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Tettamanzi M, Muratore G, Arrica G, Cuomo R, Beatrici E, Ginatempo I, Trignano C, Rubino C, Trignano E. Advancements in Face and Neck Contouring: Integrating Radiofrequency-Assisted Liposuction with FaceTite and Buccal Fat Pad Excision for Facial Slimming. Aesthetic Plast Surg 2024:10.1007/s00266-024-04245-1. [PMID: 39078425 DOI: 10.1007/s00266-024-04245-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2024] [Accepted: 07/02/2024] [Indexed: 07/31/2024]
Abstract
BACKGROUND The integration of neck liposuction with FaceTite Manipulus Radiofrequency (RF) technology and buccal fat pad excision for enhanced neck rejuvenation promise heightened precision and efficacy in sculpting the neck and jawline. Neck liposuction, coupled with RF technology, provides controlled thermal energy for adipose tissue treatment and collagen remodeling, while buccal fat pad excision offers refined contouring of the lower face and neck. This integrated approach aims to optimize patient outcomes and advance the field of esthetic plastic surgery. METHODS A prospective study was conducted from 2016 to 2023 on 80 consecutive patients who presented to the author's private clinic and required neck remodeling surgery for esthetic purposes. Patients were monitored and clinic appointments were scheduled at intervals of 0, 1, 3, 6 and 12 months post-treatment for evaluation. A tape measure recorded submental length at 1 and 6 months, and a satisfaction survey was administered one week before surgery and after six months. Physicians assessed improvement using a five-point scale for patient satisfaction and a four-point scale for overall improvement. RESULTS All patients underwent successful RFAL treatment, consistently achieving satisfaction with the outcomes. The average reduction in submental length measured 23 mm during the 6-month follow-up period. Additionally, the removal of buccal fat pads played a pivotal role in facial slimming and enhancing the esthetics of the upper cheek region. CONCLUSIONS The integration of neck liposuction with FaceTite RF technology and buccal fat pad excision offers a promising approach for enhanced neck rejuvenation and facial contouring. This combined method demonstrates heightened precision and efficacy in sculpting the neck and jawline, aiming to optimize patient outcomes and advance the field of esthetic plastic surgery. 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 www.springer.com/00266 .
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Affiliation(s)
- Matilde Tettamanzi
- Department of Surgical, Microsurgical and Medical Sciences, Plastic Surgery Unit, University of Sassari, Sassari, Italy.
| | - Giovanni Muratore
- Department of Surgical, Microsurgical and Medical Sciences, Plastic Surgery Unit, University of Sassari, Sassari, Italy
| | - Giovanni Arrica
- Department of Surgical, Microsurgical and Medical Sciences, Plastic Surgery Unit, University of Sassari, Sassari, Italy
| | - Roberto Cuomo
- Unit of Plastic and Reconstructive Surgery, Department of Medicine, Surgery and Neuroscience, University of Siena, Siena, Italy
| | - Edoardo Beatrici
- Department of Urology, Humanitas Research Hospital - IRCCS, Milan, Italy
| | - Ilaria Ginatempo
- Department of Surgical, Microsurgical and Medical Sciences, Plastic Surgery Unit, University of Sassari, Sassari, Italy
| | - Claudia Trignano
- Department of Biomedical Sciences, University of Sassari, Sassari, Italy
| | - Corrado Rubino
- Department of Surgical, Microsurgical and Medical Sciences, Plastic Surgery Unit, University of Sassari, Sassari, Italy
| | - Emilio Trignano
- Department of Surgical, Microsurgical and Medical Sciences, Plastic Surgery Unit, University of Sassari, Sassari, Italy
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Suwajo P, Buangbon M, Rachadech C, Nokehoon P, Sakulchangsujjatai N, Sophonsakulrat N, Chaisirisampan N, Krongtham P. The ideal gluteal contouring in Thai-transwomen: cross-sectional descriptive study. Transl Androl Urol 2024; 13:708-719. [PMID: 38855595 PMCID: PMC11157390 DOI: 10.21037/tau-23-678] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2023] [Accepted: 03/17/2024] [Indexed: 06/11/2024] Open
Abstract
