2011 world congress female & male genital cosmetic surgery
TRANSCRIPT
2011 World Congress
Female & MaleGenital Cosmetic Surgery
Liposuction& Autologous Fat Transfer
Marco A. Pelosi, III, MDFACOG, FACS, FICS, FAACS
CME Disclosure The Faculty reports no significant financial
relationships or other relationships with the
manufacturers of any commercial products
and/or providers of commercial services
discussed in this educational presentation and
with any commercial supporters of this activity.
Furthermore, no off-label or investigational uses
of products will be discussed without explicit
notification thereof.
Terminology
• Lipolysis• Lipoplasty• Liposuction• Liposculpture• Suction lipectomy• Suction-assisted lipectomy (SAL)
Terminology
• Small-volume (<100 mL fat)• Medium-volume (<1500 mL fat)• Large-volume (<4000 fat mL/ 5000 mL total)• Megaliposuction– CA Speier Bill: >5000 mL “unprofessional”– FL: 4000 mL limit
Terminology
Dry = nothing infiltratedWet= saline/hyaluronidase
Superwet Solution
1,000 ml
10 ml
1 ml
25 ml
Tumescent Local Anesthesia
1,000 ml
10 ml
1 ml
100 ml
Generally Accepted Lidocaine Limits
• Intravenous: 7 mg/Kg• Tumescent w/o liposuction: 25 mg/Kg• Tumescent w/ liposuction: 45 – 55 mg/Kg– Thin = 45– Avg = 50– Heavy = 55
• Florida Law: cannot exceed 50 mg/Kg
Terminology
• Manual Liposuction• Power-Assisted Liposuction• Ultrasound-Assisted Liposuction (UAL)– Internal– External
• Laser-Assisted Liposuction– Internal: “Hot” laser– External: “Cold” laser
• Disruption-Assisted Liposuction
The Tools
Aspiration Equipment
• Suction pump -100 kPa max• Syringe for small volume
Liposuction Cannulas
Fat Transfer Cannulas
LipsType 3
NLFV-Dissector
Type 1
Non LinesType 2
HandsType 2
ButtocksType 2
LabiaType 2
Augmentation Labia Majoraplasty
Typical Process
• Patient is consented, marked & photographed
• NIBP, ECG, SpO2 monitors are placed• Hep-lok is inserted• Knee-high SCDs applied
Punch or scalpel
Always Parallel
Reverse Jackknife PostionAbdominal Lipo
Long strokes
Multi-Directional Contouring
Nondominant Hand Control
Nondominant Hand Control
Blend margins
Avoid superfical layer
5mm No-Suck Zone
EBL = 5mL/liter of total aspirate
Regional Applications
High Definition Liposuction
Etching• Pectoral• Abdominal• Manual, Laser, Vaser• Ideal < 15% Body Fat
Pectoral Etching
Access
Abdominal Etching
Leaner = Better Result
Flanks & Back Strategies
Arms Liposuction
Access: Post
Medial
Lateral
Legs Liposuction
• Outer Thighs• Inner Thighs• Posterior Thighs• Anterior Thighs• Knees• Calves & Ankles
Access
Inner Thighs & Knees
Breast Liposuction
9 months
F cup D cup
Fat Transfer Techniques
2.5 - 3mm
1-2 L
Harvest Setup
11
2
3 3
45
Frompatient
Topump
Gravity x 15:00or centrifuge
discard
Light Infiltration of Recipient Site
600 cc
500ccsuperficial & deep
500cc
200cc
Augmentation Mammaplasty
Peri-glandular
Augmentation Labia Majoraplasty
LVR + Augmentation
Questions
