Treatment of lipomas and diffuse lipomatosis with NDYAG 1064 NM laser and their impact on the quality of life

Lipomas, the most common type of benign tumours, are generally developed from adipose tissue and present an incidence of 2.1 per 1000 inhabitants. In addition to lipomas, at least three other maladies of the adipose tissue lead patients to consult a doctor, especially for aesthetic purposes: multiple familial lipomatosis, diffuse congenital lipomatosis, and adiposa doloris. Unlike lipomas, these maladies are characterized by numerous lipomas, encapsulated or not, of different sizes, symmetrical or not, which may appear in the neck, limbs, or the trunk, sometimes being painful. The life quality of these patients is affected, not only from an aesthetic point of view but also from medical considerations, like pain. Chemical lipolysis has proven unsatisfactory for patients due to several reasons: the prolonged therapy, high cost, the partial dissolution of the lipomatosis, and high recurrence at one year. Surgical treatment remains the only viable option; sometimes when numerous lipomatous tumors required large and numerous incisions, treatment was refused by patients. The result after laser liposuction is excellent, the recovery time is short, without much pain for the patient, with minimal ecchymoses and edemas, without any recurrence in time, and with an excellent degree of patient satisfaction

Tумесцентната техника како регионална анестезија

Тумесцентната техника е техника на инфилтрација во супкутаното ткиво на голем волумен пуфериранфизиолошки раствор во кој е потопена мала концентрација лидокаин заедно со адреналин. Овој раствор лесно и безболно се инфилтрира и доведува до анестезија на поткожното ткиво од одредени телесни регии како абдоменотили натколеното,обезбедува помало крвавење за време на интервенциите изведувани на кожата и поткожното ткиво. Тумесцентната локална анестезија (ТЛА) е многу лесна и сигурна процедура, која широко се употребува во многу хируршки гранки. Целта на трудот беше да се направи проценка на вредноста на тумесцентната локална анестезија кај липосукција. Материјал и методи: Беа евалуирани 16 пациентки со средна возраст од 32 години(24-46), кај кои  беше извршена липосукција на една до три регии, односно на вкупно 27 регии. Во тек на интервенцијата се употреби тумесцентната техника; инфилтрација на раствор од 0,075% лидокаин со 1: 1.000.000 адреналин и 25 мл 8,4% бикарбонати во 1000 мл физиолошки раствор, средно инфилтриран раствор од 2506 мл (1600-5000), средна доза на лидокаин 25,9 мг/кг (18,9-50,6 мг/кг), вкупно средно инфилтриран лидокаин од 2010 мг (1360-4000мг). Резултати: ТЛА беше успешно реализирана; 68,8% (11) од пациентките беа среќни и задоволни, 12,5% (2) од пациентките имаа главоболка и вртоглавица, кај 12,5% (2) од пациентките беше сопрена интервенцијата поради силни болки, кај едната на една регија, кај другата на втората регија и кај 6,3% (1) од пациентките имаше лесни знаци за интоксикација со лидокаин. Немаше компликации кои бараа третман или хоспитализација, а немаше и смртен исход. Заклучок: Самостојно употребена тумесцентна локална анестезија во доза од 18-50мг/кг лидокаин кај правилно избрани пациенти е сигурна техника за регионална анестезија за процедури на поткожното масно ткиво.Tumescent technique is a technique of infiltration a large volume of buffered low concentration of lidocaine and adrenaline in normosaline in the subcutaneous tissue. This solution that is easily and painlessly infiltrated, anesthetizes a large area of subcutaneous tissue in particular body areas like: abdomen, thigh or arms; it provides less bleeding during procedures performed on the skin and subcutaneous tissue.  The tumescent local anesthesia (TLA) is a very simple and save procedure, widely used in many surgical branches. The aim of the paper was to assess the value of the tumescent local anesthesia during liposuction. Material and methods: Sixteen patients with a mean age of 32 years (24-46) underwent liposuction of one to three body areas, using tumescent technique, wide-awake. Тotal of 27 procedures were performed, with infiltration of solution of 0.075% lidocaine with 1:1,000,000 adrenaline and 25 ml of 8.4% sodium bicarbonate in 1000 ml normosaline, mean infiltrated solution of 2506 ml (1600-5000), mean dosage of lidocaine 25.9 mg/kg (18.88-50.6 mg/kg), total amount of lidocaine 2010 mg (1360-4000 mg). Results: TLA was successfully realized; 68.8% (11) of patients were happy and satisfied, 12.5% (2) of patients had headache and dizziness, in 12.5% (2) of patients the procedure was stopped because of a severe pain, one in the first region and one in the second region, and in 6.3% (1) of patients mild signs of lidocaine toxicity were observed. There were no complications that needed treatment or hospitalization; also, there were no lethal cases. Conclusion: Sole tumescent local anesthesia at a dosage 18-50 mg/kg lidocaine in prudent chosen patients seems to be safe regional anesthesia technique for the procedure of subcutaneous fat tissue

