Blood loss during liposuction has been a concern when more than 1500 mL of material are removed during one session. Several authors have claimed that blood loss is dramatically reduced when the targeted area is infiltrated with large amounts of dilute lidocaine with epinephrine ("tumescent" or "superwet" technique). Using this technique, 25 consecutive cases in which the liposuction aspirate was expected to be 1000 mL or more were investigated with pre- and postoperative measurements of hemoglobin. In addition, hemoglobin was also measured in the fluid fraction of the aspirate. The mean +/- SD aspirated volume was 1658 +/- 518 mL and the mean +/- SD fall in postoperative hemoglobin was 0.7 +/- 0.6 g/100 mL (5.4% +/- 4.9%). The mean amount of blood per liter of aspirate was calculated to be 10.5 +/- 5.2 mL. These results clearly demonstrate that the blood loss when using the tumescent or superwet technique is dramatically reduced compared with the dry or classical "wet" technique.
Nine consecutive patients who underwent syringe-assisted liposuction with a mean aspirate volume of 3633 mL (range: 1800-5500) had their lipids, lipoproteins, and sex hormones measured pre- and postoperatively. Seven of the patients also underwent an oral glucose tolerance test with measurements of insulin and C-peptide. The major finding was a significant increase in HDL cholesterol and apolipoprotein A1, while there was no significant change in sex hormones or glucose levels 9-12 months after the liposuction procedure. The results indicate that large-volume liposuction might decrease the risk of cardiovascular disease in these patients.
The potency of 98 men who underwent transurethral resection for benign prostatic enlargement was assessed before and after operation in a prospective study. Preoperatively, 38 could not maintain their erections long enough to achieve coitus. Three months after operation a decrease in erectile ability had been experienced by three of the remaining 60 patients, while two reported an improvement. At the six-month follow-up two of these patients stated that they had recovered their preoperative potency, while the third patient still experienced reduced erectile function. Examination showed normal penile blood pressure but testing with papaverine showed reduced tumescence.
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