{"id":715,"date":"2011-11-11T08:41:15","date_gmt":"2011-11-11T00:41:15","guid":{"rendered":"https:\/\/marlonlajo.com\/?p=715"},"modified":"2013-05-15T17:43:47","modified_gmt":"2013-05-15T09:43:47","slug":"a-review-of-the-principles-in-safe-liposuction","status":"publish","type":"post","link":"https:\/\/marlonlajo.com\/a-review-of-the-principles-in-safe-liposuction\/","title":{"rendered":"A review of the principles in Safe Liposuction"},"content":{"rendered":"

Marlon O. Lajo, M.D., FPAPRAS<\/span>
\n Aesthetic Surgery Center- St. Luke\u2019s Medical Center<\/span><\/p>\n

Liposuction<\/strong><\/span>
\n – Most sought after cosmetic surgeries performed by certified plastic surgeons<\/span>
\n – Localized fat deposits(LFD) are removed<\/span>
\n – Best results are obtained if with elastic skin<\/span><\/p>\n

\"Pic<\/a><\/p>\n

Liposuction has been refined through the years and is quite safe.<\/span>
\n – usually performed in a day surgery<\/span><\/p>\n

Introduction of techniques;<\/strong><\/span>
\n – Tumescent and superwet<\/span>
\n – Ultrasonic liposuction<\/span>
\n – Laser assisted liposuction<\/span><\/p>\n

> removal of large volume of fat with less blood loss, has become easier and safer<\/span><\/p>\n

Complications<\/strong><\/span>
\n Minor<\/strong><\/span>
\n – Aesthetic contour irregularities<\/span>
\n – Prolonged swelling<\/span>
\n – Scar tissue formation<\/span>
\n – Minor wound healing problems<\/span>
\n – Seromas<\/span>
\n – Sensory changes\/ discomfort<\/span>
\n – Hyperchromia<\/span>
\n – Blistering of the skin<\/span><\/p>\n

Major<\/strong><\/span>
\n – Pulmonary embolus<\/span>
\n – Deep venous thrombosis<\/span>
\n – Major infection<\/span>
\n – Penetration injuries<\/span>
\n – Skin or soft tissue necrosis<\/span>
\n – Bleeding<\/span>
\n – Pulmonary edema<\/span>
\n – Hypovolemic shock<\/span>
\n – Fat emboli<\/span>
\n – Drug toxicity<\/span>
\n – Unplanned blood transfusion<\/span>
\n – Mortality<\/span><\/p>\n

Liposuction can be performed safely if certain guidelines are followed.<\/span><\/p>\n

Increasing number of potential patients makes it relatively easy for inadequately trained or inexperienced physician to encounter disastrous complication or even death.<\/span><\/p>\n

To minimize the risk of death and disastrous complication during liposuction, these pillars of safety must be strictly followed.<\/span><\/p>\n

5 Pillars of Safe Liposuction<\/strong><\/span>
\n 1. Safe Surgeon<\/span>
\n 2. Safe Anesthesiologist<\/a><\/span>
\n 3. Safe Facility<\/span>
\n 4. Safe Co-worker<\/span>
\n 5. Safe Patient<\/span><\/p>\n

Deviation from any one of these pillars can lead to serious complications or death of the patient<\/strong><\/span><\/p>\n

\"Pic<\/a><\/p>\n

Safe Surgeon<\/span><\/p>\n

\"Pic<\/a><\/p>\n

– Properly trained and educatedin liposuction technique<\/span><\/p>\n

– Has a thorough understanding of the physiologic implications of infusing and suctioning large amounts of fluids from the body (fluid status determination )<\/span><\/p>\n

(hemodynamic parameters return 20hrs)<\/span><\/p>\n

<\/a>Safe Anesthesiologist<\/strong><\/span><\/p>\n

\"Pic<\/a><\/p>\n

– Must have a complete understanding of the procedure<\/span>
\n – Physiology of fluid infusion and removal<\/span>
\n – Must be well trained to handle preoperative, perioperative, or postoperative problems<\/span>
\n– Must have thorough evaluation of the patient prior to surgery<\/span>
\n – ( ASA class I, ASA class II )<\/span><\/p>\n

