Large-volume Liposuction Research Articles

Large-volume lipolysis assisted by low-level multifrequency laser in obesity: Short-term weight trajectories and postoperative complications

Introduction: Obesity is a chronic and complex syndrome resulting from the interactions of genetic, environmental, metabolic, and psychological factors. Current pharmacologic treatments often yield limited, unsustainable weight loss; thus, bariatric surgery and large and giant-volume liposuction have emerged as viable options for its control. Objective: This study aimed to assess Laser-assisted with large-volume liposuction in weight reduction effectiveness in obese adults and to describe the early postoperative complications of this procedure.

Intraoperative fluid management of large volume liposuction surgery, cardiometry guided stroke volume variation versus Rohrich formula, a prospective randomized trial

Intraoperative fluid management of large volume liposuction surgery, cardiometry guided stroke volume variation versus Rohrich formula, a prospective randomized trial

Evaluation of Blood Loss in Third-Generation Internal Ultrasound-Assisted Liposuction.

In large-volume liposuction procedures, one of the most important limitations of total lipoaspirate volume is blood loss. In this study, we aimed to determine the amount of blood loss in individuals who underwent a third-generation internal ultrasound-assisted liposuction (UAL). Eleven female and eleven male participants with a mean age of 35.31 (range 20-47) were included in this prospective study. The third-generation internal UAL was performed on multiple anatomical regions using the VASER® Internal Ultrasound Device (Sound Surgical Technologies; Louisville, CO). The demographic characteristics of the participants, the amount of aspirate collected, and hemoglobin (Hgb) and hematocrit (Htc) values before and after the third-generation internal UAL were evaluated. The mean third-generation internal UAL time was 74.81 ± 17.95 minutes, and the mean aspiration amount was 5,122.27 ± 1,597.43ml. The aspirated amount was 6.64% ± 2.20 of body weight. The mean Hgb value was 13.87 ± 1.99 before the third-generation internal UAL and 11.26 ± 2.16 (g/dL) after the third-generation internal UAL (z = 4.108, p < 0.001). The mean reduction in Hgb levels with the third-generation internal UAL was 2.61 ± 1.73 and 0.53 ± 0.36 per liter of aspirate taken. The mean Htc value after the third-generation internal UAL was 33.91 ± 6.03 and was significantly lower than the mean Htc value before the third-generation internal UAL, 41.39 ± 5.13 (z = -3.946, p < 0.001). The mean reduction in Htc with the third-generation internal UAL was 7.48 ± 5.42, and the Htc value decreased by 1.50 ± 1.13 per liter of aspirate ingested. The amount of aspirated supernatant was responsible for 44.4% of the change in Hgb and 30.9% of the change in Htc after the third-generation internal UAL. Knowing the reduction rates in Hgb and Htc with the third-generation internal UAL is useful to plan the amount of aspirate to be taken, the amount of blood loss that may occur with the third-generation internal UAL, and the postoperative care of the patients. 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 www.springer.com/00266 .

The Safety of Large-Amount Liposuction: A Retrospective Analysis of 28 Cases.

Our study aims to assess the safety of large amounts of liposuction in a new light. This is a retrospective review of patients who underwent large-volume liposuction from August 2020 to April 2021. Patient demographics, liposuction areas, the amount of infiltrate and aspirate, the surface area of liposuction areas, anesthesia duration, pain score after surgery, preoperative and 4-h postoperative hemoglobin, and basic metabolic panel (sodium, potassium, creatinine, urea) were measured. Out of the 28 patients, 26 (92.85%) were females. The mean age was 37.1 years old. The mean preoperative hemoglobin was 13.73 g/dL. The average anesthesia time was 220.39 min. The average amount of liposuction infiltrated was 7.55 L, and the average amount of liposuction aspirate was 6.83 L. The mean hemoglobin 4 h postoperatively was 13.7 g/dL. With proper patient selection and a comprehensive physical exam with preoperative blood workup performed in an accredited facility with a highly experienced plastic surgeon and anesthesiologist, mega liposuction can be safely performed as a day surgery procedure.

