin laxity has to be considered for an optimal outcome. Read More

    Avulsion brachioplasty: technique overview and 5-year experience.
    Plast Reconstr Surg 2014 Feb;133(2):283-8
    Huntersville and Chapel Hill, N.C. From the Hunstad Kortesis Center for Cosmetic Plastic Surgery & Medspa.
    Background: Popularity of arm-contouring procedures, once coveted by the massive weight loss population, has grown among society at large. The technique has evolved with the goal of producing a predictable and thin scar in a location that is acceptable for interpersonal interaction.

    Methods: All consecutive brachioplasty patients from May of 2008 to May of 2013 were reviewed retrospectively at a private surgery center. Read More

    Fat Ful'fill'ment: A Review of Autologous Fat Grafting.
    J Cutan Aesthet Surg 2013 Jul;6(3):132-8
    Department of Dermatology, Dr. D.Y. Patil Medical College, Navi Mumbai, Maharashtra, India.
    For more than a century, clinicians have attempted to utilise fat for the treatment of tissue deficiencies and contour abnormalities. Autologous fat transplantation for soft-tissue augmentation has become increasingly popular in recent years. The popularity of tumescent liposuction has brought renewed interest and accessibility of fat for transplantation. Read More

    A comparative study of internal laser-assisted and conventional liposuction: a look at the influence of drugs and major surgery on laboratory postoperative values.
    Drug Des Devel Ther 2013 11;7:1195-200. Epub 2013 Oct 11.
    Department of Aesthetic Medicine, Faculty of Pharmacy, Medical University of Białystok, Białystok, Poland.
    Background: Liposuction is a type of aesthetic surgery that has been performed on humans for decades. There is not much literature addressing the subject matter of pre- and post-surgery blood parameters, although this information is rather interesting. Documentation on patients who received laser-assisted liposuction treatment is particularly scarce. Read More

    Tumescent liposuction.
    Clin Plast Surg 2013 Oct;40(4):593-613
    Division of Dermatology, Department of Medicine, McMaster University, 1280 Main Street W, Hamilton, ON L8S 4L8, Canada. Electronic address:
    The evolution of liposuction has been multidisciplinary. The tumescent variant was developed using dilute local lidocaine and epinephrine and was meant to specifically exclude additional intravenous sedation, regional or general anesthesia, and intravenous fluids. Clinical pharmacology, pathophysiology, and safety studies are reviewed in this article. Read More

    Safe extensive tumescent liposuction with segmental infiltration of lower concentration lidocaine under monitored anesthesia care.
    Ann Plast Surg 2015 Jan;74(1):6-11
    From the Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
    Tumescent anesthesia makes it feasible to perform liposuction in an office setting. There are often patients who desire extensive liposuction on approximately 30% of total body surface area, which means the lidocaine total dose might be over the dosing recommendation. So the segmental infiltration is applied, although the concentration of lidocaine in tumescent fluid is gradually reduced to 0. Read More

    Tumescent suction curettage vs. curettage only for treatment of axillary hyperhidrosis evaluated by subjective and new objective methods.
    Acta Derm Venereol 2014 Mar;94(2):215-20
    Department of Clinical and Biomedical Engineering, Oslo University Hospital, NO-0027 Oslo, Norway.
    The main purpose of this study was to compare the effect of the 2 minimally invasive surgical techniques for treating axillary hyperhidrosis: superficial tumescent suction curettage and curettage only. A total of 22 patients diagnosed with axillary hyperhidrosis received one type of treatment at each side, randomized. Examinations were performed pre-operatively and at 3, 6 and 12 months following treatment. Read More

    Radiofrequency-assisted Liposuction for Arm Contouring: Technique under Local Anesthesia.
    Plast Reconstr Surg Glob Open 2013 Aug 10;1(5):e37. Epub 2013 Sep 10.
    BodySculpt Corporation, New York, N.Y.
    Background: Contouring of the arms that does not involve skin excision remains a difficult challenge due to the dependent nature and quality of the skin. Although brachioplasty remains effective, it requires a lengthy incision. Radiofrequency-assisted liposuction (RFAL) may improve skin retraction with a satisfactory aesthetic result without skin resection and the resultant scar. Read More

    Analgesic efficacy of lidocaine for suction-assisted lipectomy with tumescent technique under general anesthesia: a randomized, double-masked, controlled trial.
    Plast Reconstr Surg 2013 Aug;132(2):327-32
    Hospital Clínico J. J. Aguirre, Santiago, Chile.
    Background: Suction-assisted lipectomy is one of the most common procedures performed in plastic surgery. To minimize blood loss and to obtain adequate analgesia, a liquid solution is infiltrated into the subcutaneous plane before suction. The objective of this study was to determine whether the use of lidocaine in the infiltration solution reduces postoperative pain. Read More

    Histopathological features of tissue alterations induced by low frequency ultrasound with cavitational effects on human adipose tissue.
    Int J Immunopathol Pharmacol 2013 Apr-Jun;26(2):541-7
    Internal Medicine Unit, Policlinico Universitario di Bari, Bari, Italy.
    Low frequency, high energy level ultrasound (US) induces physical effects on tissues called ultrasonic cavitation (UC). Endermic US therapy has recently been proposed as a method to reduce non-invasively the amount of adipose tissue. Very few published studies have dealt with the biological effects of such therapies on human adipose tissue. Read More