Safe Facility<\/strong><\/span><\/p>\n

\"Pic<\/a><\/p>\n

– Must be completely equipped to deal with any problem or complication that may occur during or after the procedure<\/span>
\n – Should be certified and accredited by a nationally recognized surgery accreditation body<\/span><\/p>\n


\nSafe Co-worker<\/strong><\/span><\/p>\n

\"Pic<\/a><\/p>\n

– Staff working in the operating room and recovery room should be thoroughly trained and familiar with the procedure , care , and recovery of the patient…<\/span>
\n – Overnight care should be readily available for all patients<\/span>
\n ( although these are not necessary for everyone)<\/span><\/p>\n

> overnight(24hr) observation for large volume liposuction and to patients with underlying medical problems<\/span><\/p>\n

Safe Patient<\/strong><\/span>
\n – Must be selected appropriately for the procedure<\/span>
\n – ASA class I, ASA class II<\/span>
\n – Weight should be stable or decreasing with diet and exercise( most overweight pts are not good candidates, >26 BMI)<\/span>
\n – Must have reasonable goals and expectations<\/span>
\n – OTC and diet meds should be discontinued for 2-3 weeks prior<\/span>
\n – Patients with body dysmhorphic disorder or eating disoders should be avoided<\/span><\/p>\n

> following all the principles of safe liposuction, minor and major complications can be minimized<\/span><\/p>\n

In addition to these principles, several other issues must be considered;<\/span>
\n – Frequent communication of the surgical team<\/span>
\n – For large volume liposuction, use superwet technique instead of tumescent technique<\/span>
\n – Avoid lidocaine toxicity(not exceed 35mg\/kg)<\/span>
\n – Compressive postop garments<\/span>
\n – Core body temperature is maintained by warming\/ heating blankets, using warmed wetting solution<\/span>
\n – When in doubt, consider staging liposuction procedure<\/span>
\n – Use of compression devices even in the recovery, or overnight if admitted<\/span>
\n – Identify and mark asymmetries preoperatively<\/span>
\n – Keep accurate intraoperative data of volume infused and aspirated<\/span>
\n – Perform pinch test at the beginning, during and the completion of the procedure<\/span><\/p>\n

Reminder :<\/strong><\/span><\/p>\n

\"Pic<\/a><\/p>\n

 <\/p>\n","protected":false},"excerpt":{"rendered":"

Marlon O. Lajo, M.D., FPAPRAS Aesthetic Surgery Center- St. Luke\u2019s Medical Center Liposuction – Most sought after cosmetic surgeries performed by certified plastic surgeons – Localized fat deposits(LFD) are removed – Best results are obtained if with elastic skin Liposuction has been refined through the years and is quite safe. – usually performed in a […]<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_et_pb_use_builder":"","_et_pb_old_content":"","_et_gb_content_width":"","footnotes":""},"categories":[11],"tags":[],"_links":{"self":[{"href":"https:\/\/marlonlajo.com\/wp-json\/wp\/v2\/posts\/715"}],"collection":[{"href":"https:\/\/marlonlajo.com\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/marlonlajo.com\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/marlonlajo.com\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/marlonlajo.com\/wp-json\/wp\/v2\/comments?post=715"}],"version-history":[{"count":0,"href":"https:\/\/marlonlajo.com\/wp-json\/wp\/v2\/posts\/715\/revisions"}],"wp:attachment":[{"href":"https:\/\/marlonlajo.com\/wp-json\/wp\/v2\/media?parent=715"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/marlonlajo.com\/wp-json\/wp\/v2\/categories?post=715"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/marlonlajo.com\/wp-json\/wp\/v2\/tags?post=715"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}