Application of the liposuction techniques and principles in specific body areas and pathologies

The buttocks have been a symbol of attraction, sexuality and eroticism since ancient times and therefore, they have an important role in defining the posterior body contour. More and more people are talking about and understand the meaning and the role that buttocks play in modeling and physical beauty. The three dimensional gluteoplasty (3-DGP) is an innovative technique that allows us to change volume, shape and firmness, not only in the buttocks but also in the adjacent regions such as the thighs and trochanters, becoming an ideal tool to answer the frequent reasons of consultation of our patients about this particular area of the body: ..

Surgery-for-life:Aging, sexual fitness and self-management in Brazil

This article draws on ethnographic fieldwork on plastic surgery to explore tensions in aging norms and ideals for women in Brazil.  I situate my analysis in relation to debates about a “de-chronologized life course.”  Some scholars argue that the life course in late capitalism has become less standardized.  In this account, chronological age diminishes in importance as consumers are defined by life style choices available to all ages and the period of youth extends into middle age and beyond.  In Brazil consumers embrace plastic surgery as a means to “manage” aging, mental well-being, and reproductive and sexual health.  This promise of a flexible and optimized aging trajectory seems to echo the notion of a de-chronologized life course.  I argue, however, that medical discourse and patients’ accounts show ambivalence about aging and conflicts in the ideal of medically-managed sexual fitness for women.  Drawing on analysis of changes in family structure and women’s health regimes, I argue that passage through the life course, rather than becoming more flexible, is in some ways becoming more rigidly defined by biological processes

Fifty Years of Innovation in Plastic Surgery

© 2016 The Korean Society of Plastic and Reconstructive Surgeons.Background Innovation has molded the current landscape of plastic surgery. However, documentation of this process only exists scattered throughout the literature as individual articles. The few attempts made to profile innovation in plastic surgery have been narrative, and therefore qualitative and inherently biased. Through the implementation of a novel innovation metric, this work aims to identify and characterise the most prevalent innovations in plastic surgery over the last 50 years. Methods Patents and publications related to plastic surgery (1960 to 2010) were retrieved from patent and MEDLINE databases, respectively. The most active patent codes were identified and grouped into technology areas, which were subsequently plotted graphically against publication data. Expert-derived technologies outside of the top performing patents areas were additionally explored. Results Between 1960 and 2010, 4,651 patents and 43,118 publications related to plastic surgery were identified. The most active patent codes were grouped under reconstructive prostheses, implants, instruments, non-invasive techniques, and tissue engineering. Of these areas and other expert-derived technologies, those currently undergoing growth include surgical instruments, implants, non-invasive practices, transplantation and breast surgery. Innovations related to microvascular surgery, liposuction, tissue engineering, lasers and prostheses have all plateaued. Conclusions The application of a novel metric for evaluating innovation quantitatively outlines the natural history of technologies fundamental to the evolution of plastic surgery. Analysis of current innovation trends provides some insight into which technology domains are the most active

A Multicenter, Prospective, Randomized, Contralateral Study of Tissue Liquefaction Liposuction vs Suction-Assisted Liposuction

Tissue liquefaction liposuction (TLL) deploys a novel energy source utilizing a stream of warmed, low-pressurized, and pulsed saline to extract fat tissue. Objectives: Compare TLL to suction-assisted liposuction (SAL) to determine which device is more efficient for surgeons and provides better recovery for patients. Methods: Thirty-one adult female patients were followed prospectively in a contralateral study design comparing differences in bruising, swelling, tenderness, and incision appearance ratings between TLL and SAL procedures. Surgical efficiency and appearance of the lipoaspirate were also compared. Results: All 31 patients successfully completed the study. For TLL and SAL procedures, the average volumes of infusion (1.242 vs 1.276 L) and aspirated supernatant fat (704 vs 649 mL) were statistically similar. TLL median fat extraction rate was faster than SAL (35.6 vs 25 mL/min; P < 0.0001), and stroke rate was reduced in TLL vs SAL procedures (48 vs 120 strokes/min; P < 0.0001), and both were statistically significant. The mean total scores for bruising, swelling, treatment site tenderness, and incision appearance were lower, indicating improved patient recovery on the TLL side. Conclusions: TLL and SAL techniques produced comparable volume of fat aspirate. TLL demonstrated a 42% faster fat extraction rate and a 68% reduction in arm movements needed to complete the procedure compared to SAL, both of these differences are statistically significant. The TLL side was noted to have reduced bruising and swelling and improved incision site appearance with less tenderness compared to the SAL side