Outpatient-Based High-Volume Liposuction: A Retrospective Review of 310 Consecutive Patients.

Currently, the definition of large-volume liposuction is the removal of 5 L or more of total aspirate. Higher volumes of lipoaspirate come into consideration with higher BMIs, because more than 5 L is often required to achieve a satisfactory aesthetic result. The boundaries of what lipoaspirate volume is considered safe are based on historical opinion and are constantly in question. Because to date there have been no scientific data available to support a specific safe maximum volume of lipoaspirate, the authors discuss necessary conditions for safe high-volume lipoaspirate extraction. This retrospective study included 310 patients who had liposuction of ≥5 L over a 30-month period. All patients had 360° liposuction alone or in combination with other procedures. Patient ages ranged from 20 to 66 with a mean age of 38.5 (SD = 9.3). Average operative time was 202 minutes (SD = 83.1). Mean total aspirate was 7.5 L (SD = 1.9). An average of 1.84 L (SD = 0.69) of intravenous fluids and 8.99 L (SD = 1.47) of tumescent fluid were administered. Urine output was maintained above 0.5 mL/kg/hr. There were no major cardiopulmonary complications or cases requiring blood transfusion. High-volume liposuction is safe if proper preoperative, intraoperative, and postoperative protocols and techniques are employed. The authors believe that this bias should be modified and that sharing their experience with high-volume liposuction may help guide other surgeons to incorporate this practice with confidence and safety for better patient outcomes.

Metabolic Benefits of Large Volume Liposuction in Prediabetic Patients; A Prospective Clinical Trial

Metabolic Benefits of Large Volume Liposuction in Prediabetic Patients; A Prospective Clinical Trial

The effect of tranexamic acid on blood loss in liposuction: a randomized controlled study.

BackgroundLiposuction is one of the most common procedures in the practice of plastic surgery. Since it evolved, continuous modifications have been to decrease blood loss so that patients are hemodynamically stable intra- and postoperatively. Tranexamic acid (TXA) has long been used for its antifibrinolytic properties that were beneficial in reducing blood loss, rate of transfusion, and hemoglobin drop in major trauma and surgeries. Its use in plastic surgery, however, is still limited. In this study, we aim to illustrate the effect of intravenous (IV) and local infiltration of TXA on blood loss in liposuction surgery.MethodsBetween April 2019 and April 2021, 90 patients who requested liposuction for various body parts were randomly allocated into 3 equal groups: control group, IV TXA, and local infiltration of TXA. A sample was taken from infranatant and sent for hematocrit calculation. Volume of blood in lipoaspirate was then calculated. Patients were assessed for blood loss and postoperative bruising.ResultsVolume of blood loss in lipoaspirate was considerably lower in the TXA groups, with 60% decrease in blood loss for the local TXA group in comparison with the control group. TXA has also been shown to markedly decrease bruising tendency in postoperative liposuction patients.ConclusionsTXA can be used to decrease blood loss in large-volume liposuction, modify the need for blood transfusion intra- and postoperative, and improve the results of liposuction procedure without the need for multiple sessions.Level of evidence:Level II, Risk/Prognostic Study.

AUTOLOGOUS TRANSFUSION IN LARGE VOLUME LIPOSUCTION. COHORT FOLLOW-UP.

INTRODUCTION: With the increased knowledge about the physiology of liposuction, procedures that involve larger body surface area are now being performed, which means an increased risk of hemorrhage and the need for transfusion. Homologous blood transfusion poses well-known risks, prompting the use of alternative and safer techniques such as autologous donation. To demonstrate the utility of autologousOBJECTIVE: transfusion in a cohort of patients undergoing large volume liposuction. Observational, retrospective andMETHODS: longitudinal cohort study in patients undergoing liposuction, in the period 2017-2021. Autologous donation was performed one month and two weeks prior to surgery, ensuring that all patients were prescribed medication and prophylactic dietary measures to avoid hemoglobin depletion. 40 les of women between 26 and 46 years of age, with a bodyRESULTS AND CONCLUSIONS: mass index between 24 and 30 m/kg2 and a median aspirated volume of 6.3 Lt were analyzed. Quantied bleeding averaged 675 cc. Both initial hemoglobin and hematocrit had statistically signicant differences with values in the postoperative period (pn all. However, vital signs remained stable and no transfusion-associated adverse events occurred. Autologous transfusion is an excellent strategy for the management of bleeding in large volume liposuction.

