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Plastic and Reconstructive Surgery Oct 2015Interest in and acceptance of autologous fat grafting for use in contour abnormalities, breast reconstruction, and cosmetic procedures have increased. However, there are... (Review)
Review
BACKGROUND
Interest in and acceptance of autologous fat grafting for use in contour abnormalities, breast reconstruction, and cosmetic procedures have increased. However, there are many procedural variations that alter the effectiveness of the procedure and may account for the unpredictable resorption rates observed.
METHODS
The authors highlighted studies investigating the effects of harvesting procedures, processing techniques, and reinjection methods on the survival of fat grafts. This review focused on the impact different techniques have on outcomes observed in the following: in vitro analyses, in vivo animal experiments, and human studies.
RESULTS
This systemic review revealed the current state of the literature. There was no significant difference in the outcomes of grafted fat obtained from different donor sites, different donor-site preparations, harvest technique, fat harvesting cannula size, or centrifugation speed, when tumescent solution was used. Gauze rolling was found to enhance the volume of grafted fat, and no significant difference in retention was observed following centrifugation, filtration, or sedimentation in animal experiments. In contrast, clinical studies in patients found more favorable outcomes with fat processed by centrifugation compared with sedimentation. In addition, higher retention was observed with slower reinjection speed and when introduced into less mobile areas.
CONCLUSIONS
There has been a substantial increase in research interest to identify methodologies for optimizing fat graft survival. Despite some differences in harvest and implantation technique in the laboratory, these findings have not translated into a universal protocol for fat grafting. Therefore, additional human studies are necessary to aid in the development of a universal protocol for clinical practice.
Topics: Humans; Lipectomy; Subcutaneous Fat; Tissue and Organ Harvesting; Transplantation, Autologous
PubMed: 26086386
DOI: 10.1097/PRS.0000000000001590 -
Deutsches Arzteblatt International Apr 2015Because of their easy accessibility and versatile biological properties, mesenchymal stem cells taken from fatty tissue (adipose-derived stem cells, ADSC) are attractive...
BACKGROUND
Because of their easy accessibility and versatile biological properties, mesenchymal stem cells taken from fatty tissue (adipose-derived stem cells, ADSC) are attractive for various potential clinical uses. For example, ADSC can be added to fatty tissue before transplantation in the hope of improving the outcome of autologous lipotransfer: the modified procedure is called cell-assisted lipotransfer. The clinical use and commercial promotion of this novel stem-cell treatment (and others) are spreading rapidly, even though there is not yet any clear clinical evidence for its safety and efficacy.
METHODS
In cooperation with the German Cochrane Center, we systematically searched the literature according to the PRISMA criteria. Eight major medical databases were searched. The retrieved publications were examined by two independent reviewers and assessed using objective criteria.
RESULTS
After screening of the 3161 retrieved publications by title, abstract, and (where appropriate) full text, 78 were still considered relevant. 13 of these were reports of clinical studies; only 3 of the 13 met criteria for grade II or III evidence. The studies that were analyzed involved a total of 286 cell-assisted lipotransfer procedures with a longest follow-up time of 42 months. Oncological safety was not demonstrated.
CONCLUSION
The studies published to date have not shown that cell-assisted lipotransfer is generally superior to conventional autologous lipotransfer. They dealt with safety aspects inappropriately or not at all. The case of cell-assisted lipotransfer illustrates the indispensability of high-quality clinical evidence before the introduction of novel stem-cell-based treatments.
Topics: Adipocytes; Adipose Tissue; Autografts; Evidence-Based Medicine; Humans; Lipectomy; Mesenchymal Stem Cell Transplantation; Plastic Surgery Procedures; Tissue Engineering; Tissue Expansion; Treatment Outcome
PubMed: 25920357
DOI: 10.3238/arztebl.2015.0255 -
BioMed Research International 2018Madelung's disease is a rare lipid metabolic disorder characterized by diffuse, uncapsulated lipomas in the neck, shoulder, and other areas. It mainly affects... (Review)
Review
BACKGROUND
Madelung's disease is a rare lipid metabolic disorder characterized by diffuse, uncapsulated lipomas in the neck, shoulder, and other areas. It mainly affects middle-aged men and is related to alcohol abuse, and the cause is not clear. Surgical treatments include lipectomy and liposuction.