    Autologous fat transfer in aesthetic facial recontouring.
    Ann Plast Surg 2013 May;70(5):513-6
    Section of Plastic and Reconstructive Surgery, Department of Surgery, Medical College of Georgia, Georgia Regents University, Augusta, GA 30912-4080, USA.
    Autologous fat graft transplantation has become increasingly popular in recent years. The recognition that soft tissue volume loss contributes to the aging of the face has driven the use of this procedure. Tumescent lipoaspirate provides ready accessibility of tissue for this transplantation, despite some perceived deficiencies in the predictability of volume maintenance with this method. Read More

    [Laser-assisted lipolysis for gynecomastia: safe and effective skin retraction].
    Rev Col Bras Cir 2013 Jan-Feb;40(1):23-31
    Instituto Médico Vilafortuny, Cambrils, Tarragona, Espana.
    Objectives: To evaluate efficacy of laser lipolysis in the treatment of gynecomastia to correct breast volume, flaccidity and excess skin without its excision.

    Methods: Prospectively, 32 patients with gynecomastia under tumescent anaesthesia and sedation underwent laser lipolysis with 980 nm diode laser, 15W continuous emission and 8 to 12 kJ energy per breast. Externally cold air was used to protect the skin. Read More

    Assessment of effects of physical or chemical factors on fat particle viability by glucose transport test.
    Ann Plast Surg 2014 Aug;73(2):225-30
    From the *Department 15 of Plastic Surgery Hospital, Peking Union Medical College, China Academy of Medical Sciences, Beijing; and †Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China.
    Background: It is important to protect fat viability during grafting. This study aimed to clarify whether physical or chemical factors damage fat viability.

    Methods: Fat was harvested under high and low tumescence pressure, using syringes and a liposuction machine; this fat was injected through different gauge needles and cultured with lidocaine or epinephrine. Read More

    Tumescent, how do I do it?
    Phlebology 2013 Mar;28 Suppl 1:15-20
    Department of Vascular Surgery, Maastricht University Medical Center, P. Debyelaan 25, PO box 5800, 6202 AZ Maastricht, The Netherlands.
    Local perivenous anaesthesia has evolved from tumescent anaesthesia which has had a huge impact on liposuction procedures. Perivenous anaesthesia has had a similar effect on peripheral venous surgery. Safety during its application is further enhanced when combined with skilled ultrasound guidance and astute operator awareness. Read More

    Evaluation and application of a high performance liquid chromatographic method for prilocaine analysis in human plasma.
    Clin Lab 2013 ;59(1-2):127-32
    Central Laboratory, University Medical Center Schleswig-Holstein, Campus Luebeck, Luebeck, Germany.
    Background: Prilocaine, a local anesthetic of the amide type, is frequently applied in substantial doses during tumescent liposuction. Although it cannot be excluded that the subcutaneously infiltrated narcotic may enter the circulation and trigger adverse systemic reactions, prilocaine plasma levels have rarely been measured during routine tumescent surgery. We established and evaluated a high performance liquid chromatography (HPLC) method for analysis of this narcotic and used it to measure the drug in plasma samples drawn in the course of tumescent liposuction with prilocaine local anesthesia. Read More

    The effect of pressure and shear on autologous fat grafting.
    Plast Reconstr Surg 2013 May;131(5):1125-36
    Division of Plastic and Reconstructive Surgery, Massachusetts General Hospital, Boston, MA, USA.
    Background: Fat grafting has become routine in plastic surgery because of low donor-site morbidity, a low complication rate, and fast recovery time. The optimal technique, however, has yet to be defined. Two critical variables are pressure and shear, both defined as force divided by area. Read More

    Tumescent anaesthesia.
    Surgeon 2013 Aug 1;11(4):210-21. Epub 2013 Feb 1.
    Department of Anaesthesia and Intensive Care Medicine, Adelaide, Meath & National Children's Hospital, Tallaght, Dublin 24, Ireland.
    Tumescent anaesthesia describes the practice of injecting a very dilute solution of local anaesthetic combined with epinephrine and sodium bicarbonate into tissue until it becomes firm and tense (tumescent). It was initially described in the field of liposuction but now surgical applications for the technique are widely varied ranging across vascular surgery, breast surgery, plastic surgery and ENT procedures. It is widely used in both hospital- and office-based environments and may form the sole method of anaesthesia for surgery. Read More

    Update on liposuction: clinical pearls.
    Cutis 2012 Nov;90(5):259-65
    Weill Cornell Medical College, Cornell University, New York, New York 10075, USA.
    Tumescent liposuction (TL) is one of the most commonly performed cosmetic surgeries in the United States. Although liposuction is not a therapy for obesity, it can be used to create a more aesthetic silhouette for a given body shape. Tumescent liposuction allows for the removal of large volumes of fat with minimal blood loss, low postoperative morbidity and mortality, and excellent cosmesis. Read More

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