THE IMPACT OF LARGE VOLUME LIPOSUCTIOM WITH ADRENALINE ONLY ON THE PREGNANCY AND AESTHETIC OUTCOMES OF INFERTILE OBESE WOMEN

Background: Obesity dysregulates the hypothalamic-pituitary-ovarian axis resulting in ovulatory dysfunction and subsequent infertility. Tumescent liposuction comprised injection of a large volume of lactated Ringer's solution or normal saline, containing super-diluted epinephrine and lignocaine, in the subcutaneous fat. Even though this procedure accomplished accepted results as a body contouring surgery, the association between large-volume liposuction and infertility outcomes was not examined yet. Objectives: To reveal the aesthetic and reproductive outcomes of obese infertile female patients with established underlying hormonal irregularities and submitted to large-volume tumescent liposuction with the use of adrenaline only. Patients and Methods: The present prospective cohort study was conducted at Al-Azhar University Hospitals throughout September 2015 and August 2020. Obese or overweight infertile women within the reproductive age with menstrual irregularities, for at least one year were eligible for inclusion in the present study. These abnormalities were confirmed based on laboratory, and radiological evaluation. The procedure was done under general anesthesia and sterilization with betadine with small stabs in targeted areas. Post-operative pain was assessed using Visual analogue scale (VAS). Results: A total of 18 female patients with established infertility of more than one-year duration were included in this study. Patients were furtherly assorted based on fulfilling Rotterdam criteria into two groups: Group (A) including 10 patients with polycystic ovarian syndrome (PCOS), and group (B) encompassing eight patients without. Clinically, three cases of secondary infertility get pregnant after the procedure, one case get pregnant after eight months and two of them after one year. Furthermore, two cases of primary infertility with PCOS get pregnant after six months and the other after one year. Seven cases of secondary infertility developed dramatic improvement in hormonal profile preparing them for conception without pregnancy. Patients experienced a statistically significant decline in the body mass index (P<0.001, t=61.3). As for patients’ satisfaction, 15 (83.33%) gave a 4 or 5 score to their general appearance. This was reflected in the quality of life in which 13 (72.22%) patients were highly satisfied. No patient complained of uncomfortable postoperative pain. Conclusion: Large-volume tumescent liposuction with use of adrenaline only was a safe, effective, and promising procedure in amending the negative reproductive and aesthetic repercussions of obesity among infertile obese women. These findings were associated with satisfactory pregnancy and cosmetic outcomes, which reflected on patients’ satisfaction. No patient in our cohort experienced discomfort pain despite xylocaine non-use.

Commentary on: Safety of Large Volume Liposuction in Aesthetic Surgery: A Systematic Review and Meta-Analysis.

Commentary on: Safety of Large Volume Liposuction in Aesthetic Surgery: A Systematic Review and Meta-Analysis.

Commentary on: Safety of Large Volume Liposuction in Aesthetic Surgery: A Systematic Review and Meta-Analysis.

Kanapathy et al1 did an excellent review of large volume liposuction. Liposuction is one of the most common surgical procedures in plastic surgery,2 and it has evolved a lot both in how it is performed and the technology employed. One of the most important aspects in the evolution of the technique, in addition to the technologies utilized, has been the volume of fat removed during the surgical procedure. Initially, liposuction was created for the elimination of small volumes of fat located in specific areas.3 However, advances in technology and surgical techniques allowed increasing the amount of fat removed. The first reports of large volume liposuction had as their main limitation the significant bleeding that occurred during surgery, which usually required multiple blood transfusions to perform.4,5 With the advent of tumescent infiltration, the bleeding problem was resolved,6-8 thereby leading to the possibility of increasing...