Background Gluteal contouring is one of the major concerns of transwomen worldwide. Hip and gluteal surgery, as one type of gender-affirmation surgery (GAS), is now increasing in popularity to alleviate gender incongruence. This study investigated the ideal buttock shape in the Thai-transwomen population, which can further aid in the guidance for hip and gluteal surgery. Methods A cross-sectional descriptive study was done on transwomen attending services at Tangerine Community Health Center, the Plastic and Reconstructive Surgery Clinic in Chulalongkorn Hospital, and Gender Health Community from 2022 to 2023. Participants were inquired about their ideal gluteal contouring using survey images of gluteal contouring of varying proportions and gluteal shapes on posterior and lateral views. Results Among 373 participants, the most preferred waist-to-hip ratio (WHR) in the posterior view and lateral view were 0.65 and 0.70, respectively. Regarding gluteal convexity, many participants preferred round shape buttocks the most (47.45%), followed by the A-shape (43.97%), square shape (7.77%) and, V-shape (0.80%). In the gluteal projection aspect, the most attractive type was the middle buttock type which data were congruence among each subgroup population. Conclusions The image of a narrowing waist proportionated with a widening hip on the posterior view, with the WHR of 0.65, could be considered an ideal perception of beauty in transwomen. It could help the patient in decision-making and guiding the surgical planning.
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Affiliation(s)
- Poonpissamai Suwajo
- Department of Plastic and Reconstructive Surgery, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
- Center of Excellence in Transgender Health, Chulalongkorn University, Bangkok, Thailand
| | | | | | - Pawinee Nokehoon
- Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | | | | | | | - Patcharin Krongtham
- Department of Special Surgery, King Chulalongkorn Memorial Hospital, Bangkok, Thailand
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Tettamanzi M, Ziani F, Rodio M, Arrica G, Muratore G, Manconi A, Trignano C, Beatrici E, Liperi C, Rubino C, Trignano E. Retrospective Study on Optimizing Breast Augmentation Outcomes in Transgender Patients: A Comprehensive Analysis of Tumescent Local Anesthesia Technique. Aesthetic Plast Surg 2024:10.1007/s00266-024-03922-5. [PMID: 38459382 DOI: 10.1007/s00266-024-03922-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2023] [Accepted: 02/09/2024] [Indexed: 03/10/2024]
Abstract
BACKGROUND Tumescent local anesthesia (TLA) involves the infusion of a saline solution containing lidocaine and epinephrine into tissues to achieve localized anesthesia and vasoconstriction. While the use of TLA in sub-glandular augmentation mammoplasty has been documented, we present a modified TLA approach for primary sub-muscular breast augmentation in transgender patients based on our experience over the past years. METHODS Between the years 2014 and 2021, we performed primary sub-muscular breast augmentation on 20 transgender patients under TLA and conscious sedation. The tumescent solution consisted of 25 mL of 2% lidocaine, 8 mEq of sodium bicarbonate, and 1 mL of epinephrine (1 mg/1 mL) in 1000 mL of 0.9% saline solution. Initially, the solution was infiltrated between the pectoral fascia and the mammary gland, and subsequently, during the surgery, under the pectoralis major muscle. RESULTS The average volume of tumescent solution infiltrated during TLA was 740 mL per breast. There were no reports of adrenaline or lidocaine toxicity, and no cases required a conversion to general anesthesia. Patients experienced no pain or discomfort during the preoperative infiltration or surgical procedure. Reoperations due to short-term complications never occurred. We observed a major complication rate of 5%, represented by 1 hematoma. Long-term complications comprised one case of implant dislocation and one occurrence of dystrophic scar formation. No cases of capsular contracture needing reoperation, asymmetry, and implant rupture occurred. In total, one individual (5%) requested larger implants. Follow-up time ranged from 30 days to 1 years. CONCLUSIONS Overall, augmentation mammaplasty is a valuable choice for transgender women aiming to enhance their feminine characteristics and alleviate gender dysphoria. It is imperative for patients to conduct thorough research, grasp the potential pros and cons, and consult experienced healthcare professionals in transgender care. Additionally, tumescent local anesthesia (TLA) has proven to be a safe and efficient method for sub-muscular breast augmentation, providing effective pain control with minimal postoperative complications, resulting in high patient satisfaction. 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 www.springer.com/00266 .
