Power-Assisted Liposuction and Lipofilling: Techniques and Experience in Large-Volume Fat Grafting

Kapila²,

Aesthetic Surgery Journal Open Forum

et al. 2021

Self Cite

Background Tranexamic acid (TXA) use in surgical procedures due to its hemostatic effects has been gaining an increased interest. In plastic surgery, the effects of TXA have been studied intravenously (IV), and there have been some reports regarding local use. Objectives A comparative study examining the combined effect of IV and local TXA was conducted. Methods A randomized double-blinded controlled trial was performed for patients undergoing breast reduction treatment with liposuction and resection following the power-assisted liposuction mammaplasty (PALM) technique. All patients received 5 mL IV of 0.5 g/5 mL TXA on induction. Before installation, one researcher prepared two solutions of 1 L normal saline: one with 5 mL of 0.5 g/5 mL TXA associated with epinephrine 1:100,000 and the other with only epinephrine 1:100,000. These were randomly infiltrated in either the left or right breast. Clinical dermal bleeding was assessed for both breasts after deepithelialization. The lipoaspirate from these breasts was then compared with each other. A postoperative evaluation at 24 hours was performed to compare the ecchymosis rate. Results Ratios of decanted volume to total lipoaspirate was measured in bottles and compared between breasts. There was a statistical difference (P = 0.0002) in the ratio of decanted to lipoaspirated volume when comparing the control group (ratio: 0.21) with the treatment group (0.13). Video analysis revealed decreased dermal bleeding in the TXA group and postoperative evaluation less ecchymosis. Conclusions The combined use of IV and local TXA can help reducing blood loss in liposuction as measured by decantation in separate drain bottles and as assessed clinically preoperatively and postoperatively. Level of Evidence: 2

Section: Methodsmentioning

confidence: 99%

The Combined Effect of Intravenous and Topical Tranexamic Acid in Liposuction: A Randomized Double-Blinded Controlled Trial

Kapila²,

Aesthetic Surgery Journal Open Forum

et al. 2021

Self Cite

“…While centrifugation can increase the operating time dramatically 9 and also increase the risk of contamination, this process has the benefits of preventing compaction of the adipose tissue and preserving its capacity to diffuse into the recipient site. 10 Excess liquid at the bottom of the bag was discarded. We added clindamycin to the collected fat (600 mg/L).…”

Section: Methodsmentioning

confidence: 99%

Lipofilling to the Buttocks and Breasts in Local Anesthesia Using VASER and Expansion Vibration Lipofilling in a Closed-Loop System

Boeni¹,

Waechter-Gniadek²

2020

Am J Cosmet Surg

Large-volume fat transfer to the buttocks and breast has rapidly become popular. Lipofilling using syringes is tedious, time-consuming, and carries the risk of contamination. Most often, systemic anesthesia is being used. This study aims to evaluate the efficacy of large-volume lipofilling in local anesthesia. Local anesthesia was performed with 2 anesthetics: lidocaine and prilocaine. We performed vibration amplification of sound energy at resonance (VASER) and reciprocating power-assisted liposuction (PAL) for fat collection in a closed-loop system using a peristaltic pump. In a reverse pump setting, fat was then used for expansion vibration lipofilling. Pre- and postoperative data were collected. There were no major complications. Liposuction volumes up to 3.100 mL were extracted, and injection volumes ranged from 200 to 1600 mL. Mean operation time was 96 minutes. Satisfaction rate was high. Anesthesia was sufficient in all patients. Using a closed-loop system for fat extraction–purification and transfer is not only time- and cost-effective but also ideal for large-volume fat grafting. Recovery time is 1 to 2 days and satisfaction rate is high.

Enhanced Liposuction - New Perspectives and Techniques

“…Breast liposuction is performed with the Lipomatic machine in a closed system following the Power-Assisted Liposuction and Lipofilling (PALL) principles, as described in previous articles by the senior author [41,[44][45][46][47]. However, liposuction of the breast can also be performed by using a conventional liposuction with the hand piece attached to a suction system.…”

Section: Breast Liposuctionmentioning

confidence: 99%

Power-Assisted Liposuction Mammaplasty (PALM): A Short Scar Mammaplasty in Gigantomastia

Abboud¹,

Abboud²

2022

Breast reduction has been widely studied throughout the years, with different types of resection and breast reshaping techniques being described based on one or two pedicles. This chapter introduces the combination of parenchymal resection and liposuction to treat Gigantomastia, leaving a short scar. Liposuction improves breast remodeling, whereas breast glandular resection and repositioning enhances the upper pole fullness. The Power-Assisted Liposuction Mammaplasty (P.A.L.M.) technique is a safe and reliable procedure, insuring an optimal vascularization to the breast through the preservation of the central, superior and lateral pedicle, thus reducing the complication rate. In this chapiter we emphasize the importance of the preoperative markings, considered as essential for optimal results.