The Effects of Large Volume Liposuction on Body Weight

Objective: To study the effect of large volume liposuction on body weight and total body fat in overweight and obese patients (BMI from 25-35) and in patients with localized accumulation of fats in normal person. Background: Liposuction has become one of the most popular cosmetic procedures performed by broad- certified surgeon.Method: This study was conducted on 31 patients presented with localized accumulation of fat either in thigh, abdomen, back or gluteal region and arms or in generalized overweight patients with BMI 25-30 and obese patients class 1 with BMI 30-35 will undergo large volume liposuction in plastic surgery department, faculty of medicine, Menoufia University . All studied patients were subjected to full history general examination, local examination (for the area to be suctioned). Laboratory investigations as: Complete blood counts (CBC), blood glucose level, kidney function tests , liver function tests and bleeding profile. Results: There were statistically significant difference between preoperative measurements of total body fat and (3months, 6 months) postoperatively (P < 0.01).There were statistically significant difference between the preoperative measurements of visceral fat and postoperative measurements (after 3 months and 6 months) (P < 0.01).Conclusion: We found that the large volume liposuction in our patients significantly reduce the weight, BMI, total body fat, visceral fat, circumference of abdomen and gluteal region, also reduced plasma insulin level. Keywords: Body, Effects, Large Volume, Liposuction, Weight.

Management of large volume liposuction in lipedema patients with von Willebrand disease: A systematic review and treatment algorithm.

When performing large volume liposuction, perioperative management of lipedema patients with coagulation disorders remains challenging due to a lack of clinical experience. With a prevalence of 1% of von Willebrand disease (VWD) in the general population, basic knowledge on diagnostic and adapted surgical strategies are essential for patients' safety. Based on a selective literature review, the purpose of this article is to present a standardized algorithm for diagnosis and perioperative treatment of VWD patients undergoing large volume liposuction. The databases MEDLINE (via PubMed) and Web of Science were selectively searched with the term "(((liposuction) OR (surgery)) OR (lipectomy)) AND (((VWD) OR (hemostaseology)) OR (von Willebrand disease))". Included were articles published in English or German until November 2020. The evidence for large volume liposuctions in patients with VWD is limited. Experience is largely based on operations with similar bleeding risks. A safe performance requires an adjustment of the surgical technique and a customized perioperative drug substitution plan. According to the current literature, perioperative thromboembolic events appear to be rare with adequate drug treatment. The implementation of the developed diagnostic and treatment algorithm may help further reducing bleeding complications and improve the safety for treated patients.

The Effects of Large Volume Liposuction on Body Weight

The Effects of Large Volume Liposuction on Body Weight

Safety of Large-Volume Liposuction in Aesthetic Surgery: A Systematic Review and Meta-Analysis.

Current literature clearly outlines the complication rates of liposuction in general; however, data specific to large-volume liposuction (LVL) remain unclear. The authors aimed to synthesize the current evidence on the safety of LVL with this systematic review. A comprehensive search in the MEDLINE, EMBASE, and CENTRAL databases was conducted for primary clinical studies reporting on safety or complications related to aesthetic LVL from 1946 to March 2020. The primary outcome measure was the incidence of surgical complication, and the secondary outcome measure was changes in metabolic profile. Meta-analyses were conducted to pool the estimated surgical complication incidence and metabolic changes. Twenty-three articles involving 3583 patients were included. The average aspirate volume was 7734.90 mL (95% CI = 5727.34 to 9742.45 mL). The pooled overall incidence of major surgical complications was 3.35% (95% CI = 1.07% to 6.84%). The most common major complication was blood loss requiring transfusion (2.89% [95% CI = 0.84% to 6.12%]) followed by pulmonary embolism (0.18% [95% CI = 0.06% to 0.33%]), hematoma (0.16% [95% CI = 0.05% to 0.32%]), necrotizing fasciitis (0.13% [95% CI = 0.04% to 0.29%]), and deep vein thrombosis (0.12% [95% CI = 0.03% to 0.27%]). No fat embolism or death was reported in the included studies. The pooled overall incidence of minor surgical complication was 11.62% (95% CI = 6.36% to 18.21%), with seroma being the most common minor complication (5.51% [95% CI = 2.69% to 9.27%]). Reductions in lipid profile, glucose profile, body weight, and hematocrit level were observed after LVL. The authors meta-analyzed and highlighted the complication rates specifically related to LVL in this study; however, the current data are limited by the lack of level 1 evidence.

