Avoiding unfavourable outcomes in liposuction

Ultrasound Calculation of Fat Volume for Liposuction: A Clinical Software Validation

BACKGROUND

Fat manipulation procedures such as liposuction contain a degree of subjectivity primarily guided by the surgeon's visual or tactile perception of the underlying fat. Currently, there is no cost-effective, direct method to objectively measure fat depth and volume in real time.

OBJECTIVES

Utilizing innovative ultrasound-based software, the authors aimed to validate fat tissue volume and distribution measurements in the preoperative setting.

METHODS

Eighteen participants were recruited to evaluate the accuracy of the new software. Recruited participants underwent ultrasound scans within the preoperative markings of the study area before surgery. Ultrasound-estimated fat profiles were generated with the in-house software and compared directly with the intraoperative aspirated fat recorded after gravity separation.

RESULTS

Participants' mean age and BMI were 47.6 (11.3) years and 25.6 (2.3) kg/m2, respectively. Evaluation of trial data showed promising results following the use of a Bland Altman agreement analysis. For the 18 patients and 44 volumes estimated, 43 of 44 measurements fell within a confidence interval of 95% when compared with the clinical lipoaspirate (dry) volumes collected postsurgery. The bias was estimated at 9.15 mL with a standard deviation of 17.08 mL and 95% confidence interval between -24.34 mL and 42.63 mL.

CONCLUSIONS

Preoperative fat assessment measurements agreed significantly with intraoperative lipoaspirate volumes. The pilot study demonstrates, for the first time, a novel companion tool with the prospect of supporting surgeons in surgical planning, measuring, and executing the transfer of adipose tissues.

LEVEL OF EVIDENCE: 4

The use of Liposuction to treat significant contour abnormalities associated with Lipomyeloeningocoele

INTRODUCTION

Since 1972 when first pioneered, liposuction has developed and is now one of the commonest aesthetic procedures performed worldwide. Evidence of its application in aesthetic lipomodelling is widely known, but there are scant reports in the literature on the use of liposuction in more unusual cases. We report its use as a safe and successful method of contour correction in two cases of lipomyelomeningocoele (LMMC), a form of spina bifida. To our knowledge, this has never been reported before.

METHOD

A prospective review was performed and both cases were followed up during the treatment period. Both patients were treated at the Royal Belfast Hospital for Sick Children. Patient charts were reviewed and magnetic resonance imaging was used.

RESULTS

Two patients, aged 11 and 17 years, had a large LMMC over the lumbosacral area. Preoperative imaging was obtained in each case to ensure the procedure could safely avoid the underlying spinal cord structures. The use of the Microaire© suction device allowed precise fat extraction. Postoperative images demonstrate reduction of lipomatous bulk and improved contour.

CONCLUSION

We have shown that when used with caution liposuction is a safe and effective technique for volume reduction of a LMMC in carefully selected cases.

Quality survey on efficacy of carboxytherapy for localized lipolysis

BACKGROUND

A survey was conducted to ascertain the efficacy of carboxytherapy for localized lipolysis.

METHODS

Patients on physical, dietary, or drug concurrent therapy were excluded. Paired measurements (initial versus 8th course) between treated (right) and untreated (left) sides were compared for braline, upper arm, abdomen, and thigh.

RESULTS

Ten women, age range 23-37 years, were reviewed. Weight and body mass index were unchanged. Significant reductions (P < 0.01) were obtained for braline and abdominal caliper and ultrasound measurements. Mean (SD) decreases in caliper braline and abdomen measurements were 6.9 (5.9) and 4.3 (3.0) mm, respectively. Mean (SD) changes in ultrasound abdominal readings were -6.6 (3.8), -7.4 (3.2), and -6.8 (3.5) mm for upper, lower, and flank, respectively. Limb girth measurements were significant for the thigh (-1.3 [0.8] mm) but not for the upper limb.

CONCLUSION

These results are in agreement with those reported originally and demonstrate that carboxytherapy is locally effective in reduction of subcutaneous fat.