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Affiliation(s)
- Matilde Tettamanzi
- Plastic Surgery Unit, Department of Surgical, Microsurgical and Medical Sciences, University of Sassari, Sassari, Italy.
| | - Federico Ziani
- Plastic Surgery Unit, Department of Surgical, Microsurgical and Medical Sciences, University of Sassari, Sassari, Italy
| | - Manuela Rodio
- Plastic Surgery Unit, Department of Surgical, Microsurgical and Medical Sciences, University of Sassari, Sassari, Italy
| | - Giovanni Arrica
- Plastic Surgery Unit, Department of Surgical, Microsurgical and Medical Sciences, University of Sassari, Sassari, Italy
| | - Giovanni Muratore
- Plastic Surgery Unit, Department of Surgical, Microsurgical and Medical Sciences, University of Sassari, Sassari, Italy
| | - Anna Manconi
- Plastic Surgery Unit, Department of Surgical, Microsurgical and Medical Sciences, University of Sassari, Sassari, Italy
| | - Claudia Trignano
- Department of Biomedical Sciences, University of Sassari, Sassari, Italy
| | - Edoardo Beatrici
- Department of Urology, Humanitas Research Hospital - IRCCS, Milan, Italy
| | - Corrado Liperi
- Intensive Care Unit, Emergency Department, AOU Sassari, Sassari, Italy
| | - Corrado Rubino
- Plastic Surgery Unit, Department of Surgical, Microsurgical and Medical Sciences, University of Sassari, Sassari, Italy
| | - Emilio Trignano
- Plastic Surgery Unit, Department of Surgical, Microsurgical and Medical Sciences, University of Sassari, Sassari, Italy
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Tettamanzi M, Sanna C, Liperi C, Manconi A, Trignano C, Rubino C, Trignano E. Outcomes of Abdominoplasty in Tumescent Local Anesthesia Combined with Subdural Anesthesia. Aesthetic Plast Surg 2024; 48:361-368. [PMID: 38129353 DOI: 10.1007/s00266-023-03795-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Accepted: 12/01/2023] [Indexed: 12/23/2023]
Abstract
BACKGROUND Abdominoplasty is a common surgical procedure performed under general anesthesia, and although the use of TLA combined with subdural anesthesia has never been reported in abdominoplasty, it offers several benefits such as safe and effective local anesthesia and vasoconstriction. We outline our experience with the TLA technique for primary abdominoplasty over the last 7 years. METHODS From 2014 to 2021, TLA and subdural anesthesia have been used in primary abdominoplasty surgeries for 106 patients. The TLA solution consisted of 25 mL of 2% lidocaine, 8 mEq of sodium bicarbonate, and 1 mL of epinephrine (1 mg/1 mL) diluted in 1000 mL of 0.9% saline solution. The solution was then injected with a 2-mm cannula into the subcutaneous adipose tissue in the suprafascial plane. The subdural anesthesia was performed at intervertebral level L1-L2 using Ropivacaine 15/18 mg in 4 ml. RESULTS Patients aged from 32 to 75 years. The amount of tumescent solution infiltrated ranged between 500 and 1000 mL. Mean surgery time was 70 minutes, and recovery room time averaged at 240 minutes. Major complications related to the surgery were observed in 12.26% of patients, including eight hematomas and five seromas. Two patients experienced wound dehiscence, and no dystrophic scar formation was observed. Eventually, there was no need for a conversion to general anesthesia. CONCLUSIONS Tumescent local anesthesia combined with subdural anesthesia is a highly effective and safe method for performing abdominoplasty. This technique has proven to be an excellent choice for primary abdominoplasty, providing significant benefits to patients and surgeons alike due to its safe administration, precise pain management during and after surgery, and minimal postoperative side effects. 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 www.springer.com/00266 .
