Liposuction and the treatment of nasolabial folds

We investigate whether the application of liposuction to the nasolabial region is a useful adjunct to the rhytidectomy procedure. We have devised a system to grade the severity of the depth and the length of the nasolabial folds pre-and postoperatively. This grading system was used to evaluate the nasolabial region in 60 consecutive patients who underwent rhytidectomy. We compared two subgroups: those who underwent rhytidectomy alone (Group I) and those who underwent rhytidectomy augmented by liposuction in the region of the nasolabial folds (Group II). A change in the length of the fold occurred in 2% of Group I and in 30% of Group II. A change in depth of the fold occurred in 12% of Group I and in 70% of Group II. These results suggest that suction-assisted lipectomy consistently improves the results of rhytidectomy in the region of the nasolabial fold.Presented at the Annual Meeting of the American Society for Aesthetic Plastic Surgery, San Francisco, California, March 1988     

小切口去脂缝线法重睑300例体会

术者选择了３００例上睑臃肿单睑采用小切口眶隔分离去脂，小切口去脂后双上睑不会产生凹陷，术中出血很少，消除了上睑臃肿，然后连续缝线法重睑成形术，临床观察效果很满意。并根据不同脸型设计重睑线，特别是一些双外眦下垂的单睑，通过提高外眦的角度得以纠正。连续缝线法重睑成形术，不需拆线。该方法对上睑损伤较小，术后肿胀轻，消退较快，术后不用包扎，可以正常工作，肿胀消退后不遗留瘢痕，重睑线自然，如受术者个别不满意，修改方便，没有后遗症。此方法对上睑臃肿单睑重睑成形术是理想方法之一。     

Stem Cells from the Fat Tissue of Rabbits: An Easy-To-Find Experimental Source

Stem cells, because of their pluripotentiality and unlimited capacity for self-renewal, project great promise for tissue engineering and are expected to allow significant advances for distinct reconstructive procedures. This study aimed to establish a versatile experimental model with potential application to distinct lines of research in plastic surgery. The search was guided by the need for mesenchymal stem cells that can be easily obtained for laboratory research. The authors studied the anatomy of a number of animals as potential donors and indicated the white New Zealand rabbit (Oryctolagus cuniculus) for this purpose. The animals of this species present definite areas of lipid tissue on their back, allowing easy access to the tissue by either exeresis or liposuction.     

盐酸曲马朵胶浆剂在腹部吸脂术中的应用

目的探讨应用盐酸曲马朵胶浆剂镇痛以减少利多卡因用量。方法采用两种局部麻醉方式,对腹部吸脂术患者进行利多卡因用量的比较。对照组7例采用常规肿胀液分区麻醉,利多卡因浓度0.05%;观察组8例,采用自行研制的曲马朵胶浆剂,采取直肠给药方式,灌注均一次完成,肿胀液利多卡因浓度为0.01%。结果两组患者主观感觉麻醉效果均满意。对照组利多卡因用量37.52～41.67mg/kg,灌注液4500ml/60kg～6500ml/78kg;观察组利多卡因用量12.5mg/kg(60kg)～10.90mg/kg(78kg),灌注液7500ml/60kg～8500ml/78kg。由静置后吸出液颜色判断,观察组比对照组出血量明显减少。结论在腹部吸脂术中,应用盐酸曲马朵胶浆剂直肠给药镇痛,可以大大地减少利多卡因用量,从而增加灌注量和提高手术安全性。     

Ultrasonic Liposuction Versus Surgical Lipectomy

Obesity is a serious problem in our century. Nowadays, the incidence of obesity has been increased to 35%. Two common methods for surgical treatment of obesity are surgical lipectomy and ultrasound-assisted liposuction (UAL). This study included 40 patients in two groups, 20 patients in the surgical lipectomy group and 20 patients in the UAL group. Abdominal surgical lipectomy was done in 20 patients (12 female, 8 male), with ages ranging 28–60 years. Abdominal UAL was done in 20 patients (11 females, 9 male), with ages ranging 20–55 years. General anesthesia was used for surgical lipectomy. Tumescent anesthesia was used for 13 UAL patients and general anesthesia was used for the remaining 7. The average time for surgical lipectomy was shorter than that for UAL. The average hospital stay for the surgical lipectomy group was almost five times longer than for UAL. The UAL group also recovered four times faster and required analgesics half as long. The average amount of fat removed in each case was 2.22 kg with UAL and 1.97 kg with surgical lipectomy. The UAL group received analgesic drugs for five days, whereas the surgical lipectomy group received analgesic drugs for 10 days because they sustained more pain. In this study, I do not discuss or compare the major complications of each method because the groups were not large enough. However, there were some minor UAL complications, echymosis in 80%, orthostatic hypotension for three or four days in 75%, infection in one patient, postoperative epidermal loss in small area of the abdomen in two patients, and cellulitis in 75%. All were resolved after one month. UAL is a special method with fewer major complications and shorter hospital stays than surgical lipectomy. The incisions in UAL are smaller, but the operation lasts much longer than surgical lipectomy.     