Genetical stability and osteogenic ability of mesenchimal stem cells on demineralized bone matrices

Journal of Osseointegration Volume 7, Issue 1, 1 March 2015, Pages 2-7 Open Access Genetical stability and osteogenic ability of mesenchimal stem cells on demineralized bone matrices (Article) Pozzuoli, A.a, Gardin, C.b, Aldegheri, R.a, Bressan, E.c, Isola, M.d, Calvo-Guirado, J.L.e, Biz, C.a, Arrigoni, P.a, Feroni, L.b, Zavan, B.b a Department of Surgical,Oncological and Gastroenterological Sciences, University of Padua, Padua, Italy b Department of Biomedical Sciences, University of Padua, Padua, Italy c Department of Neurosciences, University of Padua, Padua, Italy d Department of Animal Medicine, Production and Health (MAPS), Italy e Department of General Dentistry, Faculty of Medicine and Dentistry, University of Murcia, Murcia, Spain Hide additional affiliations View references (44) Abstract Aim: Tissue engineering is a rapidly expanding field with regard to the use of biomaterials and stem cells in the orthopedic surgery. Many experimental studies have been done to understand the best characteristics of cells, materials and laboratory methods for safe clinical applications. The aim of this study was to compare the ability of 2 different human demineralized bone matrices (DBMs), the one enriched and the other not enriched with hyaluronic acid, to stimulate in vitro the proliferation and the osteogenic differentiation of human adipose-derived stem cells (ADSCs) seeded onto an osteoconductive scaffold. Materials and Methods: ADSCs were isolated, by enzymatic digestion, from abdominal adipose tissue of 5 patients undergoing cosmetic lipoaspiration surgery. ADSCs were then seeded onto a 3D scaffold in the presence of the two different osteoinductive matrices of human demineralized bone and evaluated for proliferation and osteogenic differentiation. The safety of the methods was verified using array-Comparative Genomic Hybridization (array-CGH). Results: ADSCs were able to differentiate in osteogenic sense. Both DBMs showed the ability to induce osteogenic differentiation of the cells. Conclusion: array-CGH showed no changes at genome level, thus confirming the safety of materials and method

Tumescent Injections in Subcutaneous Pig Tissue Disperse Fluids Volumetrically and Maintain Elevated Local Concentrations of Additives for Several Hours, Suggesting a Treatment for Drug Resistant Wounds.

PurposeBolus injection of fluid into subcutaneous tissue results in accumulation of fluid at the injection site. The fluid does not form a pool. Rather, the injection pressure forces the interstitial matrix to expand to accommodate the excess fluid in its volume, and the fluid becomes bound similar to that in a hydrogel. We seek to understand the properties and dynamics of externally tumesced (swollen) subcutaneous tissue as a first step in assessing whether tumescent antibiotic injections into wounds may provide a novel method of treatment.MethodsSubcutaneous injections of saline are performed in live and dead pigs and the physical properties (volume, expansion ratio, residence time, apparent diffusion constant) of the resulting fluid deposits are observed with diffusion-weighted magnetic resonance imaging, computed tomography, and 3D scanning.ResultsSubcutaneous tissue can expand to a few times its initial volume to accommodate the injected fluid, which is dispersed thoroughly throughout the tumescent volume. The fluid spreads to peripheral unexpanded regions over the course of a few minutes, after which it remains in place for several hours. Eventually the circulation absorbs the excess fluid and the tissue returns to its original state.ConclusionsGiven the evidence for dense fluid dispersal and several-hour residence time, a procedure is proposed whereby tumescent antibiotic injections are used to treat drug-resistant skin infections and chronic wounds that extend into the subcutaneous tissue. The procedure has the potential to effectively treat otherwise untreatable wounds by keeping drug concentrations above minimum inhibitory levels for extended lengths of time