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Affiliation(s)
- Matilde Tettamanzi
- Plastic Surgery Unit, Department of Surgical, Microsurgical and Medical Sciences, University of Sassari, Sassari, Italy.
| | - Claudia Sanna
- Plastic Surgery Unit, Department of Surgical, Microsurgical and Medical Sciences, University of Sassari, Sassari, Italy
| | - Corrado Liperi
- Intensive Care Unit, Emergency Department, AOU Sassari, Sassari, Italy
| | - Anna Manconi
- Plastic Surgery Unit, Department of Surgical, Microsurgical and Medical Sciences, University of Sassari, Sassari, Italy
| | - Claudia Trignano
- Department of Biomedical Sciences, University of Sassari, Sassari, Italy
| | - Corrado Rubino
- Plastic Surgery Unit, Department of Surgical, Microsurgical and Medical Sciences, University of Sassari, Sassari, Italy
| | - Emilio Trignano
- Plastic Surgery Unit, Department of Surgical, Microsurgical and Medical Sciences, University of Sassari, Sassari, Italy
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Tettamanzi M, Pili N, Rodio M, Serra PL, Trignano C, Rubino C, Trignano E. Use of Radiofrequency-Assisted Liposuction (BodyTite) for Upper Arms Lifting. Aesthetic Plast Surg 2023; 47:2495-2501. [PMID: 37314467 PMCID: PMC10784384 DOI: 10.1007/s00266-023-03452-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Accepted: 06/04/2023] [Indexed: 06/15/2023]
Abstract
BACKGROUND Body contouring surgery is increasingly requested by patients, both for aesthetic and post-bariatric purposes. There has also been a rapid increase in demand for noninvasive aesthetic treatments. While brachioplasty is burdened by numerous complications and unsatisfactory scars, and conventional liposuction is unsuitable for all patients, nonsurgical arm remodeling performed with radiofrequency-assisted liposuction (RFAL) allows to effectively treat most of patients, regardless of the amount of fat and ptosis of the skin and avoiding surgical excision. METHODS A prospective study was conducted on 120 consecutive patients who presented to the author's private clinic and required upper arm remodeling surgery for aesthetic purposes or after weight loss. Patients were classified according to the modified classification of El Khatib and Teimourian. Pre- and posttreatment upper arm circumferences were taken after 6 months of follow-up to assess the degree of skin retraction obtained by treating the arm with RFAL. A satisfaction questionnaire regarding the appearance of the arms (Body-Q upper arm satisfaction) was administered to all patients before surgery and after 6 months of follow-up. RESULTS All patients were effectively treated with RFAL, and no cases required conversion to brachioplasty. The average reduction in arm circumference was 3.75 cm at 6 months follow-up, and patients' satisfaction increased from 35 to 87% posttreatment. CONCLUSIONS Radio frequency is a valid tool to treat most patients with upper limbs skin laxity, with significant aesthetic results and a high degree of patient satisfaction, regardless of the degree of skin ptosis and lipodystrophy of the arm. 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 www.springer.com/00266 .
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Affiliation(s)
- Matilde Tettamanzi
- Plastic Surgery Unit, Department of Surgical, Microsurgical and Medical Sciences, University of Sassari, Sassari, Italy.