Ten-Year Experience With the Surgical Treatment of Lipedema—Long-Term Follow-up After Multi-stage Liposuction

PURPOSE: Liposuction is increasingly being utilized as an established surgical treatment of lipedema. Although conservative treatment is still considered as first-line treatment, removing the pathological adipose tissue with liposuction is possibly the only available therapy with long-term symptom reduction. However, data on long-term outcomes after surgical intervention in lipedema patients are lacking. METHODS: Between July 2010 and July 2019, 106 patients with lipedema underwent a total of 298 liposuction procedures. All patients completed a standardized questionnaire. Complaints associated with lipedema were assessed using a visual analogue scale score. The need for conservative treatment before and after surgery was compared using a composite complex decongestive therapy score. In cases where preoperative data were missing, retrospective acquisition was performed. Median follow-up time was 20.0 months (interquartile range, 10.3–42.0 months). RESULTS: The mean amount of lipoaspirate was 6354.73 ml (±2796.72 ml). No serious complications were observed following large-volume liposuction. Overall, a significant improvement of lipedema-associated symptoms could be observed. The need for conservative treatment was significantly reduced in long-time follow-up (complex decongestive therapy score reduction of 37.5%, interquartile range 0%–88.8%). In multigroup comparison, better results could be achieved when surgical treatment was performed at earlier stages. CONCLUSIONS: Liposuction of patients with lipedema is a safe treatment with long-lasting results in reducing the patient’s need for conservative treatment and improving lipedema-associated complaints. For an optimal outcome, surgical treatment should be considered at an early stage of the disease. Before performing liposuction, appropriate treatment of severe obesity is advisable.

Fasting Insulin Level Changes after Large Volume Liposuction

Abstract Background Obesity is a disabling disease which has gained greater attention worldwide. It significantly increases the risk for other diseases such as insulin independent diabetes mellitus also known as diabetes type 2. The most common surgical procedure for obesity is liposuction. It is traditionally performed either as small-volume liposuction or large-volume liposuction. Aim of the Work to spot the light on the effect of large volume liposuction on fasting insulin level changes after 3 months postoperative and to find if LVL may obtain any improvement in metabolic variables. This study will provide the clinician with a more valid basis on which to advise patients undergoing body-contouring procedures, particularly to ensure realistic expectations regarding the effects of body-reshaping procedures on general health. Patients and Mehtods This is prospective study was conducted on a total of 15 overweight and obese (BMI 26–35 kg/m2) premenopausal women (age 21–40years). All subjects were at their maximum body weight and weight stable for at least 3 months. The study took place at Ain Shams University Hospitals and other authorized hospitals under supervision of thesis supervisors studying fasting insulin changes after 3 months following large volume liposuction. Results The present study demonstrates that large-volume abdominal liposuction should, by itself, be considered a clinical therapy for obesity and its metabolic sequelae. Aspiration of large amounts of subcutaneous abdominal fat in women with abdominal obesity, besides having cosmetic benefits, does significantly improve fasting insulin levels. Therefore, the procedure is safe and could successfully help obese subjects to reduce their potential metabolic risks. Conclusion The analysis of the study suggests that plastic surgery could play a role in metabolism. The surgical removal of fat is not detrimental with regard to variation of metabolic indices.

Erratum to: Occurrence and surgical treatment of massive Morel-Lavallée lesion after large-volume liposuction: A rare clinical case

Erratum to: Occurrence and surgical treatment of massive Morel-Lavallée lesion after large-volume liposuction: A rare clinical case

Erratum to: Occurrence and surgical treatment of massive Morel-Lavallée lesion after large-volume liposuction: A rare clinical case

Erratum to: Occurrence and surgical treatment of massive Morel-Lavallée lesion after large-volume liposuction: A rare clinical case

Large-volume liposuction in acquired partial lipodystrophy

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