Midiabdominoplasty: Indications and Technique

In the treatment of aesthetic deformities of the abdomen there are three points we should analyze: the skin, the fat tissue, and the muscles. Based on these points we can classify it into six groups. Midiabdominoplasty is indicated in the correction of deformities of groups 2, 3, and 4. A small fusiform resection of skin is done in the lower abdomen, undermining of the skin up to the umbilicus (or to the xiphoid appendix if necessary to treat diastasis of the rectus muscles in the supraumbilical region), and desinsertion of the umbilicus, with no external scar, are the main points in this technique. The main complication was the formation of seroma. No necrosis of the flap or unsightly scars were observed. The results were good, with the patients satisfied with their new abdomens.     

结合肿胀吸脂术的中央蒂乳房缩小术

目的 探讨一种新的乳房缩小术。方法 对9例乳腺肥大患者采用肿胀吸脂技术去除皮下脂肪，经环绕乳晕的内，外两个环形切口形成真皮帽，楔形切除乳腺后用“真皮帽”固定塑形。结果 术后乳房外形良好，天乳头乳晕坏死，切口皮肤皱褶于3个月内逐渐自然消失。结论 结合肿胀吸脂术的中央蒂乳房缩小术对于乳房中度肥大是一个简单，安全，有效的乳房缩小方法。     

Removal of intra-abdominal visceral adipose tissue improves glucose tolerance in rats: role of hepatic triglyceride storage

Epidemiological studies have demonstrated a strong link between increased visceral fat and metabolic syndrome. In rodents, removal of intra-abdominal but non-visceral fat improves insulin sensitivity and glucose homeostasis, though previous studies make an imprecise comparison to human physiology because actual visceral fat was not removed. We hypothesize that nutrient release from visceral adipose tissue may have greater consequences on metabolic regulation than nutrient release from non-visceral adipose depots since the latter drains into systemic but not portal circulation. To assess this we surgically decreased visceral white adipose tissue (~ 0.5 g VWATx) and compared the effects to removal of non-visceral epididymal fat (~ 4 g; EWATx), combination removal of visceral and non-visceral fat (~ 4.5 g; EWATx/VWATx) and sham-operated controls, in chow-fed rats. At 8 weeks after surgery, only the groups with visceral fat removed had a significantly improved glucose tolerance, although 8 times more fat was removed in EWATx compared with VWATx. This suggests that mechanisms controlling glucose metabolism are relatively more sensitive to reductions in visceral adipose tissue mass. Groups with visceral fat removed also had significantly decreased hepatic lipoprotein lipase (LPL) and triglyceride content compared with controls, while carnitine palmitoyltransferase (CPT-1A) was decreased in all fat-removal groups. In a preliminary experiment, we assessed the opposite hypothesis; i.e., we transplanted excess visceral fat from a donor rat to the visceral cavity (omentum and mesentery), which drains into the hepatic portal vein, of a recipient rat but observed no major metabolic effect. Overall, our results indicate surgical removal of intra-abdominal fat improves glucose tolerance through mechanism that may be mediated by reductions in liver triglyceride.     

脂肪切除术后大鼠体重、血糖、胰岛素及OB基因表达的研究

目的探讨大量脂肪去除术后体重,部分血生化指标如血糖、胰岛素、及OB基因表达受到的影响,同时摸索出一套由动物脂肪组织提取mRNA进行RT-PCR的方法。方法本实验采用配对分组,自身前后对照的动物实验研究方法。参考文献,选用大鼠为实验动物模型。取血采用断尾法,脂肪标本通过开腹采取宫旁,肾周及腹膜后脂肪;各生化指标利用相应的生化方法进行测定;OB基因表达变化用分子生物学方法进行半定量分析。统计分析用配对T检验。结果手术组大鼠体重,血清胰岛素水平无明显变化(P＞0.05),血糖,基因表达水平降低。对照组体重明显增加(P＜0.05)。结论大量脂肪切除,可降低大鼠的血糖水平;不会导致大鼠的体重很快增加。但OB基因表达水平的降低,会使脂肪组织产生较少的瘦素,理论上将导致受术者食欲增加。     

Lymphosuction – a new treatment modality for chronic filarial lymphedema

The surgical treatment of filaritic lymphedema despite various well reasoned attempts in the past to improve function and contour has to date defied cure. The technique of blunt suction lipectomy has been applied in eight cases and it appears to be well tolerated with encouraging short term results. The final results were accepted favourably by the patients because of smaller incisions, instant improvement in contour, reduction in weight of limb in addition to simple and minimal postoperative care required. Based on our findings, lymphosuction can be a useful treatment modality in mild grades of filarial lymphedema, though further long term clinical observations and studies are required to define its exact indications and limitations. Severe cases require lymphosuction plus excisional debulking. Received: 17 January 1996 / Accepted: 15 July 1997