METHODS
This systematic review analyzed the treatment of Madelung's disease described in 52 articles including complete patient details, published between 2000 and 2015, and retrieved from the Web of Science, PubMed, Medline, and Embase.
RESULTS
Lipectomy was performed in most cases and achieved more complete removal and better control of iatrogenic lesions of nearby structures than liposuction. Liposuction achieved good cosmetic results and is simpler and less invasive than lipectomy, but clinical experience is limited.
CONCLUSIONS
Both lipectomy and liposuction have advantages and drawbacks. Surgeons should base the choice of optimal treatment on patient characteristics. Novel surgical techniques and etiologically targeted treatments hold promise as future therapies.
Topics: Animals; Choice Behavior; Humans; Lipectomy; Lipomatosis, Multiple Symmetrical; Surgeons
PubMed: 29682541
DOI: 10.1155/2018/3975974 -
Seminars in Interventional Radiology Aug 2020Lymphedema of the extremities related to oncologic therapies such as cancer surgery, radiation therapy, and chemotherapy is a major long-term cause of morbidity for... (Review)
Review
Lymphedema of the extremities related to oncologic therapies such as cancer surgery, radiation therapy, and chemotherapy is a major long-term cause of morbidity for cancer patients. Both nonsurgical and surgical management strategies have been developed. The goals of these therapies are to achieve volume reduction of the affected extremity, a reduction in patient symptoms, and a reduction in associated morbidities such as recurrent soft-tissue infections. In this article, we review both nonsurgical and surgical management strategies. Traditional surgical therapy has focused on more ablative techniques such as the Charles procedure and suction-assisted lipectomy/liposuction. However, newer more physiologic surgical methods such as lymphovenous anastomoses and vascularized lymph node transfers have become a more common treatment modality for the management of this complex problem.
PubMed: 32773955
DOI: 10.1055/s-0040-1713447 -
Plastic and Reconstructive Surgery.... Oct 2020Lipoabdominoplasty has evolved over the last 6 decades through contributions from numerous luminaries in plastic and reconstructive surgery. (Review)
Review
BACKGROUND
Lipoabdominoplasty has evolved over the last 6 decades through contributions from numerous luminaries in plastic and reconstructive surgery.
METHODS
The authors review historical perspective and provide a contemporary examination of trends in lipoabdominoplasty.
RESULTS
In 1967, Pitanguy popularized abdominoplasty (without liposuction) as a technique for augmenting ventral hernias repairs and subsequently for aesthetic improvement of the abdomen. After the introduction of suction assisted lipectomy by Illouz in 1983, abdominoplasty became a central tool in a diverse armamentarium of anterior and lateral abdominal wall contouring procedures. Liposuction was initially utilized with mini-abdominoplasty in order to improve contour. Subsequently, Matarasso advanced the safe combination of liposuction with full abdominoplasty. Additionally, he systematized the variety of cutaneous undermining, excision, and liposuction procedures utilized in abdominal contouring as indicated by the degree of skin laxity and musculofascial diastasis. Lockwood advocated high lateral tension closure of the superficial fascial system of the abdomen to improve the contour of the hips and flanks. Saldanha advanced selective undermining and anterior abdominal wall perforator preservation to minimize wound healing and seroma complications associated with lipoabdominoplasty procedures.
CONCLUSION
In abdominal contour surgery, surgeons can rely on classic techniques and algorithms that have withstood the test of time while modifying their approaches with advances backed by compelling and rigorously obtained evidence.
