Washington: A technique that combines liposuction and tummy tuck, and is designed to reduce surgical trauma , is providing excellent patient outcomes with a low complication rate, according to a study.
ASPS Member Surgeon Dr. Eric Swanson, a plastic surgeon in private practice in Leawood, Kansas, presents an in-depth report on his experience with a combined technique of liposuction and abdominoplasty in a large series of patients over five years.
Detailed Analysis of Combined `Lipoabdominoplasty` In the combined "lipoabdominoplasty" procedure, patients initially underwent ultrasonic liposuction to remove excess fat from the abdomen and flanks (love handles).
Liposuction was followed by abdominoplasty-or " tummy tuck"-to eliminate excess abdominal tissue and loose skin. Outcomes after lipoabdominoplasty in 150 patients were compared to liposuction alone in 384 patients and abdominoplasty alone in 17 patients.
Notably, no liposuction patients developed seromas-collections of fluid under the skin-which is attributed to limited ultrasound to reduce tissue trauma. There was a low (five percent) rate of seromas after abdominoplasty.
Swanson wrote that seromas have led some plastic surgeons to leave behind some abdominal fat and connective tissue during abdominoplasty in an effort to reduce this risk. He believes that preserving this excess tissue is unnecessary and compromises the cosmetic result.
The study demonstrates that by using shorter periods of ultrasound and eliminating the traditional use of electrodissection during surgery, the risk of seromas may be minimized while at the same time achieving excellent cosmetic outcomes.
By first injecting the tissues with fluid containing epinephrine, blood loss is reduced, making cautery dissection unnecessary.
Swanson also described a modified form of general anesthesia - total intravenous anesthesia without muscle paralysis - to reduce the risk of blood clots in the legs. Only one patient in his series developed this complication and was successfully treated.
He wrote that by adopting safe preventive measures, surgeons may reduce the risk of this serious complication without the need for blood-thinning medication. Patients also recover more quickly after surgery, averaging only 51 minutes in the recovery room, and experience less nausea.
The study has been published in Plastic and Reconstructive Surgery-Global Open, the official open-access medical journal of the American Society of Plastic Surgeons (ASPS).