Lipoplasty: A case for a low-volume procedure

Abstract

Background: During recent years, the maximum volume of wetting solution used in lipoplasty procedures has increased. However, an increase in reported deaths and complications from lipoplasty since the introduction of high-volume techniques have raised questions about the safety of these procedures. Objective: This study evaluated the safety and effectiveness of low-volume lipoplasty performed with the patient under local anesthesia and conscious sedation. Methods: A contour map indicating the volume of fluid infiltrated/fat to be removed from each elevation was drawn on the patient 1 to 2 days before the procedure. Low pressure was used to infiltrate subcutaneous fluid, first to the most superficial fat layer just deep to the skin and then, under higher pressure controlled by the surgeon, to the entire thickness of the fat layer. Fat removal commenced when skin vasoconstriction become evident. The total volume of aspirate removed per site was measured, and the fat content of the aspirate was estimated. Results: In a series of 189 consecutive patients, the total amount of fat removed per procedure ranged from 246 to 4505 mL and averaged 1396 mL. There were no major complications. Conclusions: It is possible to perform lipoplasty effectively on obese patients and/or patients requiring treatment of a large percentage of body surface area while using less than 5 L of subcutaneous infiltration. Low-volume infiltration enables extensive fat removal with potentially less risk and fewer complications than higher-volume infiltration techniques.