| | - Nicola Pili
- Plastic Surgery Unit, Department of Surgical, Microsurgical and Medical Sciences, University of Sassari, Sassari, Italy
| | - Manuela Rodio
- Plastic Surgery Unit, Department of Surgical, Microsurgical and Medical Sciences, University of Sassari, Sassari, Italy
| | - Pietro Luciano Serra
- Plastic Surgery Unit, Department of Surgical, Microsurgical and Medical Sciences, University of Sassari, Sassari, Italy
| | - Claudia Trignano
- Department of Biomedical Sciences, University of Sassari, Sassari, Italy
| | - Corrado Rubino
- Plastic Surgery Unit, Department of Surgical, Microsurgical and Medical Sciences, University of Sassari, Sassari, Italy
| | - Emilio Trignano
- Plastic Surgery Unit, Department of Surgical, Microsurgical and Medical Sciences, University of Sassari, Sassari, Italy
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Trignano E, Beatrici E, Liperi C, Serra PL, Trignano C, Rubino C, Tettamanzi M. Letter to the Editor: Outcomes of Intramuscular Gluteal Augmentation With Implants Using Tumescent Local Anesthesia. Aesthetic Plast Surg 2023:10.1007/s00266-023-03680-w. [PMID: 37798495 DOI: 10.1007/s00266-023-03680-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Accepted: 09/14/2023] [Indexed: 10/07/2023]
Affiliation(s)
- Emilio Trignano
- Department of Surgical, Microsurgical and Medical Sciences, Plastic Surgery Unit, University of Sassari, Sassari, Italy
| | - Edoardo Beatrici
- Department of Urology, Humanitas Research Hospital - IRCCS, Milan, Italy
| | - Corrado Liperi
- Intensive Care Unit, Emergency Department, AOU Sassari, Sassari, Italy
| | - Pietro Luciano Serra
- Department of Surgical, Microsurgical and Medical Sciences, Plastic Surgery Unit, University of Sassari, Sassari, Italy
| | - Claudia Trignano
- Department of Biomedical Sciences, University of Sassari, Sassari, Italy
| | - Corrado Rubino
- Department of Surgical, Microsurgical and Medical Sciences, Plastic Surgery Unit, University of Sassari, Sassari, Italy
| | - Matilde Tettamanzi
- Department of Surgical, Microsurgical and Medical Sciences, Plastic Surgery Unit, University of Sassari, Sassari, Italy.
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Saqr H, El Fahar MH. Letter to the Editor Regarding "Outcomes of Intramuscular Gluteal Augmentation with Implants Using Tumescent Local Anesthesia". Aesthetic Plast Surg 2023:10.1007/s00266-023-03585-8. [PMID: 37639025 DOI: 10.1007/s00266-023-03585-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Accepted: 07/30/2023] [Indexed: 08/29/2023]
Affiliation(s)
- Hazem Saqr
- School of Medicine, Newgiza University (NGU), Giza, Egypt
| | - Mohammed H El Fahar
- Plastic and Reconstructive Surgery Department, Faculty of Medicine, Mansoura University, 60 El Gomhoria St, Mansoura, 35516, DK, Egypt.
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Fajardo Perez M, Espinoza Morales K, Rodriguez Sojo JF, Prada Castellnos Y, Galluccio F. A Novel Two-Step Ultrasound-Guided Technique for Anesthesia and Postsurgery Analgesia in Gluteal Augmentation Surgery. Cureus 2023; 15:e43546. [PMID: 37593073 PMCID: PMC10427781 DOI: 10.7759/cureus.43546] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/15/2023] [Indexed: 08/19/2023] Open
Abstract
In recent years, there has been an increase in demand for gluteal augmentation and reshaping surgeries with intramuscular implants which are becoming increasingly popular. Until now, this surgery was mainly performed under general anesthesia, but recently locoregional anesthesia techniques, such as tumescent local anesthesia, are being applied more and more. Today, the use of ultrasound for locoregional anesthesia and analgesia allows us to perform techniques that are increasingly precise and burdened with lower risks. In this report, we present a novel two-step ultrasound-guided technique combining a botox injection in the gluteus maximus four weeks before surgery and tumescent anesthesia with a cluneal nerve block. Furthermore, the combination of anesthetic and analgesic techniques can guarantee a better result both in terms of surgical execution of the intervention and in reducing pain and improving patient comfort in the postoperative period.
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Affiliation(s)
- Mario Fajardo Perez
- Pain Medicine, Morphological Madrid Research Center (MoMaRC), Madrid, ESP
- Anatomical Lab, Universidad Cientifica del Sur, Lima, PER
| | - Karla Espinoza Morales
- Anesthesiology, Hospital Centro de Atención Integral en Salud (CAIS) de Puriscal, San José, CRI
| | | | | | - Felice Galluccio
- Rheumatology & Rehabilitation, Fisiotech Lab Studio, Firenze, ITA
- Pain Medicine, Morphological Madrid Research Center (MoMaRC), Madrid, ESP
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