PubMed: 33173672
DOI: 10.1097/GOX.0000000000003144 -
Ear, Nose, & Throat Journal Mar 2021
Topics: Dysphonia; Humans; Hyaluronic Acid; Larynx; Lipectomy; Male; Medical Illustration; Middle Aged; Vocal Cord Paralysis
PubMed: 31550934
DOI: 10.1177/0145561319863366 -
Medical Devices (Auckland, N.Z.) 2014Since its introduction by Illouz and others over 30 years ago, suction-assisted lipectomy/liposuction/lipoplasty has evolved tremendously and has developed into one of... (Review)
Review
Since its introduction by Illouz and others over 30 years ago, suction-assisted lipectomy/liposuction/lipoplasty has evolved tremendously and has developed into one of the most popular procedures in aesthetic plastic surgery. Liposuction is an effective procedure employed to treat localized adipose deposits in patients not suffering from generalized obesity. These accumulations of subcutaneous fat often occur in predictable distributions in both men and women. A cannula connected to a suction-generating source allows for small incisions to be strategically placed and large volumes of fat to be removed. This fat removal leads to improved harmonious balance of a patient's physique and improved body contour. Various surgical techniques are available and have evolved as technology has improved. Current technology for liposuction includes suction-assisted lipectomy, ultrasound-assisted, power-assisted, laser-assisted, and radiofrequency-assisted. The choice of technology and technique often depends on patient characteristics and surgeon preference. The objective of this review is to provide a thorough assessment of current technologies available to plastic surgeons performing liposuction.
PubMed: 25093000
DOI: 10.2147/MDER.S47322 -
The Western Journal of Medicine Jun 1988
Topics: Adipose Tissue; Humans; Suction
PubMed: 3176477
DOI: No ID Found -
Zhongguo Xiu Fu Chong Jian Wai Ke Za... Dec 2018To summarize the research progress of abdominoplasty. (Review)
Review
OBJECTIVE
To summarize the research progress of abdominoplasty.
METHODS
The literature related to abdominoplasty in recent years was reviewed and the evolution of this surgical method and related surgical techniques were summarized.
RESULTS
By removing excess skin adipose tissue from abdominal wall and strengthening loosening muscle fascia system, the abdominal wall contour can be improved by abdominoplasty. With the development of liposuction, selective flaps undermining, progressive tension sutures, and Scarpa fascia retention, the trauma and complications of abdominoplasty are significantly reduced, and better aesthetic result is achieved.
CONCLUSION
At present, the incidence of abdominoplasty complication is still the highest among cosmetic surgeries, and further exploration is needed to reduce complications and improve aesthetic effects.
Topics: Abdominal Wall; Abdominoplasty; Lipectomy; Surgical Flaps; Sutures
PubMed: 30569692
DOI: 10.7507/1002-1892.201805088 -
Annals of Medicine and Surgery (2012) Dec 2017Nowadays, liposuction is the most frequently performed aesthetic surgery procedure in Western Countries. This technique has had rapid development since the 1970s, when... (Review)
Review
INTRODUCTION
Nowadays, liposuction is the most frequently performed aesthetic surgery procedure in Western Countries. This technique has had rapid development since the 1970s, when it was experimented for the first time by A. and G. Fischer. It is currently widely used in clinical practice for many different situations in aesthetic, reconstructive and functional fields.
MATERIALS AND METHODS
This review aims to describe the historical evolution of liposuction by analyzing the transformation of the method in function of the introduction of innovative ideas or instruments. We have also focused on reporting the major clinical applications of this surgical technique, applicable to almost the entire body surface. We finally analyzed the complications, both major and minor, associated with this surgical technique.
RESULTS
Liposuction is mainly used to correct deep and superficial fat accumulations and remodel the body contour. It has become an essential complementary technique to enhance the aesthetic result of many other aesthetic procedures such as reduction mammoplasty, abdominoplasty, brachioplasty, thigh lift and post bariatric body contouring. However, it can be largely used for the treatment of innumerable pathologies in reconstructive surgery such as lipomas, lipedema, lipodystrophies, pneudogynecomastia and gynecomastia, macromastia e gigantomastia, lymphedema and many others. The complication rate is very low, especially when compared with conventional excisional surgery and the major, complications are generally associated with improper performance of the technique and poor patient management before and after surgery.
CONCLUSION
Liposuction is a safe, simple and effective method of body contouring. It has enormous potential for its application in ablative and reconstructive surgery, far from the most common aesthetic processes with a very low complication rate.
PubMed: 29158895
DOI: 10.1016/j.amsu.2017.10.024