Dual-Plane Lipoplasty for the Superficial and Deep Layers:

Gluteal contour improvement: different surgical alternatives

BACKGROUND

Surgical techniques to achieve improvement in buttocks contour have evolved dramatically. The authors present their experience with the different techniques and indications they use to achieve improvement in this region.

METHODS

This study reviewed the surgical procedures performed by the senior author over a 15-year period among patients seeking improvement of the gluteal region. Procedures were analyzed according to the characteristics and needs of each patient, and the resulting levels of patient satisfaction were evaluated.

RESULTS

From April 1995 to March 2010, 908 patients (862 women and 46 men) ages 18-61 years requested and underwent surgery for gluteal contour improvement. The surgical procedures were liposuction with lipoinjection for 811 patients (89.3%); liposuction with gluteal implants for 62 patients (6.8%); liposuction with gluteal implants and lipoinjection to the hips for 22 patients (2.4%); liposuction, gluteal implants, and a buttock-lift for 7 patients (0.7%); and liposuction, gluteal implants, lipoinjection, and a buttock-lift for 6 patients (0.6%). The volume of infiltrated fat ranged from 120 to 1,160 ml per buttock, with an average of 380 ml per buttock. The implants used ranged from 250 to 450 ml (average, 325 ml).

CONCLUSIONS

Surgery performed with the goal of gluteal contour improvement is detailed and demanding with respect to the multiple and diverse techniques. The proper selection of these procedures and their order are paramount to achieving a successful outcome for both the patient and the surgeon.

Obesity: an endocrine tumor?

Obesity is one of the most common disorders in clinical practice. The prevalance of obesity has increased by more than 60% since 1990. Adipose tissue acts as an endocrine organ secreting many factors into the blood, known as adipokines, including leptin, adipsin, acylation-stimulating protein, adiponectin, etc. This article examines the hypothesis that obesity may be evaluated as an endocrine tumor, regarding its genetic basis, hyperplasia and hypertrophy of adipocytes, neovascularisation within the adipose tissue associated with growth, and beneficisal metabolic effects of surgical removal of excess adipose tissue by liposuction. Assuming obesity as an endocrine tumor may bring out new treatment modalities. Liposuction as "cytoreductive surgery", antiangiogenic teraphy or anti-neoplastic drugs may be important components of obesity treatment in future.

Lipoaspiration and Its Complications: A Safe Operation

Although lipoaspiration has been considered a safe surgical procedure for the last 30 years, reports indicate that this procedure has a high index of complications. This study was performed to analyze experience with patients in a clinical practice for the past 8 years who underwent lipoaspiration, either alone or in combination with another surgical procedure, and to compare the results with previous reports in the literature. The patients were divided into four groups: lipoaspiration alone of less than 5 liters, lipoaspiration alone of more than 5 liters, lipoaspiration combined with abdominoplasty, and lipoaspiration combined with another surgical procedure. Complications were divided into minor or major, depending on previous reports, and statistical analysis was used to determine any significant difference among the four groups. From January of 1994 to December of 2001, 1047 patients underwent lipoaspiration, either alone or in combination with another surgical procedure. A 21.7 percent incidence of minor complications was noted, as well as a 0.38 percent incidence of major complications. Minor complications included palpable and visible irregularities, seromas, cutaneous hyperpigmentation, overcorrection, cutaneous slough, and local infection. Major complications included fat embolism syndrome, cutaneous necrosis, and extended infection. No statistical difference was noted among the groups studied. The incidence of complications was similar to that in clinical reports in the world literature, being of a low percentage rate when compared with the reports of other types of surgical procedures. On the basis of these results, lipoaspiration continues to be a safe surgical procedure, but to maximally avoid complications, one should be mindful of all the factors that could predispose to them.